Assessing local capacity to expand rural breast cancer screening and patient navigation: An iterative mixed-method tool

Stephen J. Inrig, Robin T. Higashi, Jasmin A. Tiro, Keith E. Argenbright, Simon J Craddock Lee

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background Despite federal funding for breast cancer screening, fragmented infrastructure and limited organizational capacity hinder access to the full continuum of breast cancer screening and clinical follow-up procedures among rural-residing women. We proposed a regional hub-and-spoke model, partnering with local providers to expand access across North Texas. We describe development and application of an iterative, mixed-method tool to assess county capacity to conduct community outreach and/or patient navigation in a partnership model. Methods Our tool combined publicly-available quantitative data with qualitative assessments during site visits and semi-structured interviews. Results Application of our tool resulted in shifts in capacity designation in 10 of 17 county partners: 8 implemented local outreach with hub navigation; 9 relied on the hub for both outreach and navigation. Key factors influencing capacity: (1) formal linkages between partner organizations; (2) inter-organizational relationships; (3) existing clinical service protocols; (4) underserved populations. Qualitative data elucidate how our tool captured these capacity changes. Conclusions Our capacity assessment tool enabled the hub to establish partnerships with county organizations by tailoring support to local capacity and needs. Absent a vertically integrated provider network for preventive services in these rural counties, our tool facilitated a virtually integrated regional network to extend access to breast cancer screening to underserved women.

Original languageEnglish (US)
Pages (from-to)113-124
Number of pages12
JournalEvaluation and Program Planning
Volume61
DOIs
StatePublished - Apr 1 2017

Fingerprint

Patient Navigation
Early Detection of Cancer
navigation
cancer
Breast Neoplasms
Community-Institutional Relations
Vulnerable Populations
Clinical Protocols
Interviews
infrastructure
method
county
screening
Navigation
Cancer screening
Mixed methods
Breast cancer
funding

Keywords

  • Access to care
  • Breast cancer screening
  • Evaluation design and research
  • Service capacity

ASJC Scopus subject areas

  • Social Psychology
  • Business and International Management
  • Geography, Planning and Development
  • Strategy and Management
  • Public Health, Environmental and Occupational Health

Cite this

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title = "Assessing local capacity to expand rural breast cancer screening and patient navigation: An iterative mixed-method tool",
abstract = "Background Despite federal funding for breast cancer screening, fragmented infrastructure and limited organizational capacity hinder access to the full continuum of breast cancer screening and clinical follow-up procedures among rural-residing women. We proposed a regional hub-and-spoke model, partnering with local providers to expand access across North Texas. We describe development and application of an iterative, mixed-method tool to assess county capacity to conduct community outreach and/or patient navigation in a partnership model. Methods Our tool combined publicly-available quantitative data with qualitative assessments during site visits and semi-structured interviews. Results Application of our tool resulted in shifts in capacity designation in 10 of 17 county partners: 8 implemented local outreach with hub navigation; 9 relied on the hub for both outreach and navigation. Key factors influencing capacity: (1) formal linkages between partner organizations; (2) inter-organizational relationships; (3) existing clinical service protocols; (4) underserved populations. Qualitative data elucidate how our tool captured these capacity changes. Conclusions Our capacity assessment tool enabled the hub to establish partnerships with county organizations by tailoring support to local capacity and needs. Absent a vertically integrated provider network for preventive services in these rural counties, our tool facilitated a virtually integrated regional network to extend access to breast cancer screening to underserved women.",
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author = "Inrig, {Stephen J.} and Higashi, {Robin T.} and Tiro, {Jasmin A.} and Argenbright, {Keith E.} and Lee, {Simon J Craddock}",
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AU - Argenbright, Keith E.

AU - Lee, Simon J Craddock

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AB - Background Despite federal funding for breast cancer screening, fragmented infrastructure and limited organizational capacity hinder access to the full continuum of breast cancer screening and clinical follow-up procedures among rural-residing women. We proposed a regional hub-and-spoke model, partnering with local providers to expand access across North Texas. We describe development and application of an iterative, mixed-method tool to assess county capacity to conduct community outreach and/or patient navigation in a partnership model. Methods Our tool combined publicly-available quantitative data with qualitative assessments during site visits and semi-structured interviews. Results Application of our tool resulted in shifts in capacity designation in 10 of 17 county partners: 8 implemented local outreach with hub navigation; 9 relied on the hub for both outreach and navigation. Key factors influencing capacity: (1) formal linkages between partner organizations; (2) inter-organizational relationships; (3) existing clinical service protocols; (4) underserved populations. Qualitative data elucidate how our tool captured these capacity changes. Conclusions Our capacity assessment tool enabled the hub to establish partnerships with county organizations by tailoring support to local capacity and needs. Absent a vertically integrated provider network for preventive services in these rural counties, our tool facilitated a virtually integrated regional network to extend access to breast cancer screening to underserved women.

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