Breast Cancer Screening in Native American Women at an Urban Minnesota Community Clinic
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Abstract
The Native American Community Clinic (NACC) in Minneapolis, MN, expressed a need for a breast cancer screening patient education brochure and a policy regarding breast cancer screening, due to the absence of these in their clinic. Native American women have some of the lowest breast cancer screening rates along with the poorest five-year survival rate for breast cancer. Early screening and detection of breast cancer is thought to be the key to survival. The reason for these low breast cancer screening rates among Native American female patients is multifactorial, but lack of knowledge and provider recommendation are two known barriers. The purpose of this practice improvement project was to develop a culturally appropriate breast cancer screening patient education brochure with a policy that outlines use. The healthcare providers, medical director, and the patient advisory group at the NACC evaluated the brochure, and the medical director evaluated the policy. The Plan, Do, Study, Act method was utilized to facilitate the process and address the clinic goals. The project first reviewed current guidelines and literature for breast cancer screening. After one set of guidelines was selected, the brochure was created. The healthcare providers, medical director, and patient advisory group members were then given a qualitative survey. The responses to the survey gave suggestions for revisions, which were made to the brochure. Revisions included things such as using different guidelines, including more information on mammography, and including photographs of Native American women. The policy was then created. The policy included which guidelines to use when offering screening, whom to offer screening to, and guidance on how to properly document breast cancer screening and education after each visit. The medical director was then given a qualitative survey, which inquired about necessary revisions. The medical director suggested only one minor revision (change in wording). Following a total of four meetings and multiple revisions, the educational brochure and policy were approved by the NACC medical director. Future research should focus on expanding culturally appropriate patient education materials in clinical settings, such as the NACC.