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

2. 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

3. Who we serve All women, Native or Non-Native, who: • Are SEARHC beneficiaries • Live in Southeast Alaska • Are 18-64 for BCHP • Are 30-64 for WISEWOMAN • Have a limited income • Have insurance that does not fully cover women’s preventive or diagnostic services • If age 65+, are without Medicare Part B

4. 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 1/1/98 - 12/31/11

5. 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

6. SEARHC Women’s Health Program Goal Reduce morbidity, mortality and health disparities in breast and cervical cancer

7. DP12-1205 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

8. What’s worked so far: • “Captive audience” RPMS Clinic User Population • Clinic connections • Door-to-door, face-to-face • Integrated programming • Special Women’s Health Clinic events • Provider champions • Unique partnerships • Patience!

9. Captive Audience • RPMS Clinic User Population in a centralized service system • “ever seen at a SEARHC clinic” • Women’s Health Tracking Package • Breast & cervical cancer screening status reports • Targeted calling and mailing lists

10. 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

11. Door-to-door, face-to-face • Women’s 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

12. 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

13. Special Women’s Health Clinic Events • Evening and Saturday Clinics • “Specialty Clinic” model • “Pre-mobile” mammogram events • CHAPs training clinic

14. 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?)

15. 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

16. 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

17. Select DP12-1205 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

18. Questions? Thank you! Nancy Jo Bleier, LCSW, C-ASWCM WISEWOMAN Women's Health Program Coordinator Southeast Alaska Regional Health Consortium 966-8849 nancyjb@searhc.org