Avon Conference Call

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Reaching Older Women with Cancer Screenings
Avon Conference Call December 10, 2003 By Holly
Kiger, RN, MN Director, Health Services Center
for Healthy Aging
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Overview of Presentation

• Overview of Center for Healthy Aging
• Cancer Detection ProgramEvery Woman Counts
• Literature Review
• Reaching older women in Los Angeles County

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• Private, non-profit community based organization
• Provides cancer screenings, health education,
  mental health and psychosocial services to older
  adults
• Volunteer University trains supervises 150
  volunteers annually
• Service area Los Angeles county (population 6
  million--multiethnic)

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Cancer Detection Program Every Woman Counts

• Breast and cervical cancer screenings
  provided free for women
• Age 40
• Low-income (200 Poverty)
• Uninsured or Underinsured

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Cancer Detection Program Every Woman Counts

• Screenings provided at our clinic
• Clinical breast exam
• Instructions on breast self exams
• Pelvic and pap smear
• Appointment for mammogram across the street _at_
  Saint Johns Health Center
• Screen 1100 women/year

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Ethnicity of Women Served

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Cancer Detection Program Every Woman Counts

• Services for women with findings
• Referrals for diagnostic procedures
• Connections to treatment and support services if
  cancer is found
• Ongoing case management to assure access to
  needed services

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• CHA identified as one of 10 Model Programs by
  Avon Breast Cancer Fund in 1999
• Funding renewed in 2000, 2001, 2002 2003
• Awarded a 2-year grant from the Avon Foundation
  for 2004-5 with the John Wayne Cancer Institute

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• 2004-5 Grant
• Continuation of Current Project
• Outreach education of women about breast cancer
  screenings

• Train supervise a multicultural cadre of
  volunteers to assist with education outreach

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2003 Model Volunteer Programs
The Los Angeles Witness Project
8 Witness Role Models
8 Lay Health Advisors
Tell A Friend 4
trainings 40 women trained
Promatoras de Salud 27 active volunteers
trained by Behavioral Health
Services 8 received Tell A Friend training
from CHA ACS
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• 2004-5 Grant
• Other components of CHAs Outreach Education
  Project

• Provide wide variety of educational
  presentations
• (Reach 300/year)
• Staff 20 health fairs each year
• (Reach 4000/year)
• Annual community bi-lingual (Spanish/English)
  conference
• Co-sponsored with local Senior Center
• (Reach 500 women, majority 65)

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• 2004-5 Grant
• Other components of CHAs Outreach
  Education Project

• Promote 11 outreach by current patients
• Paid advertising
• Coupon Mailings to 10,000 homes 7X/yr
• Westside Life Magazine ad several times/yr
• Media outreach
• CHA cancer survivor featured in
• CA Dept of Health Services promotional poster
• Avons annual report

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• 2004-5 Grant
• Other components of CHAs Outreach
  Education Project

• Participated in 2003 Avon Walk
• TV Channel 22
• --segment on Spanish TV station about our free
  community conference
• TV Channel 4 news
• --Tell A Friend feature story
• Santa Monica Cable TV
• --Coffee Break segment on CHAs cancer
  detection program

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• 2004-5 Avon Foundation Grant with John Wayne
  Cancer Institute Center for Healthy Aging
• NEW ACTIVITIES FOR 04-05
• Education of older women
• Breast health
• Nutrition
• Osteoporosis
• 2-year Research Project
• 80 postmenopausal women newly diagnosed with
  breast cancer
• Each woman will receive weekly phone calls for 6
  weeks from specially trained Senior Peer
  Counselors
• Randomized controls with delayed treatment
• Pre post testing for QOL, etc.

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Screening Older Women

• Risk Factors
• age

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Cases of Breast Cancer in 1994 By Age
National Cancer Institute
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Screening Older Women

• Risk Factors
• Age
• However, research shows that
• Nearly 1/3 of women aged 65 are not as concerned
  about breast cancer as when they were younger
  (NCI CHFA telephone survey, 1999)
• Only 57 of women aged 65 knew about
  recommendations for mammograms every 1-2 yrs.
• (NCI CHFA telephone survey, 1999)
• 77 aware that Medicare will cover costs, but
  only 58 had actually used Medicare for a
  mammogram (NCI CHFA telephone survey, 1999)

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Screening Older Women

• Risk Factors
• Age
• Minority women nearly 2X as likely to be unaware
  of Medicare benefit
• (NCI CHFA telephone survey, 1999)
• 72 of women over 50 are unaware that breast
  cancer is more common in older women
• (Breast Cancer Care, 2003)

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Screening Older Women

• Risk Factors
• Age
• Possible explanation Early educational efforts
  focused on younger women
• Pink ribbon campaign begun in 1994 features
  mostly young models, actresses and media
  personalities
• (news.telegraph.co.uk, 13/10/03)

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Screening Older Women

• Risk Factors
• Obesity
• International study (Britain, Japan, Italy US)
• released August, 2003
• Postmenopausal women
• The more women weighed, the higher their risk
  of cancer (also had higher levels of estrogen)
• (Boston Herald.com 8/20/03)