Abstract

1. Abstract Howard University Cancer Center, Delmarva Foundation, Mid- Atlantic Cancer Information Service and Men Against Breast Cancer formed a partnership to offer Mammo Days. The primary purpose of the project is to provide free mammography screening to women who receive Medicare with the intent of promoting the habit of obtaining annual mammograms. Additionally, the project explores the knowledge and utilization of Medicare mammography benefits among African American women in the District of Columbia. Participants are identified through various means including churches, media promotions and other screening programs. Women who come in for screening complete a brief survey to determine their knowledge and utilization of Medicare benefits. Preliminary data indicate that the majority of women surveyed to date are not aware that Medicare provides coverage for mammograms and the rates of usage among those who are aware are low. Information from this program will be utilized to develop broader targeted public education programs.

2. Background African American women living in the District of Columbia are less likely to have mammograms if they are elderly or living in less affluent Wards. Analysis of Medicare claims by the Delmarva Foundation show that 51% of African American women age 50-67 living in DC had mammograms in 2001 and 2002 compared to 61% of white women. The highest usage rates of Medicare mammography screening occurred in the District Wards with affluent and ethnically diverse residents while the Wards that are predominantly African American and less affluent had participation rates of 51 percent or less.

3. Objectives • Provide mammograms to at least 60 Medicare recipients annually • Assess the knowledge and usage levels of Medicare mammography benefits among African American women age 50 and older living the District of Columbia • Determine barriers to utilizing Medicare benefits among African American women • Determine the best channels for reaching the target population

4. Methods Participants are identified through targeted promotions in the areas of greatest need. Churches, CDC Breast and Cervical Early Detection Program, Community Based Organizations, and local media promotions are used to notify women of Mammo Day screenings. Women attending Mammo Days receive a clinical breast exam and mammograms free of charge. Prior to getting screened participants are asked to complete a short questionnaire regarding their knowledge and usage of Medicare mammography benefits and barriers to use.

5. Results To date eight Mammo Days have been held and 76 surveys have been completed. Based upon the completed surveys to the majority of women were not aware of the Medicare mammography benefit. Among the women who were aware of the benefit the majority had not utilized it to obtain a mammogram. Several key channels were noted as resources for obtaining information about the Medicare benefit. Mammo Days was most often mentioned as a source for finding out more information about Medicare coverage for mammograms.

6. Results Cont. Q1). Do you know that Medicare pays for mammograms? Yes 12% Yes 6% Age 50-64 Age 65 and older No 39% No 6% No Response 37% Age 50-64 Age 65 and older Q2). Have you ever used Medicare to pay for mammograms? Yes 0% Yes 6% Age 50-64 Age 65 and older No 53% No 41% Age 50-64 Age 65 and older

7. Results Cont. Q3). How did you find out about Medicare coverage for mammograms? 1. Mammo Days 2. Television program promoting Mammo Days 3. Friends and family members

8. Discussion Preliminary information collected from the Mammo Days project indicates a need to increase public education to promote Medicare benefits for mammography. Programs specifically aimed at targeting African American women in urban areas are needed. Collecting more information to understand barriers to utilizing Medicare mammography benefits among women who are aware of coverage is an important next step for this project.