CITY OF COLUMBUS, OH
Mayor Gregory Lashutka

Mayor Supports Outreach and Screening for Younger Women and Underserved Populations

The Columbus Health Department. s efforts on breast cancer awareness are characterized by extensive collaboration and outreach, strongly supported by Mayor Gregory Lashutka. This has resulted in funding innovations and creative multi-cultural approaches that are widely recognized. To replicate these successes, the Ohio State Department of Health contracts with the city health department to implement the Breast and Cervical Cancer Early Detection Program. This effort provides breast and cervical cancer screening for all of Franklin County plus the six contiguous counties and the county of Fayette. Highlights of the breast cancer awareness initiatives in Columbus follow.

BEST: Screening for Younger Women

The Breast Education, Screening and Treatment Program (BEST) enables the city to follow the American Cancer Society (ACS) guidelines that call for screening to start at age forty for women. In a collaborative effort unique to Columbus, BEST involves three organizations: the Columbus Health Department; the ACS/Franklin County Unit; and the Columbus Race for the Cure. This initiative supplements the $404,563 Breast and Cervical Cancer Early Detection Program grant from the Centers for Disease Control and Prevention. These funds come through the Ohio Department of Health. Proceeds from the Race for the Cure, plus some other private funds, provide the $50,000 the Columbus Health Department needs for screening medically indigent women from age forty through forty-nine. The ACS gives administrative in-kind support to BEST.

Generous Community Support

The health department has enlisted public and private hospitals to provide treatment for diagnosed low-income women. Most hospitals have charity funds, and private physicians also donate their time. Community clinics are integrated into the city. s breast cancer awareness efforts. These six centers are city-funded and managed under the auspice of Columbus Neighborhood Health Center, Inc.

The health department works with the Columbus YWCA, which has an ENCOREplus Breast and Cervical Cancer Program. This initiative assists with community education and outreach. ENCOREplus also offers babysitters and transportation for women undergoing screening.

The media is supportive. Public service announcements (PSAs) are run on radio and television and in newspapers - - both the majors and those of the priority populations to be reached. Health department staff frequently use talk shows to announce breast and cervical cancer screening. Retailers help with advertisements on prescription bags, flyers in grocery bags, and in coupon mailings. Time and weather telephone numbers also have advertised breast and cervical cancer screening.

In addition, a statewide coalition, the Ohio Breast and Cervical Cancer Coalition, has been formed to supplement local efforts to reduce the morbidity and mortality associated with these diseases. Coalition members include staff and volunteers from hospitals, survivor groups, the Breast and Cervical Cancer Project, ACS, nurse. s associations, Planned Parenthood, YWCA, and other interested private and community organizations.

Multi-Cultural Outreach

A significant portion of Columbus. s African American population is reached through both the African American Cancer Support Group and KUUMBA, an organization of ministers. wives. Started in 1993 by the health department, KUUMBA ("creative" in Swahili) also promotes cervical cancer screening, good health practices, and reduction of teenage pregnancy. In promoting breast cancer awareness, breast cancer survivors from the African American Cancer Support Group go into churches that are recruited for outreach through health fairs and by word of mouth. The effort includes medical talks and use of the mobile mammography unit of the Ohio State University Comprehensive Cancer Center.

In trying to reach the Asian population in Columbus, the health department first used a cross-cultural thirty-second television spot, but found this message too general. After becoming more familiar with Asian culture, the health department concluded that Asian women tend to spend little time on themselves, focusing instead on family needs. Thus, the health department created a PSA urging Asian women to seek screening for the sake of their families. It has also been found that Asian women are more at ease with a female provider, particularly another Asian woman, and the health department makes this accommodation whenever possible. Another challenge is the translation of materials into the various Asian languages represented in Columbus. Accordingly, the health department has entered into a partnership with the Asian American Health Coalition to do the translations and to provide interpreters during breast/cervical cancer screening examinations.

Outcomes

Since 1994, the Columbus Health Department has enrolled 2,393 women in its breast cancer screening program. Of the 37 diagnosed women, 36 have received treatment. The one who declined is pursuing alternative approaches.

Contact: Carla E. Hayden, R.N., M.B.A., Columbus Health Department, 614/645-1836.

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