Disability and Health Program

Vanessa Nehus Principal Investigator

Vanessa Smith Program Coordinator

Judy Young Promotion Specialist

We envision the inclusion of all women in affordable, accessible screening and equal treatment of breast cancer in Arkansas.

History & Research of Barriers to Breast Care for Women with Disabilities

Barriers to Health Care1. Structural or Physical Access to

Facility/Equipment.

2. Financing Issues

3. Health Promotion

4. Provider Knowledge/Attitude

Breaking Down the Barriers to Health Care for Women with Disabilities National Summit, December 2004.

Structural/Physical Access to Facility/Equipment Transportation Inaccessible parking Inaccessible bathrooms Inaccessible exam equipment

Thierry, JM (2000) Observations from the CDC: Increasing Breast & Cervical Cancer Screening among Women with Disabilities. Journal of Women’s Health & Gender-Based Medicine, 9 pgs 9-12.

Mele, Archer & Pusch ( July/August 2005) Access to Breast Cancer Screening Services for Women with Disabilities. Journal of Obstetric, Gynecologic, & Neonatal Nursing pgs 453-464.

Financing Issues Medicare Deductibles Medications Limited number of covered visits

Mele, Archer & Pusch ( July/August 2005) Access to Breast Cancer Screening Services for Women with Disabilities. Journal of Obstetric, Gynecologic, & Neonatal Nursing pgs 453-464.

Health Promotion Inaccessible Materials Do not target women with disabilities Knowledge & confidence of the patient

Thierry, JM (2000) Observations from the CDC: Increasing Breast & Cervical Cancer Screening among Women with Disabilities. Journal of Women’s Health & Gender-Based Medicine, 9 pgs 9-12.Mele, Archer & Pusch ( July/August 2005) Access to Breast Cancer Screening Services for Women with Disabilities. Journal of Obstetric, Gynecologic, & Neonatal Nursing pgs 453-464.

Provider Knowledge/Attitude Previous negative experiences with

providers Felt non-disability related medical

concerns were ignored Do not receive same standards of care

as non-disabled peersMele, Archer & Pusch ( July/August 2005) Access to Breast Cancer Screening Services for Women with Disabilities. Journal of Obstetric, Gynecologic, & Neonatal Nursing pgs 453-464.Beth Israel Deaconess Medical Center. (2006). Disparities in breast cancer treatment for women with disabilities. Retrieved February 25, 2007, from http://www.hms.harvard.edu/news/pressreleases/bid1106breastcancer.htmlVerger, P., Aulagnier, M., Souville, M., Ravaud, J.F., Lussaulat, P.Y., Garnier, J.P., Paraponaris, A. (2005) Women with disabilities: General practitioners and breast cancer screening, American Journal of Preventive Medicine, 28(2), 215-220.

Arkansas StatisticsBehavioral Risk Factor Surveillance System

Women 40+ years of age* 2000-2007 data combined6424 women without disabilities (65%)3411 women with disabilities (35%)

*A mammogram is an x-ray of each breast to look for breast cancer. Have you ever had a mammogram?

"Yes" response

87.82

89.1

No Disability

Disability

Dis

abili

ty S

tatu

s

Percent

*Have you ever had breast cancer?3.58

2.05

0

0.5

1

1.5

2

2.5

3

3.5

4

Disability No Disability

DisabilityNo Disability

*How long has it been since you had your last mammogram?

76.7

14.059.25

81.69

11.656.66

0

10

20

30

40

50

60

70

80

90

Disability No Disability

W/in past 2 years2-5 years ago5 or more years ago

What is the most important reason why you haven’t had a mammogram?

0

5

10

15

20

25

30

35

40

45

50

Disability No Disability

Age/Too young

Cost

Just didn't get around toitNot recommended bydoctorNo need/Low risk

Other

If you wanted to have a mammogram, would you have to pay for all, part or none of the cost?

22.87

33.94

43.19

25.21

38 36.79

0

5

10

15

20

25

30

35

40

45

Disability No Disability

AllPart(includes co-pay)None

*How difficult would it be for you to pay for the cost of the mammogram test?

32.56

20.81 20.11

26.53

14.83

19.2522.09

43.83

0

5

10

15

20

25

30

35

40

45

Disability No Disability

Very DifficultSomewhat difficultA little difficultNot at all difficult

*Are you aware that the Health Department offers free/low cost breast exams and mammograms?

"Yes" response

52.03

53.77

No Disability

Disability

Dis

abili

ty S

tatu

s

Percent

*Do you have some type of health insurance plan?

"Yes" response

87.63

87.42

No Disability

Disability

Dis

abili

ty S

tatu

s

Percent

*At any time in the past year, were you without health insurance?

"Yes" response

4.39

7.11

No Disability

Disability

Dis

abili

ty S

tatu

s

Percent

*What type of health insurance do you have?

43.3

29.2

78.

330.

5112

.61

3.98

2

60.1

5

25.8

49.

410.

29 0.29 2.51

1.19

0

10

20

30

40

50

60

70

Disability No Disability

Employer

Someone Else'sEmployerBuys their own

Medicare

Medicaid

Military/CHAMPUS

Other

In the past month, have you noticed any posters, billboards, commercials, or advertisements with a message about having a mammogram test?

"Yes" response

67.4

68.53

No Disability

Disability

Dis

abili

ty S

tatu

s

Percent

The Right to Know Campaign: Increasing The Right to Know Campaign: Increasing Breast Cancer Awareness for Women with Breast Cancer Awareness for Women with

Physical DisabilitiesPhysical Disabilities

The Right to Know Campaign: Increasing The Right to Know Campaign: Increasing Breast Cancer Awareness for Women with Breast Cancer Awareness for Women with

Physical DisabilitiesPhysical Disabilities

Centers for Disease Control and PreventionNational Center on Birth Defects and Developmental Disabilities

PurposePurposePurposePurpose

The purpose of the project is The purpose of the project is to develop culturally relevant to develop culturally relevant concepts, messages, and concepts, messages, and health promotion materials health promotion materials designed to increase breast designed to increase breast cancer screening among cancer screening among women aged 40 years and women aged 40 years and older with physical disabilitiesolder with physical disabilities

The Right to Know MaterialsThe Right to Know Materials

DisseminationDisseminationDisseminationDisseminationKey AspectsKey Aspects

Roll out national campaign (2008)Roll out national campaign (2008) Distribute campaign materials to key Distribute campaign materials to key

partnerspartners Conduct national awareness campaignConduct national awareness campaign

AdvertisingAdvertising Public relationsPublic relations Community outreachCommunity outreach

Key AspectsKey Aspects

Roll out national campaign (2008)Roll out national campaign (2008) Distribute campaign materials to key Distribute campaign materials to key

partnerspartners Conduct national awareness campaignConduct national awareness campaign

AdvertisingAdvertising Public relationsPublic relations Community outreachCommunity outreach

DisseminationDisseminationDisseminationDisseminationCampaign Web siteCampaign Web site

Launch the new “Right to Know” Web site Launch the new “Right to Know” Web site (2008)(2008)

Campaign productsCampaign products Spotlight on partnersSpotlight on partners E-cardsE-cards QuizQuiz Success storiesSuccess stories

Campaign Web siteCampaign Web site

Launch the new “Right to Know” Web site Launch the new “Right to Know” Web site (2008)(2008)

Campaign productsCampaign products Spotlight on partnersSpotlight on partners E-cardsE-cards QuizQuiz Success storiesSuccess stories

Arkansas Capacity Goal

Improve the ability of local health organizations to deliver breast cancer screening services to women with disabilities.

Capacity Objectives Assess the ability of local health

organizations to deliver breast cancer screening services to women with disabilities

Identify strengths and weaknesses

Provide feedback, offer training and technical assistance

Arkansas Communication Goal

Raise awareness of breast cancer among women over 40 with physical disabilities.

Communication Objectives

Educate women with disabilities on the risk of breast cancer

Educate women regarding the availability and location of resources

Educate non-traditional partners about the need for promotion of breast health