Intervention to Increase Women's Breast and Cervical Cancer Screening at the UCSD Student-run Free Clinic Project Baker Clinic Site.
Decreasing morbidity and mortality from breast and cervical cancer starts with screening and early detection. Prior to this project, although women at UCSD's Free Clinic were sporadically referred for mammograms and Pap smears at local community health centers, there was no system or mechanism in place that ensured referral, documentation, and database entry of their screenings. The goal of this project was to create such a system, starting with the Baker site. The screening status of all the women at Baker seen within the last year was identified through the free clinic database and was added to the charts if known. Those who did not have any documented screenings were contacted to try to attain that information. A partnership was created with Oceanview Community Health Center, a Federally Qualified Health Center, near Baker clinic, which agreed to clear schedules for a few providers for several days yearly to perform Pap smears and breast exams (with outside referrals for mammograms) for Baker patients only. During the screening week, a total of 29 Baker Elementary School UCSD SRFCP patients were seen over the course of three days to obtain breast and cervical cancer screening. The show rate was 76% (29/38). The rate of patients up to date on cancer screening before and after the intervention was 114/191 (58%) and 143/191 (75%) (p<0.001), respectively. During the project, a meeting was set up as part of the women's empowerment group at Baker to identify what barriers prevented them from not receiving screening tests. Some of these barriers included lack of knowledge for screening recommendations, and perception of lack of need if no symptoms were present. Thus educational information sessions for both medical students and patients about screening guidelines and protocols for referring patients to community health centers were created. This encouraged medical students to ask patients if they have had their preventive tests and refer those who were in need.