The Rose – Empower Her® to Care (EHC6) Abstract and Significance Need: Early detection provides the best chance of detecting breast cancer at its earliest when women have treatment options and survival rates are over 98%. Evidence shows a 20% decrease in breast cancer mortality due to screening women at average risk for the disease. However, the use of mammography as well as timely breast care remains out of reach for many. Social determinants significantly influence a person's health condition. Those living in challenging environments who are uninsured, have limited income, and limited access to health care services are less likely to participate in breast cancer screening. According to th...

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The Rose ‒ Empower Her® to Care (EHC6) Abstract and Significance Need: Early detection provides the best chance of detecting breast cancer at its earliest when women have treatment options and survival rates are over 98%. Evidence shows a 20% decrease in breast cancer mortality due to screening women at average risk for the disease. However, the use of mammography as well as timely breast care remains out of reach for many. Social determinants significantly influence a person's health condition. Those living in challenging environments who are uninsured, have limited income, and limited access to health care services are less likely to participate in breast cancer screening. According to the American Cancer Society's Breast Cancer Facts and Figures, only 30% of uninsured women were to-up-to-date with breast cancer screening recommendations compared to 64% of insured women.

Few mammography facilities exist outside a larger metropolitan area, and most do not have resources for women with no health insurance or limited financial resources. And for many, transportation, lack of job flexibility, and familial commitments make it difficult to travel to a mammography facility. Rural Texas counties have a more significant cancer burden than their urban counterparts due to access-to-care barriers and lack of infrastructure to carry out prevention programs.

To address the barriers, The Rose seeks grant funding of $1,999,245 over 24 months to support the maintenance and expansion of the CPRIT-funded Empower Her® to Care Project (EHC6). EHC6 will increase the delivery of breast cancer screening, diagnostic procedures, and patient navigation services to 3,580 underserved women in the existing 41 established program counties while expanding to two additional counties – Falls and Milam Counties.

Project Strategy: The Rose's Empower Her® Maintenance and Expansion (EHC6) project uses a multicomponent, evidence-based interventions to reduce or eliminate structural barriers and out-of-pocket costs to increase breast screening in underserved women in the 43-county service area.

The program intends to serve 3,580 clients with screening and diagnostic service and patient navigation and an additional 2,000 with education and outreach. The Rose will assign Community Engagement Navigators (CEN) to the 43-county service area. The CENs will work in communities to engage the community and clinical partners to schedule outreach and education activities and mobile mammography events. The CENs will also navigate patients into screening and diagnostic care and follow the patient to the resolution of their clinical process.

The EHC6 also removes the financial barrier to screening and breast care and ensures women comply with recommended screening or follow-up care. Uninsured women who meet program eligibility guidelines will have no out-of-pocket cost.

The Rose will utilize the mobile mammography program to remove transportation and access issues for women in the service area. The Rose operates three mobile coaches, and a fourth will arrive in the Fall of 2021.

According to HealthyPeople 2020, people with regular and consistent care are more likely to comply with regular preventive services, including cancer screenings. Community-based clinics are essential in providing services to those who lack access and reside in communities with limited medical facilities. The EHC6 program will extend the community-based offerings of partners and increase the partners' impact on their communities.

Goals: The Empower Her® to Care Program aims to save lives from breast cancer. The program has three goals over the program's 24 months: • Maintain access to the current services areas of 41 counties, and expand services to two additional counties - Milam and Falls; • Increase access to coordinated care, patient navigation, and treatment for women diagnosed with breast cancer from the 43-county service area, and • Improve the community impact of project partners in the program's service area. The EHC6 will reach 55,000 people through outreach, partner promotion, and small, large, and social media and serve 5,580 people with screening and diagnostic services, patient navigation, outreach, and education.

Significance and Impact: Through the program, The Rose expects to provide screening and diagnostic care to women who would otherwise forego breast care because of cost, access, or other limitations. Women who receive screening services will be compliant with screening recommendations and part of an automated reminder system for subsequent screening. With mammography compliance and timely follow-up, and the continuation of financial investment, the partnership of The Rose and the Cancer Prevention and Research Institute of Texas continues the positive impact on Southeast Texas by saving lives and improving the safety-net systems that sustain vulnerable and underserved communities.

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