Outreach Strategies That Work Nancy Jo Bleier, LCSW, C-ASWCM WISEWOMAN Women's Health Program Coordinator Southeast Alaska Regional Health Consortium Nancy Jo Bleier, LCSW, C-ASWCM WISEWOMAN Women's Health Program Coordinator Southeast Alaska Regional Health Consortium

Who we are The SEARHC BCHP program is federally funded through a Cooperative Agreement with the Centers for Disease Control and Prevention The program also receives additional support from the SouthEast Alaska Regional Health Consortium The SEARHC BCHP program is federally funded through a Cooperative Agreement with the Centers for Disease Control and Prevention The program also receives additional support from the SouthEast Alaska Regional Health Consortium

Who we serve All women, Native or Non- Native, who: Are SEARHC beneficiaries Live in Southeast Alaska Are for BCHP Are for WISEWOMAN Have a limited income Have insurance that does not fully cover womens preventive or diagnostic services If age 65+, are without Medicare Part B Are SEARHC beneficiaries Live in Southeast Alaska Are for BCHP Are for WISEWOMAN Have a limited income Have insurance that does not fully cover womens preventive or diagnostic services If age 65+, are without Medicare Part B

Reach - Since 1998: Screened a total of 9,096 women. Provided 16,536 breast cancer screenings. Provided 30,276 cervical cancer screenings. Diagnosed 101 breast cancers. Diagnosed 156 HSIL, CIN2, CIN3/CIS and invasive cervical cancers. source of data - WHTP Minimum Data Element file 1/1/ /31/11 Screened a total of 9,096 women. Provided 16,536 breast cancer screenings. Provided 30,276 cervical cancer screenings. Diagnosed 101 breast cancers. Diagnosed 156 HSIL, CIN2, CIN3/CIS and invasive cervical cancers. source of data - WHTP Minimum Data Element file 1/1/ /31/11

Services we provide: Pap tests Clinical breast exams Screening & diagnostic mammograms Breast biopsies, breast ultrasounds Surgical consultations Colposcopies and colposcopy-directed biopsies, LEEP, cryotherapy Integrated cardiovascular screening and healthy lifestyle support services through WISEWOMAN Pap tests Clinical breast exams Screening & diagnostic mammograms Breast biopsies, breast ultrasounds Surgical consultations Colposcopies and colposcopy-directed biopsies, LEEP, cryotherapy Integrated cardiovascular screening and healthy lifestyle support services through WISEWOMAN

SEARHC Womens Health Program Goal Reduce morbidity, mortality and health disparities in breast and cervical cancer

DP Public Education and Targeted Outreach Promote population-based screening Promote screening among disparate and other population subgroups Use program planning approaches to prioritize populations and activities Develop and cultivate partnerships to maximize reach Implement evidence-based strategies for public education and targeted outreach Promote population-based screening Promote screening among disparate and other population subgroups Use program planning approaches to prioritize populations and activities Develop and cultivate partnerships to maximize reach Implement evidence-based strategies for public education and targeted outreach

Whats worked so far: Captive audience RPMS Clinic User Population Clinic connections Door-to-door, face-to-face Integrated programming Special Womens Health Clinic events Provider champions Unique partnerships Patience! Captive audience RPMS Clinic User Population Clinic connections Door-to-door, face-to-face Integrated programming Special Womens Health Clinic events Provider champions Unique partnerships Patience!

Captive Audience RPMS Clinic User Population in a centralized service system ever seen at a SEARHC clinic Womens Health Tracking Package Breast & cervical cancer screening status reports Targeted calling and mailing lists RPMS Clinic User Population in a centralized service system ever seen at a SEARHC clinic Womens Health Tracking Package Breast & cervical cancer screening status reports Targeted calling and mailing lists

Clinic Connections RPMS-generated outreach lists reviewed by local clinic staff on a per- community basis Remove moved, deceased, otherwise unavailable Update RPMS Registration for system- wide use RPMS-generated outreach lists reviewed by local clinic staff on a per- community basis Remove moved, deceased, otherwise unavailable Update RPMS Registration for system- wide use

Door-to-door, face-to-face Womens Health Program staff often go door-to-door during scheduled special clinic events and mobile mammography clinics Contact with women outside of work (grocery store, ball games, etc) leveraged into clinic appts Womens Health Program staff often go door-to-door during scheduled special clinic events and mobile mammography clinics Contact with women outside of work (grocery store, ball games, etc) leveraged into clinic appts

Integrated Programming Leverage interest in WISEWOMAN as a club Merge outreach or due now lists from RPMS-based tracking packages (BCHP, CRC, WW) Compare other databases and registry data (DPP and LBP, Health Promotion) Support from primary care staff to review due now status in clinic Leverage interest in WISEWOMAN as a club Merge outreach or due now lists from RPMS-based tracking packages (BCHP, CRC, WW) Compare other databases and registry data (DPP and LBP, Health Promotion) Support from primary care staff to review due now status in clinic

Special Womens Health Clinic Events Evening and Saturday Clinics Specialty Clinic model Pre-mobile mammogram events CHAPs training clinic Evening and Saturday Clinics Specialty Clinic model Pre-mobile mammogram events CHAPs training clinic

Provider Champions Provider recommendation still a strong strategy Identify and support a provider champion in each primary care facility Streamline referral system (how many hoops?) Provider recommendation still a strong strategy Identify and support a provider champion in each primary care facility Streamline referral system (how many hoops?)

Unique Partnerships Alaska Breast & Cervical Health Partnership Joint outreach, public education, provider education projects designed to maximize geographic reach of funded programs State of Alaska-WISEWOMAN-BCHP partnership in Wrangell Alaska Breast & Cervical Health Partnership Joint outreach, public education, provider education projects designed to maximize geographic reach of funded programs State of Alaska-WISEWOMAN-BCHP partnership in Wrangell

Patience Takes time to develop relationships: In villages and larger communities Within clinics (high turnover in rural areas) Within the care team setting In ever-changing systems Moving targets for multiple stakeholders With patients Takes time to develop relationships: In villages and larger communities Within clinics (high turnover in rural areas) Within the care team setting In ever-changing systems Moving targets for multiple stakeholders With patients

Select DP focus areas Increase employer/corporate outreach Refine public education messages Explore policy approach to highest-risk patients (similar to CRC) Provider education re: current screening recommendations (just when you think you have it figured out…) Evaluate, evaluate, evaluate Increase employer/corporate outreach Refine public education messages Explore policy approach to highest-risk patients (similar to CRC) Provider education re: current screening recommendations (just when you think you have it figured out…) Evaluate, evaluate, evaluate

Questions? Thank you! Nancy Jo Bleier, LCSW, C-ASWCM WISEWOMAN Women's Health Program Coordinator Southeast Alaska Regional Health Consortium Thank you! Nancy Jo Bleier, LCSW, C-ASWCM WISEWOMAN Women's Health Program Coordinator Southeast Alaska Regional Health Consortium