Date of Graduation

Spring 5-19-2017

Document Type

Restricted Project/Capstone - USF access only

Degree Name

Master of Public Health (MPH)

College/School

School of Nursing and Health Professions

Abstract

Early detection and treatment of breast cancer vastly improves the chance of survival. Unfortunately, there is a disproportionate gap in health outcomes based on socioeconomic status (SES). Though a high SES correlates to higher incidences of breast cancer, a low SES correlates to late-stage diagnosis and an increased risk of mortality. Low SES populations face a number of barriers such as lack of access to care and fear of costs, which puts them at a disadvantage for unfavorable outcomes. Programs and policies like mobile mammography vans and the Affordable Care Act have been implemented to address barriers. Despite efforts, these interventions have not been enough to resolve health disparities. The Avon Breast Center, which operates under the San Francisco Department of Public Health, is a public health program that provides breast cancer services at little or no cost to patients. In order to increase accessibility to screening, the mobile mammography program was created; however, funding for the program is limited. My role within the organization was to conduct a program evaluation to assess the impact of the mammovan in the hopes of utilizing the data to obtain additional funding for the program. From January to March of 2017, 296 women were screened on the van. Among those women, 11.8% required follow-ups and 8.6% were categorized as a B4/B5 for suspicious malignancies. Adherence rates were an average of 72% and varied by clinic. With the use of a key informant interview, I learned that African American women were less likely to attend their appointments compared to Asian women who almost always attended their appointments. Furthermore, a patient survey identified actual and perceived barriers that patients faced. While the results were aimed towards obtaining funding, the data implicates areas of improvement and topics for future research, policies and programs.

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