With CPRIT support, the initial Breast Screening and Patient Navigation (BSPAN1) program has successfully provides comprehensive mammography and appropriate follow-up services across five rural and underserved North Texas counties, a region reporting the highest-age adjusted rates of breast cancer (Health Services Region 03). Our BSPAN1 program has achieved excellent results: screening 1683 women in the first year of funding, we report a positive rate of 6.1 cancers per 1,000 patients screened, which exceeds the national averages by 380%.

Incorporating key elements of the 2005 Texas Cancer Plan, BSPAN1 removes geographic and financial barriers to deliver screening and patient navigation in r...

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With CPRIT support, the initial Breast Screening and Patient Navigation (BSPAN1) program has successfully provided comprehensive mammography and appropriate follow-up services across five rural and underserved North Texas counties, a region reporting the highest-age adjusted rates of breast cancer (Health Services Region 03). Our BSPAN1 program has achieved excellent results: screening 1683 women in the first year of funding, we report a positive rate of 6.1 cancers per 1,000 patients screened, which exceeds the national averages by 380%.

Incorporating key elements of the 2005 Texas Cancer Plan, BSPAN1 removes geographic and financial barriers to deliver screening and patient navigation in rural communities. BSPAN’s approach is grounded in collaboration with local community leaders and health care providers to increase access to breast cancer screening, diagnostic mammograms, and biopsies. As a contractor for the Texas Breast & Cervical Cancer Services (BCCS), BSPAN leverages state and federal funds to provide culturally sensitive services in collaboration with multi-sectoral local community partners (e.g., civic groups, physician practices, community hospitals, churches).

The BSPAN program has three components: 1) Outreach & Health Promotion to reach underserved women in rural communities; 2) Delivery & Navigation to guide patients through screening and appropriate follow-up; and 3) Centralized Reimbursement to fund mammography services through our Texas BCCS contract, Medicaid, and local philanthropies. With our initial CPRIT award, we demonstrated that BSPAN1 is highly successful when we provide all three program components to a rural county. However, the complexity of providing all the resources necessary to implement all three program components constrains our ability to expand the program to other rural counties.

Therefore, in BSPAN2, to improve reach and sustainability, we will evolve the program into a decentralized regional delivery model for the 3 components. In this competitive renewal, we will: continue to screen women in the initial 5 counties and expand BSPAN2’s reach and sustainability to 12 additional counties (total= 17) by training counties to take on one or two of the components while Moncrief/UT Southwestern continues to provide the third, i.e centralized reimbursement as a Texas BCCS contractor. We will then evaluate how implementation of the BSPAN2 program can lead to equivalent screening success.

Over the funding period, BSPAN2 will reach approximately 74,000 women and serve more than 6,700 unique women, providing more than: 6,700 screening mammograms, 6,100 diagnostic mammograms, and 2,300 biopsies. Findings will be used to develop a Readiness Assessment Criteria (RAC) tool, training curricula, and an internet-based data-entry application by which the benefits of BSPAN2 can be brought to many rural and underserved communities across Texas and the country.

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