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Selma J. Morris, M.Ed.Breast Health LiaisonGrady Health System

Atlanta, Georgia

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FUNDING

Atlanta 2-Day Walk

“It’s the Journey”

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INTRODUCTION

Address disparities of breast cancer among multicultural populations

Non traditional, non threatening arena

Inconvenience

Timing

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SETTING

Hartsfield-Jackson Atlanta International Airport (under auspices of City of Atlanta)

R. L. Brown, Jr. Health Center (under auspices of the Grady Health Center) located in the Atrium of airport:

- Primary Care

- Occupational Health

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EMPLOYEES/SUPPORT STAFF

Total Employees exceeds 56,000 Concession Outlets – >200 Department of Aviation – 340 Limousine Operators – 86 Hotel/Motel Shuttles – 18 Taxicabs – 300 Airlines – >40

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“A PRINCIPLES”

Acceptability Availability Accessibility Affordability Accountability

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GOALS “E FACTORS”

Grady Health System Administration

FAA Administration Employers Venues:

- Monthly concession meetings

- Presentations at board meetings

ENCOURAGE

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EDUCATE

Employees learn the 3 components of breast health:

Clinical Breast Examination

Mammography

Breast Self-Exam

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ENGAGE

Employees recognize importance of

worksite early detection programs via:

One-on-One

Lunch & Learn

Other Educational Methods

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EMPOWER

Attendees learned how

to take responsibility

for one’s body and oneself!

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EMPLOY

Multicultural & Multilingual Seasoned Community Health Advocates (CHAs)

Two Day Training - Utilizing Cultural Modification of Annie B. Casey Competency Training Modules

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EVALUATE

Process Outcome Impact Feasibility of replication to other

airports nationally/internationally

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CHAs ACTIVITIES Recruitment of Employees/Support Staff

(foot soldiers) Obtain Consent Forms Obtain Knowledge, Attitude, Behavior &

Practice (KABP) pre/post tests Provide Culturally Appropriate BSE

Teaching = brochures, pamphlets, breast models & Liv Kits

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CHAs ACTIVITIES (cont…) Facilitate Referrals for Follow-up and

Other Needs as Identified Reminder Phone Calls Where Appropriate, Accompany

Employees/Support Staff to Mammography and Other Appointments

Document All Activities Participate in Community Activities

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INTERVENTION

Daily - CHAs provide education for those attending clinic

Daily - Clinic staff (MD’s/Nurse Practitioners) perform clinical breast examinations (CBE)

Monthly - Health care providers donate their time to clinic to perform CBE’s and see those designated with abnormal CBE's

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INTERVENTION (cont…) Quarterly - Latino breast health program in

collaboration with Dia de la Mujer Latino:- Latino health care providers

- Latino CHAs

- Latino breast cancer survivor

- Latino music

- Latino food

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FOLLOW-UP

Employees with insurance referred to their PCP for mammography

Employees without insurance given free mammograms via:

- BreasTest & More Program - Georgia CDC & Prevention Program

- Donated mammograms

- Project funds

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RESULTS OUTCOMES

Total Program Participants = >3,500

Total Questionnaires Completed

= >2,000

Clinical Breast Examinations = >200

Mammography Referrals > 150

DNKA’s < 30%

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RESULTS PROCESS

Employee Satisfaction (Sometimes difficult for employees/support staff to keep appointments = airport priorities, etc.)

Employer Satisfaction (Project feedback)

Community Health Advocates (Valuable resources for ongoing health education and health promotion)

Need inclusion of marketing personnel to enhance participation

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IMPACT

Airport staff mirrors diversity of America Provides an arena to address chronic disease

disparities: Cardiovascular Disease Other cancers: cervical, prostate, colorectal, etc. Stroke Hypertension Diabetes Mental Health

Feasibility of replication nationally/internationally

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LESSONS LEARNED

Airports - a community within itself Airport employees - reflect diversity

of America Airports - provide captured audience

for health promotion CHAs - valuable and underutilized

health care personnel

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LESSONS LEARNED (cont…)

Inclusion of men as breast CHAs

Inclusion of marketing expertise to enhance program participation

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NEXT STEPS

Program Continuation CHAs presenting at their annual meeting –

Unity Conference Ongoing participation in health promotion

activities – City of Atlanta, Golds Gym, etc. Seeking ongoing funding Explore feasibility of educating

passengers

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COMMUNITY HEALTH ADVOCATES

- Dorothy Brandon - Shirley Lewis

- Sylvia Clark - Gladys Long

- Jackie Davis - Melissa Luck

- Amanda Hill - Gloria Rollins

- Dana Howard - Christine Smith

- Ruby Johnson - Elsie Stephens

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PROVIDERS - DR. PHILLIP & GROUP

R. L. Brown, Jr. Airport Health Center Providers

Grady Health System Mid-Level Providers

Morehouse School of Medicine Emory School of Medicine Rogsbert Phillips, MD GHS – Avon Foundation

Comprehensive Breast Center

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COLLABORATORS/ PARTNERS

American Cancer Society American Heart Association Association of Black Cardiologists Bosom Buddies Breast Friends Dia de la Mujer Latina

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COLLABORATORS/PARTNERS (cont…)

Food & Drug Administration Liv Kits Men Against Breast Cancer National Black Leadership Initiative On

Cancer Pan Asian Association Sisters By Choice Susan G. Komen Breast Cancer Foundation

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THANK YOU!