1. Breast Care for Women of Mid-Michigan (BCM) Mary Smania, MSN, FNP-BC Assistant Professor MSU College of Nursing Nurse Practitioner

2. A PROGRAM FOR UNDERSERVED WOMEN AT MICHIGAN STATE UNIVERSITY

3. Funding Thank you to the Mid-Michigan Affiliate of Susan G. Komen for the Cure

4. Objectives Describe patient care realities of underserved populations in the greater Lansing area including access to care, available resources, and treatment received. Identify potential strategies to meet the patient care needs of underserved populations in the greater Lansing area.

5. Background Cancer outcomes-affected by screening, early detection, early diagnosis which influence timeliness for treatment all affecting optimal survival Population of individuals lacking health insurance increasing in US and MI-at 22.3% ( CDC. 2012) Individuals lacking health insurance with low income regardless of ethnicity or race, bear the great burden of cancer disease. (NCI, 2011) Low-income, uninsured women more likely to have breast cancers detected at late stage and less likely to survive breast cancer NCI (2011) CDC (2011)

6. Gaps in Care In 1991 Michigan Department of Community Health implemented at comprehensive Breast and Cervical Cancer Control Program (BCCCP) through a grant from the CDC Program is for women age 40 and up No breast care programs for women under age 40 Goal of the BCM is to fill the unmet gap of breast care services for uninsured, low income women in the Mid-Michigan Area.

7. Overview of the Program Filling the unmet gap of breast care services for women under 40 Partnered with Sparrow Hospital, CAP Lab, MSU Radiology, MSU Surgery, Physician Anesthesia Services Provided all aspects of essential breast care from evaluation, diagnosis, diagnostic services to surgical services and breast health education. Close relationships with referring agencies: Planned Parenthood, Health Departments, Neighborhood Centers, Primary Care Clinics

8. The Women We Serve Served 129 patients October 2009-November 2012 279 diagnostic tests (mammogram and ultrasound), 123 women have received follow up care, 6 surgeries Started with proposed 33 new patients per year up to 50 new patients per year Average yearly household income- $13,700 Patients agree or strongly agree that they would not have received services if it were not for this program on exit survey Patients agree or strongly agree that they worry less about breast cancer after receiving care and are satisfied with the care they receive

9. Race

10. Counties

11. Insurance

12. New Program Fall 2012 Free screening mammogram for uninsured, low- income women over 40 Started in 2012 MSU Health Team-collaboration between College of Nursing, Department of Radiology, Department of Surgery, Sigma Theta Tau. Worked with Ingham County Health Department to collaborate with formation of plan. Community Outreach Breast Health Screening

13. Conclusion BCM has been transformational in affecting the lives of the women who have been served providing essential care to those who are low income and under or uninsured. New Program with free screening mammogram Patient Story of R.M.

14. Questions Thank you for your attention!

15. References Ayanian, J.Z., Weissman, J.S., Schneider., E.C., Ginsburg. J.A., & Zaslavsky A.M. (2000). Unmet Health Needs of Uninsured Adults in the United States. Journal of American Medical Association, 284, 2061-2069. Centers for Disease Control and Prevention. (2012) Vital Signs: Racial Disparities in Beast Cancer Severity-United States, 2005-2009, MMWR, Retrieved from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6145a5.htm?s_cid=mm6145a5 _w http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6145a5.htm?s_cid=mm6145a5 Mid-Michigan Affiliate of Susan G. Komen for the Cure, Community Profile Report. (2011). Report of the Mid-Michigan Affiliate of Susan G. Komen for the Cure. Retrieved from http://www.komenmidmichigan.org/grants/ National Cancer Institute (2012) Center to Reduce Cancer Health Disparities Access. Retrieved from: http://www.crchd.cancer.gov/disparities/defined.htmlhttp://www.crchd.cancer.gov/disparities/defined.html National Center for Chronic Disease Prevention and Health Promotion-Centers fir Disease Control and Prevention. (2008). Behavioral Risk Factor Surveillance System, 2008 [Data File]. Retrieved from: http:/www.cdc.gov/BRFSS/ Richardson, L.C. (2004). Treatment of Breast Cancer in Medically Undeserved Women: A Review. The Breast Journal, 10, 2-5.