Turning the Page on Breast Cancer in Ohio: Lessons learned from implementing a multilevel intervention to reduce breast cancer mortality among Black women.

BACKGROUND: Turning the Page on Breast Cancer (TPBC) uses a multilevel approach to reduce breast cancer (BC) mortality among Black women. TPBC intervenes by (1) improving health care facilities' ability to conduct effective BC screening, follow-up, and treatment; (2) involving community-based organizations; and (3) providing education and personal risk information through a culturally relevant website. Ohio has among the worst BC mortality rates in the United States for Black women. TPBC is in its third year of providing targeted interventions in 12 Ohio counties with particularly high BC rates among Black women. METHODS: TPBC enrolls health care facilities, collects organizational and patient data, and conducts key informant interviews to inform the provision of appropriate evidence-based interventions. TPBC engages Black communities through community-based organizations and social media advertising. The TPBC website offers BC information, connects Black women to community BC resources, and provides access to a risk-assessment tool. RESULTS: TPBC has provided tailored information packets, evidence-based interventions, and systematic support for improving the tracking and follow-up of breast health care among patients in 10 clinical partnerships. The project has provided education at community events monthly since mid-2021. The TPBC website (http://endbreastcancerohio.org) is promoted through social media (primarily Facebook) and community events to reach Black women aged 25-70 years. To date, 4108 unique users have visited the website, of whom 15.9% completed the risk assessment. CONCLUSIONS: Novel strategies are needed to address persistent disparities in BC outcomes among Black women. TPBC demonstrates the potential effectiveness of multiple methods of community-based, clinic-based, and web-based engagement. PLAIN LANGUAGE SUMMARY: Turning the Page on Breast Cancer (TPBC) aims to reduce breast cancer mortality among Black women in Ohio by conducting multilevel, community-engaged interventions in 12 counties. Women are provided risk information and education at virtual and in-person community events and through a community-friendly website that was launched in November 2020. Almost 4000 women have visited the website, which offers community-targeted information, urges screening for individuals at elevated risk, and offers access to patient navigation services; 655 users have used a breast cancer risk-assessment tool on the site. Community-based organizations conduct educational efforts. TPBC partners with health care facilities, which are taught to improve their ability to conduct effective breast cancer screening, follow-up, and treatment. So far, TPBC has provided educational information, evidence-based intervention lists, tailored information packets, and ongoing quarterly support to partners in 10 counties. Evaluation will focus on aggregated data for screening and genetic testing referral at the clinic level.

Scripted tours through a giant inflatable colon: An innovative and effective educational tool in urban communities.

Colorectal cancer (CRC) is the second leading cause of cancer-related death among men and women in the US and mortality rates are increasing among young adults. Although CRC is largely preventable with screening and often curable when detected at an early stage, many age-appropriate individuals remain unscreened or are not currently up-to-date with screening. We aimed to examine the impact of providing guided, scripted tours through an inflatable colon on three domains: CRC knowledge, likelihood of communicating about CRC with others, and the intention to be screened for CRC in a diverse, urban population. The inflatable walk-through colon was exhibited at five community events in Franklin County, Ohio between March 2015 and August 2016. A pre and posttest research design and composite scores were stratified into three age groups (<45 years, 45-49 years and ≥ 50 years of age). Descriptive statistics were used to describe and compare demographic characteristics. Logistic regression was used to examine potential associations between demographic factors and the three outcomes of interest. These tours led to statistically significant increases in CRC knowledge, communication, and intention to undergo CRC screening among participants in all three age cohorts. In addition, the intention of undergo screening after a tour among individuals<45 years of age were nearly three times that of those older than 50 (OR = 2.66; 95%CI = 1.49-4.75). Overall, this study supports the use of scripted tours through an inflatable colon exhibit as a potentially effective intervention to increase age-appropriate CRC screening uptake.

Breast Cancer Disparities Among Women in Underserved Communities in the USA.

PURPOSE OF REVIEW: Breast cancer disparities that exist between high-income countries (HIC) and low- and middle-income countries (LMICs) are also reflected within population subgroups throughout the United States (US). Here we examine three case studies of US populations "left behind" in breast cancer outcomes/equity. RECENT FINDINGS: African Americans in Chicago, non-Latina White women in Appalachia, and Latinas in the Yakima Valley of Washington State all experience a myriad of factors that contribute to lower rates of breast cancer detection and appropriate treatment as well as poorer survival. These factors, related to the social determinants of health, including geographic isolation, lack of availability of care, and personal constraints, can be addressed with interventions at multiple levels. SUMMARY: Although HICs have reduced mortality of breast cancer compared to LMICs, there remain inequities in the US healthcare system. Concerted efforts are needed to ensure that all women have access to equitable screening, detection, treatment, and survivorship resources.