donportal.securespsites.com docu… · web viewthe greater amarillo affiliate of susan g. komen...
TRANSCRIPT
Susan G. Komen for the Cure®
Greater Amarillo Affiliate
Acknowledgements
The Greater Amarillo Affiliate of Susan G. Komen for the Cure wishes to thank everyone who helped to research, compile, and write this community profile. Many thanks to West Texas Family and Community Services, a project of the Psychology, Sociology and Social Work departments of West Texas A&M University, led by Sara E. Northrup, M.A., LBSW with assistance from Michael D. Nino, B.S. Without their research, this project could not have been successful. We also thank our current grantees, service providers, and key informants for their participation.
Additionally, the affiliate thanks Lisa Hoff Davis, Executive Director, and Brandi Ruiz, Mission Coordinator, for their work leading the project and compiling information. Finally, thanks to Whitney Kelly, Affiliate President, for writing the words around the data.
Table of Contents
4Executive Summary
4Introduction
4Overview Demographic and Breast Cancer Statistics Key Findings
4Overview of Programs and Services Key Findings
5Overview of Exploratory Data Key Findings
5Narrative of Affiliate Priorities
5Affiliate Action Plan
6Introduction
6Affiliate History
6Organizational Structure
6Description of Service Area
6Purpose of Report
7Demographic and Breast Cancer Statistics
7Data Source and Methodology Overview
7Overview of Key Demographic & Breast Cancer Statistics at State and County Level
10County/Counties of Interest: What the Data Shows
11Demographic and Breast Cancer Findings
13Programs and Services
13Data Source and Methodology Overview
13Programs and Services Overview
16Partnerships and Grant Opportunities
17Promising Practices and Evidence-Based Programs
17Public Policy Perspectives
18Programs and Service Findings
19Exploratory Data
19Data Sources and Methodology Overview
19Exploratory Data Overview
20Exploratory Data Findings
21Conclusions
21Putting the Data Together
21Selecting Affiliate Priorities
22Affiliate Action Plan
22Community Partnerships
22Existing Grant Solutions
22Needed Grant Opportunities
23Public Policy Efforts
24Education and Outreach
25List of Figures
25List of Tables
25List of Appendices
Executive Summary
Introduction
The Greater Amarillo Affiliate of Susan G. Komen for the Cure has held races for the past nineteen years and became an affiliate in 2003. The paid staff of the affiliate consists of the Executive Director, Lisa Hoff Davis, and Mission Coordinator, Brandi Ruiz (Ms. Ruiz’ position began in the 2009-2010 fiscal year, reporting to the Executive Director). The chapter serves the top twenty-six counties of the Texas Panhandle, an extremely large and mainly rural area. The population of the area is clustered in a few of the cities with a total population of approximately 413,000.
This profile discusses in detail the characteristics of the service area and breast cancer statistics for the area. It also provides an overview of programs and services available for breast health, explores findings of breast cancer incidence and mortality for the area, lists the affiliate’s priorities for programs and grant funding, and details the affiliate’s plan of action for the next two years.
Overview Demographic and Breast Cancer Statistics Key Findings
The initial data used was provided by Claritas Inc (2007) through the Greater Amarillo Affiliate of Susan G. Komen for the Cure. The secondary data provided qualitative and quantitative data for twenty-six counties in the Texas Panhandle. The figures provided by Claritas Inc (2007) also provided quantitative data regarding breast cancer and breast health throughout the United States.
Key Findings:
1. Twenty-two out of the twenty-six counties in the Greater Amarillo Affiliate area are over the highest (113.7) state average incidence rates. The affiliate should prioritize screening and support for these 22 counties: Armstrong, Donley, Briscoe, Childress, Collingsworth, Roberts, Hall, Wheeler, Carson, Gray, Swisher, Oldham, Lipscomb, Randall, Hutchison, Hemphill, Sherman, Castro, Potter, Hartley, Hansford, and Moore.
2. Almost 40 percent (39.4%) of women over the age of 40 reported not receiving a mammogram in the last twelve months.
3. Caucasian women are represented consistently in all four stages of breast cancer. However, African American women have higher rates of stage 3 and 4 breast cancer when compared to other ethnic groups.
Overview of Programs and Services Key Findings
Information for the breast cancer programs and services of the service area was collected through internet research, key informant interviews, and historical review of service providers. Information was collected at the county, city, and service area levels. After collecting all sources of breast cancer programs, staff reviewed all of the data for detailed schedules, services, program availability, and funding sources. The profile includes a listing of all service providers.
Services are scattered across the Panhandle, and treatment facilities are located only in Amarillo. Due to the small number of service and treatment providers, many women do not have access or have limited access to education, screening, and treatment for breast health.
Overview of Exploratory Data Key Findings
The exploratory data collected for the profile has helped the affiliate identify barriers to services, the cultural and behavioral considerations related to health care, the effect of location on services (rural vs. urban), and the best methods to supplement the statistical information as topics for further exploratory research.
Narrative of Affiliate Priorities
After consideration of the statistical and community data coupled with a review of the available programs and services, the affiliate has identified four priorities for the upcoming two years:
1. Fund programs for underserved women: 10% of families fall below the poverty line and 31% of women are uninsured.
2. Focus funding in six counties: Gray, Hansford, Potter, Randall, Dallam, and Carson. These counties are home to 67% of the Panhandle’s population while also representing high incidence and counties with service providers. The counties are also adjacent to counties without service providers so the affiliate can investigate rural versus urban obstacles to service.
3. Encourage partnerships: The expected success of the WISE Woman Project and the coordination of services created by the project highlight the potential for additional partnerships. Increased partnership and coordination with the BCCCP will stretch funding dollars and ensure more women have access to screening and diagnosis.
4. Address cultural and ethnic obstacles to education, screening, and diagnosis: Although Caucasian women are more than half of the population, the minority groups of the Panhandle are expected to grow faster than the Caucasian group during the upcoming census. Caucasian women have traditionally had better access to healthcare, so emphasis on minority groups will provide data for future programs and grant opportunities.
Affiliate Action Plan
The affiliate’s action plan details how it will increase success in the areas of community partnerships, building on best practices in existing grants, improving public policy efforts (especially with the BCCCP), and increase education and outreach opportunities.
Introduction
Affiliate History
The Greater Amarillo Affiliate of Susan G. Komen for the Cure has held races for the past nineteen years, but became an affiliate in 2003. Two paid staff shared the Executive Director position 2003-2005 and the current Executive Director was hired in 2005. The chapter has sustained continuous and admirable growth throughout its history. For grant year 2009-2010, the chapter awarded $217,000 to its grant recipients.
Organizational Structure
The paid staff of the affiliate consists of the Executive Director, Lisa Hoff Davis, and Mission Coordinator, Brandi Ruiz (Ms. Ruiz’ position began in the 2009-2010 fiscal year, reporting to the Executive Director). Ms. Davis reports to the eleven-member board of directors.
Description of Service Area
The chapter serves the top twenty-six counties of the Texas Panhandle: an extremely large and mainly rural area. The population of the area is clustered in a few of the cities with a total population of approximately 413,000. Area service providers draw clients from across the service area. Treatment providers are located in the center of the service area in Amarillo, so patients seeking treatment for breast cancer must travel to Amarillo for radiation or chemotherapy.
Figure 1
Purpose of Report
This profile will discuss in detail the characteristics of the service area and breast cancer statistics for the area. It will also provide an overview of programs and services available for breast health, explore findings of breast cancer incidence and mortality for the area, list the affiliate’s priorities for programs and grant funding, and detail the affiliate’s plan of action for the next two years.
Demographic and Breast Cancer Statistics
Data Source and Methodology Overview
Breast cancer is the most common form of cancer in women throughout the world. A recent study estimated 1.15 million women were diagnosed with breast cancer and 411,000 died from it in 2002. Currently, there are approximately 4.4 million women living who have been diagnosed with breast cancer in the past five years throughout the world. Breast cancer incidence rates continue to rise with a 30-40 percent increase from 1970s to the 1990s, but more rapidly in developing counties. Just in the United States alone over 192,000 women will be diagnosed with breast cancer this year (American Cancer Society). Breast cancer and breast cancer awareness continues to be a major concern in the United States.
However, increased public discussion concerning breast health does not always translate into improved breast health practices—although research has shown early detection of cancer through mammography can improve a person’s survival rate. The following examines breast health, breast health practices, knowledge of breast health and willingness to seek out medical information regarding breast health in twenty-six counties in the Texas Panhandle. The objective is to identify gaps in services in the twenty-six counties, in order to lessen breast cancer mortality rates in the Texas Panhandle.
Data Source and Methodology Review:
The initial data used was provided by Claritas Inc (2007) through the Greater Amarillo Affiliate of Susan G. Komen for the Cure and West Texas A & M University. The secondary data provided qualitative and quantitative data for twenty-six counties in the Texas Panhandle. The figures provided by Claritas Inc (2007) also provided quantitative data regarding breast cancer and breast health throughout the United States. The study is exploratory, so the raw data was first reviewed. Once the data was reviewed specific questions began to emerge just purely from observation. As the data was thoroughly reviewed staff utilized multiple methods of research to complete the community profile. The affiliated used various types of data; specifically:
1. Demographic Data (age, race, education etc)
2. Specific breast health/cancer data (Incidence, Morality, and Prevalence)
Community Resources data obtained from a self-reported survey (N= 58)
Overview of Key Demographic & Breast Cancer Statistics at State and County Level
In order to understand the severity of breast cancer in the Texas Panhandle the affiliate first examined breast cancer rates at a national level. For the purposes of this study the total female population and the prevalent breast cancer cases for the 10 largest states were examined. The prevalent breast cancer rates compared to states total population are fairly small; however, when examining prevalent breast cancer cases for Texas and California, Texas had a higher ratio rate than California. The ratio for females diagnosed with breast cancer in California for 2007 is approximately 1 out of every 244; comparatively in Texas 1 out of every 222 were diagnosed with breast cancers in 2007. (See picture below.)
Figure 2
The Greater Amarillo Affiliate of Susan G. Komen for the Cure covers twenty-six counties in the Texas Panhandle. For the purposes of this study all twenty-six counties were analyzed. Once the initial data was analyzed for all twenty-six counties, six primary counties were identified for a deeper analysis using a survey developed by the profile team. The twenty-six counties are: Potter, Randall, Hutchison, Gray, Moore, Deaf Smith, Parmer, Ochiltree, Dallam, Swisher, Childress, Castro, Carson, Hansford, Wheeler, Donley, Hall, Hemphill, Lipscomb, Collingsworth, Hartley, Sherman, Oldham, Armstrong, Briscoe and Roberts.
The chart below shows breast cancer rates for all of the counties of the Panhandle:
Breast Cancer Prevalence by County
Area: Greater Amarillo Affiliate
Ranked by Prevalent Breast Cancer Cases (Desc)
National Average Age for Prevalence of Breast Cancer: 59.1
FIPS
Prevalent
Avg Age for
County
2007 Female
Breast Cancer
Prevalence of
Code
County
State
Population
Cases
Breast Cancer
48381
Randall
TX
57,044
271
58.2
48375
Potter
TX
59,940
271
59.7
48179
Gray
TX
10,581
56
61.7
48233
Hutchinson
TX
11,214
56
60.3
48117
Deaf Smith
TX
9,507
39
59.5
48341
Moore
TX
10,077
36
58.7
48369
Parmer
TX
4,890
21
60.1
48437
Swisher
TX
3,646
19
61.4
48111
Dallam
TX
4,461
19
59.7
48357
Ochiltree
TX
4,730
19
59.0
48069
Castro
TX
3,674
17
60.3
48075
Childress
TX
2,984
17
61.4
48065
Carson
TX
3,267
17
60.3
48483
Wheeler
TX
2,403
13
61.7
48129
Donley
TX
2,034
12
62.0
48195
Hansford
TX
2,691
12
60.9
48191
Hall
TX
1,928
11
62.4
48087
Collingsworth
TX
1,532
9
62.3
48211
Hemphill
TX
1,665
8
60.1
48295
Lipscomb
TX
1,550
8
61.4
48011
Armstrong
TX
1,153
7
61.6
48421
Sherman
TX
1,327
6
59.8
48359
Oldham
TX
1,073
5
59.3
48045
Briscoe
TX
805
5
61.7
Table 1
Based on population and reported breast cancer information, twenty counties were excluded from further study. For many of the counties, cancer information was suppressed due to the small number of cases. For other counties, their small populations coupled with the small number of cases of breast cancer made them unable to be examined with statistical accuracy.
Below are the counties (with their female population) that were excluded from statistical analysis:
County/Counties of Interest: What the Data Shows
Table 2
It is important to understand the target population for this current study. Most community profiles focus only on women age from 40-65; however, the affiliate believes this limits the study significantly and shuts the door on the young age groups. Although the risk of breast cancer is lower for women under the age of forty, there is still much to be learned about these younger populations and their knowledge of breast cancer and breast health. As a result, the following study focused in women ranging from ages 18 to 65<.
When examining the twenty-six primary counties, pertinent gaps were identified that must be addressed. First, almost forty percent (39.4%) of women over the age of forty reported not receiving a mammogram in the last twelve months. The most reported response for not receiving routine mammograms was other (15.7%).
Demographic and Breast Cancer Findings
The average incidence rates for the state of Texas range anywhere from 96.4 to 113.7 according the Centers of Disease Control and Prevention. The second gap that is the most alarming is twenty-two out of the twenty-six counties in the Greater Amarillo Affiliate area are over the highest (113.7) state average incidence rates. The affiliate should prioritize screening and support for these 22 counties: Armstrong, Donley, Briscoe, Childress, Collingsworth, Roberts, Hall, Wheeler, Carson, Gray, Swisher, Oldham, Lipscomb, Randall, Hutchison, Hemphill, Sherman, Castro, Potter, Hartley, Hansford, and Moore.
Race:
Racial disparities in breast cancer cases for all four phases were examined using data provided by Claritas Inc (2007). Once the necessary data was complied and analyzed, the results showed Caucasian women have the most consistency across all counties with all four stages of breast cancer. The results also showed African American women have a higher rate of stages 3 and 4 of breast cancer compared to the other ethnic groups. The overall results of the data helped to develop more in-depth questions regarding race that would be administered in the survey of six counties mentioned earlier. It is apparent that there are some disparities among ethnic groups; however, further research must be employed to explore these disparities.
Six Primary Counties:
A basic questionnaire was developed to attempt to fill in some of the gaps observed in the initial data analysis. The survey instrument assessed basic demographic information; as well as pertinent questions regarding access to health care and health care/breast health practices. In order to obtain the most accurate and non-biased results 525 questionnaires were sent out the six primary counties via mail. Attached in the envelope was a consent form outlining the objective of the study and a post marked return envelope. This was to ensure a high return rate of completed questionnaires. Respondents were limited on the amount of time they had to return the filled questionnaire and signed consent. Unfortunately we were only able to obtain 58 completed questionnaires. This could have been for a number of reasons; the amount of time allotted, the subject matter, not of interest, etc.
The basic demographic data showed age ranged from 26 to 86 years of age with 51 being the median age. The majority of the respondents were from Gray County (41.4%); however, Hansford (17.2%), Potter (15.5%), Randall (10.3%), Dallam (10.3%), and Carson (5.2%) produced respondents. The majority of the respondents were Caucasian (91.4%), with Hispanic (6.9%) and American Indian (1.7%) representing the rest of the total population. The respondents educational background varied with the majority have a high school diploma (46.6%), followed by Bachelors Degree (20.7%), Associates Degree (13.8%), Masters Degree (8.6%), GED (5.2%), PhD/M.D (3.4%) and No formal education (1.7%).
Findings:
This study set out to examine breast health issues in the upper twenty-six counties of the Texas Panhandle. The survey data and data provided by Claritas Inc. (2007) provided the framework for the following conclusions.
First, twenty-two out of the twenty-six counties were found to have among the highest average incidence rate of breast cancer in the state. Additionally, these rates played out in comparison with another state. As previously mentioned, Texas has a higher ratio rate for women diagnosed with breast cancer than California. Even though California is more densely populated, Texas has more breast cancer cases.
These high rates of incidence beg further examination. The study found, among those surveyed, 40% of women over forty were not receiving annual mammograms for a variety of reasons. This is only one of three recommended steps for early detection. Targeted, continued education is a clear indication for this age group.
Finally, Caucasian women are represented consistently in all four stages of breast cancer. However, African American women have higher rates of stage 3 and 4 breast cancer when compared to other ethnic groups. Targeted educational campaigns could assist in a rate reduction in this particular group.
Programs and Services
Data Source and Methodology Overview
Information for the breast cancer programs and services of the service area was collected through internet research, key informant interviews, and historical review of service providers. Information was collected at the county, city, and service area levels. After collecting all sources of breast cancer programs, staff reviewed all of the data for detailed schedules, services, program availability, and funding sources.
Information and additional sources of information were collected from the Lubbock Affiliate of Susan G. Komen for the Cure, Texas Department of State Health Services, M.D. Anderson Hospital, American Cancer Society, Harrington Cancer Center, Baptist St. Anthony’s Health System, and United Way of Amarillo and Canyon.
Programs and Services Overview
For this project, staff collected all breast healthcare providers in the twenty-six county service area and compiled the contact information. This list represents fewer providers than are usually found in a large metropolitan area and shows how important the few providers are to this large region. Because the Comprehensive Breast Center of the Harrington Cancer Center and Texas Oncology are the only providers of chemotherapy and radiation treatment for breast cancer in the Panhandle, some women may drive more than 100 miles for treatment.
Although there are a few locations for mammography and mobile mammography programs, they are scattered across the service area and may still require women to drive more than an hour for screening. The scarcity of service providers creates many problems for access to healthcare due to transportation issues and difficulty for follow-up care.
Below is a listing of all breast healthcare providers in the twenty-six counties of the Texas Panhandle:
Breast Healthcare Providers by County
County (or service area)
Program/Service Provider
Armstrong County
Coalition of Health Services Inc. Claude Medical Clinic
201 S. Park
Claude, TX 79019
(806) 226-5611
Childress
Coalition of Health Services, Inc., Fox Rural Health Clinic
Highway 83 North
Childress, TX 79201
(940) 937- 9654
Gray
Pampa Regional Medical Center-Women’s Health Clinic
1 Medical Plaza
Pampa, TX 79065
(806) 663-5663
Hall
Fox Rural Health Clinic
Highway 83 North
Childress, TX 79201
(940) 937-9654
Hansford
Family Medical Center of Hansford County
702 S. Roland
Spearman, TX 76081
(806) 659-2846
Hemphill
Hemphill County Hospital-Harrington Cancer Center Mobile Mammography
1020 S. 4th Canadian, TX 79014
(806) 359-4673
Ochiltree
Perryton Health Center
3101 Garrett Dr. Perryton, TX 79070
(806) 435-7224
Potter/ Randall (Amarillo and Panhandle region)
Texas Panhandle Family Planning Health Centers
1501 S. Taylor
Amarillo, TX 79101
(806) 372- 8746
Comprehensive Breast Center of the Harrington Cancer Center
1310 Wallace Blvd.
Amarillo, TX 79106
(806) 356-1905
Northwest Women and Children Clinic
814 Martin Rd.
Amarillo, TX 79107
(806) 342-4789
Texas Oncology
1000 S Coulter St # 100, Amarillo, TX 79106
(806) 358-8654
Northwest Texas Hospital Women’s Imaging Center
1501 S. Coulter
Amarillo, TX 79106
(806) 354-1000
Women’s Healthcare & Associates
1301 S. Coulter Amarillo, TX 79106
(806) 355-6330
Sherman
Stratford Clinic
1220 Purnell PO Box 1107 Stratford, TX 79084
Table 3
As a graphical representation of these service providers as well as incidence and mortality of breast cancer, the map below illustrates incidence of breast cancer with blue pins, mortality with red pins, and service providers with yellow pins:
Figure 3
Because of the scarcity of providers for breast healthcare, the women of the Texas Panhandle have many impediments to service. Only eleven of the twenty-six counties have service providers, so a woman is more likely to have to travel outside her county than to receive service in her home county. Mammograms are provided in Amarillo, Hereford, and Dumas only. For mammograms in other towns, women rely on the mobile mammography unit of Harrington Cancer Center (For a detailed schedule of locations, see https://secure.harringtoncc.org/fileadmin/files/forms/comprehensive_breast_center/OUTREACH_DATES_2009.pdf). For women diagnosed with breast cancer, they have only two locations for treatment, both in Potter County. This scattering of service providers mirrors the problems identified through surveys and key informant interviews: many women do not have regular mammograms which leads to higher mortality rates throughout the area.
Partnerships and Grant Opportunities
The Greater Amarillo Affiliate of Susan G. Komen for the Cure currently partners with the Amarillo Area Breast Health Coalition to fund and support the WISE (Women Inspiring, Serving, and Educating) Woman Project. This project trains selected women in low income housing communities to educate their neighbors and friends about access and use of available breast health programs. The project began in August 2008 and the first women were trained in April 2009. The project has the potential to reach hundreds of women and builds additional partnerships with American Cancer Society, American Housing Foundation, Texas Tech University Health Sciences Center (Laura W. Bush Center for Women’s Health and School of Medicine), Baptist St. Anthony’s Health System, and Harrington Cancer Center. For the project, Komen for the Cure acts as the funding source for most of the program with other partners providing staff, services, and in-kind donations. It also provides seamless services for traditionally underserved women who do not regularly receive mammograms.
Through the WISE Woman Project, a woman can receive breast health information and instruction about access to mammograms, participate in “mammogram events” to receive a Komen-funded mammogram, and then be referred to another partner for treatment and support. The project includes transportation and child care in order to remove the two most frequently cited reasons for not being able to access services.
In addition to this project, Komen Amarillo is excited about its current grantees and its increased reach across the service area. Beginning in the 2009-2010 grant cycle, the affiliate has granted funding for a project of the Texas A & M Agrilife Extension to educate older, rural women about breast health screening and funding for appropriate services. The Agrilife Extension has offices in all counties of the Panhandle and will be able to reach women who have not been served by other grants.
Another grant that is reaching across the Panhandle is being conducted by Amarillo College’s public broadcasting television station, KACV. KACV will produce and broadcast public service announcements about breast health in both English and Spanish. Because KACV’s service area mirrors Komen Amarillo’s, the affiliate sees this grant as a great way to both publicize Komen’s impact on the area and make breast health information available to all women in the Panhandle.
Other current grantees include Amarillo Girl Scouts and Harrington Cancer Center. Under the Girl Scouts’ grant one event will educate girls and women about breast cancer risk factors and early detection methods. Under the Harrington Cancer Center grant, Komen provides screening and diagnostic mammography for medically underserved women. It especially targets women who are 18-35 years old and have high risk factors for breast cancer. Because Harrington is a BCCCP provider, the center maximizes available funding by determining which funding source better serves the patient. Because BCCCP funds have been decreasing, Komen funds have become critical for providing mammograms for underserved women.
Based on current grants, Komen Amarillo is successfully attempting to reach all of its service area and women who can benefit from breast health education, programs, and services. However, the performance of the grants will determine the success of the programs. The affiliate will continue to encourage entities that serve the entire Panhandle to apply for funds. Until additional service providers can be found, Komen Amarillo hopes to continue to fund Harrington Cancer Center and its programs for low income, underserved women.
Promising Practices and Evidence-Based Programs
For this funding cycle, grantees, medical professionals, and community members attended a grant workshop hosted by the affiliate and facilitated by the National Cancer Institute; most of them have included evidence-based objectives in their grants. The affiliate has already begun to plan the workshop for 2010 and expects to conduct it yearly for existing and potential grantees. This will ensure all grantees incorporate evidence-based programs and best practices from other grantees.
The WISE Woman Project, Agrilife grant, and Harrington Cancer Center grant have strong components of objective measurement and community impact: the affiliate will know exactly how many women receive education, screening, diagnosis, and treatment.
Public Policy Perspectives
Komen Amarillo coordinates services with the BCCCP through the services of Harrington Cancer Center, the main provider of cancer screening and treatment for the Texas Panhandle. For the past few years, funding from BCCCP has been declining, so Komen Amarillo has recently allowed the Cancer Center to revise its grant to include women of all ages.
Although more than 134,000 women have been served since 1992 through the BCCCP (Dorothy Marley, BCCCP representative), only about 20,000 Texas women are served each year, reaching a mere 3% of those who are eligible for services. The director of BCCCP for Texas is Emelda Garcia. The affiliate has not built a relationship with her, but will plan to begin to coordinate with her during the next few years to improve women’s access to the BCCCP funding and services.
The affiliate has a much better relationship with all of its elected officials. The Amarillo mayor, Debra McCartt has been a regular supporter and participant in the Race for the Cure. The Executive Director has recently lobbied both state and national representatives. In January 2009, Ms. Davis met with Senator Kel Seliger and Representatives David Swinford, John Smithee, and Warren Chisum. In April 2009, she travelled to Washington, D.C. to meet with Senators Kay Bailey Hutchison and John Cornyn and Representatives Mac Thornberry and Randy Neugebaur.
The affiliate has good working relationships with state representatives and will strive to improve the relationships with its national elected officials.
Programs and Service Findings
From a thorough review of the available programs and services of the Texas Panhandle, the affiliate affirmed its understanding of the thin coverage of its service area. Many women do not have access to basic services and programs. The affiliate continues to initiate discussions with the region’s healthcare centers about grant opportunities through Komen for the Cure. During the collection of exploratory data, the researchers investigated how women accessed healthcare and what the women perceived as barriers to service.
Exploratory Data
Data Sources and Methodology Overview
The SGK data packs provided by Thomson Reuters have given an excellent insight into local cancer estimates.
There are questions that require further exploration in the overall assessment process. This additional, subjective data will be collected from surveys, focus groups and other methods identified in community data. The following are identified for further study:
· What are the barriers to services?
· What are the cultural and behavioral considerations related to health care?
· What effect does location have on services (rural vs. urban)?
· What is the best method to supplement the statistical information?
As this information is preliminary, further study will produce more conclusive results.
Exploratory Data Overview
The section of the survey dedicated to the breast health and breast cancer knowledge produced some interesting results. Of the 58 respondents 86.2% reported having easy access to medical services, 96.6 % reported having received information concerning self-breast exams, and 91.4% receiving information on breast cancer and breast health, 100% reported that mammograms are important to women’s overall health. When respondents were asked if they had ever received a mammogram (82.8%) and if they had received a mammogram in the last twelve months (60.3), an overwhelming majority reported yes. Also, almost ninety percent (87.7) of respondents reported receiving annual physical exams.
Those respondents who reported never receiving a mammogram or not receiving a mammogram in the last twelve months were asked why not: interestingly, the majority of the responded to the “other” category (26.7%), followed by to expensive/no insurance (20%), haven’t had any problems (20%), put it off/ too lazy (16.7%), didn’t know I needed it (3.3%), and never thought about it (3.3%). Those who marked the other category were given the opportunity to specify their reason here were some of the most common responses:
“Dr. suggested waiting until age 40”
“It was not due”
“Needs to be done every two years”
“Breast Feeding”
“Scared”
“Dr. Moved Away”
Exploratory Data Findings
The exploratory data collected for the community profile brought up more opportunities for research. The affiliate understands that a larger sample size would produce statistically relevant information. However, addressing the response rate to surveys will have to be improved first. The affiliate has identified barriers to services, the cultural and behavioral considerations related to health care, effect of location on services (rural vs. urban), and best methods to supplement the statistical information as topics for further exploratory research.
Conclusions
Target Area Findings
From the quantitative and qualitative data collected for the community profile, the affiliate discovered many areas of attention in the Texas Panhandle. First, twenty-two out of the twenty-six counties were found to have among the highest average incidence rate of breast cancer in the state.
These high rates of incidence beg further examination. The study found, among those surveyed, 40% of women over 40 were not receiving annual mammograms for a variety of reasons. Clearly, targeted and continued education is indicated for this age group.
Additionally, Caucasian women are represented consistently in all four stages of breast cancer. However, African American women have higher rates of stage 3 and 4 breast cancer when compared to other ethnic groups. Targeted educational campaigns could assist in a rate reduction in this particular group.
Research also confirmed the affiliate’s understanding of the thin service coverage of the area: Many women do not have access to basic services and programs. The affiliate continues to initiate discussions with the region’s healthcare centers about grant opportunities through Komen for the Cure. Barriers to service and rural versus urban access will become a priority for further investigation during the next two years.
Finally, the exploratory data helped the affiliate identify barriers to services, the cultural and behavioral considerations related to health care, effect of location on services (rural vs. urban), and best methods to supplement the statistical information as topics for further exploratory research.
Putting the Data Together
Because of the suppressed data (due to small numbers) in many of the service area counties, the affiliate removed many of the counties from further study. Additionally, the small number of service providers also limited the opportunities for further investigation. After examining incidence and mortality for available counties, the affiliate paired the service providers to counties with high incidence or mortality from breast cancer. Then, based on responses to surveys, the affiliate uncovered the recurring themes of high incidence and mortality due to limited access to services and educational needs based on the sparse service providers and few education opportunities.
Selecting Affiliate Priorities
After reviewing breast cancer statistics for the twenty-six counties of the Texas Panhandle, examining the available programs and services, and incorporating exploratory data, the affiliate has identified the following priorities for the upcoming two years:
1. Target underserved women: 10% of families fall below the poverty line, 31% of women are uninsured, and 40% of women over forty did not get an annual mammogram.
2. Focus funding in six counties: Gray, Hansford, Potter, Randall, Dallam, and Carson. These counties are home to 67% of the Panhandle’s population while also representing high incidence and counties with service providers. The counties are also adjacent to counties without service providers so the affiliate can investigate rural versus urban obstacles to service.
3. Encourage partnerships: The expected success of the WISE Woman Project and the coordination of services created by the project highlight the potential for additional partnerships. Increased partnership and coordination with the BCCCP will stretch funding dollars and ensure more women have access to screening and diagnosis.
4. Address cultural and ethnic obstacles to education, screening, and diagnosis: Although Caucasian women are more than half of the population, the minority groups of the Panhandle are expected to grow faster than the Caucasian group during the upcoming census. Caucasian women have traditionally had better access to healthcare, so emphasis on minority groups will provide data for future programs and grant opportunities.
Affiliate Action Plan
Community Partnerships
The affiliate will pursue additional community partnership opportunities and will encourage grantees to engage in partnership activities. This supports item 3 of the priority list and ensures grant funding makes the greatest impact on the community.
Existing Grant Solutions
The affiliate has already begun to address some of the issues uncovered by the community profile. The WISE Woman Project is a new partnership of both new and previous grantees working together to serve low income, minority women in two of the target counties. Also, the Texas Agrilife grant is providing education opportunities across the entire service area. Both grants provide opportunities for future best practices to address the affiliate’s priorities.
Needed Grant Opportunities
Future grant opportunities should expand existing grant work. Future grants should bring more education and screening to rural areas (like the Texas Agrilife grant), focus on serving low income and minority women (like the WISE Woman Project), or address the high incidence and mortality of the targeted counties (like all of the existing grantees). The affiliate ensures future grantees will understand and address these needs by conducting annual grant writing workshops with the help of the Cancer Information Service of the National Cancer Institute.
Public Policy Efforts
In order to improve the affiliate’s coordination with the BCCCP funding, staff will begin work with the Texas Director (or her designee) to discuss ways to improve the 3% of women who are eligible for services.
Education and Outreach
Education and outreach continue to be high priorities for the affiliate. Through both quantitative and qualitative data, the affiliate learned that women throughout the service area did not know how to access services or were ignorant of basic breast health concepts. The affiliate will continue to work for additional education opportunities: its recent hiring of a Mission Coordinator demonstrates its commitment to education. The community profile uncovered the need to address cultural and ethnic barriers to service which the affiliate will incorporate into future grant requests.
List of Figures
Figure 1: Service Area Map
Figure 2: Incidence Rates for Texas
Figure 3: Resource Map
List of Tables
Table 1: Breast Cancer Prevalence by County
Table 2: 20 Remaining Counties
Table 3: Breast Healthcare Providers by County
List of Appendices
Appendix A: Focus Group Sample Questions
Appendix B: Key Informant Interview Sample Questions
Appendix C: Survey Request
Appendix D: Consent Form
Appendix E: Key Informant Survey
Appendix F: Key Informant Interview Guide
Appendix G: Survey Scripts
Appendix H: National and Texas Breast Health Program and Service Providers
Appendices
Appendix A:
Focus Group Sample Questions
1. Do you go to the doctor regularly? Do you have a local healthcare provider?
2. Where is someone most likely to go for breast health information?
3. What does breast health screening mean to you? Do you know the recommended guidelines for breast health screening?
4. If you didn’t have insurance, what would you expect to pay for a mammogram?
5. What do you think are the barriers that prevent women from seeking or getting breast health screening in your community?
Examples if no one is responding:
a. Transportation
b. Financial/Uninsured
c. Lack of facilities/providers for your community
6. What could your doctor do to encourage women to seek breast health services?
Examples if no one is responding:
a. Reminder at each visit
b. Link you to program/service that would help pay
c. Nothing, I would need insurance first
7. What type of program could we provide to make it easier for women to access breast health services?
Examples if no one is responding:
a. Mobile Mammogram Units
b. Transportation/Vouchers
c. Awareness Campaigns
d. Helpline/Hotline (with translators)
8. Who could we partner with in your community to best get the word out about breast health to women in this community?
9. What does Susan G Komen for the Cure mean to you?
a. Do you know what we do in the Columbus Community?
Survivors
1. Did you have any difficulty finding providers/services?
2. What was the most difficult and most beneficial aspect of your breast cancer experience?
3. What programs/services would you recommend to other survivors? What advice would you give them?
4. How much did financial considerations affect your treatment decisions? Did your work schedule impact your decisions?
5. What services were missing? Support Groups, survivorship programs, after-care, etc
6. In your community, where should Komen prioritize its funding: Education, Screening, Treatment, Survivorship?
Appendix B:
Key Informant Interview Sample Questions
Key informant interviews should include five to ten questions that provide in-depth understanding to specific areas of focus. Initial scripted questions start the discussion, but the interviewer should always probe and ask more questions to clarify dialogue and get as much information as possible on the topic.
The questions created by the community profile team should always be tailored to who is being interviewed. Additionally, the questions should address the gaps in knowledge that still exist after collecting and reviewing demographic data, breast cancer statistics and program and services reports. Data collected using key informant interviews will only be as good as the questions the community profile team creates to address the real issues in the community.
When creating the questions, the team should always ask the following:
· Why do we want to know this?
· Who will be interviewed? i.e. provider, community member, etc.
· Is this going to lead to areas we can address?
· How will this inform our (grants process, marketing, education) efforts in the community?
When creating the questions, the team should remember these rules:
· Use open-ended questions
· Avoid questions that can be answered with yes or no
· Focus the questions from general to specific
The questions provided here are examples that may help the community profile team understand what types of questions to create for and ask of a key informant.
Key Informant Sample Questions (Providers)
1. How would you describe the women who are least likely to be getting regular breast health screening?
a. What neighborhoods do these women live in?
b. Where do they work?
c. What businesses do they frequent?
d. Describe their ethnic background.
e. What are their family situations like?
2. How would you describe the women who are least likely to receive effective breast health services? * see above probing questions
3. How successful is the current healthcare system in meeting the needs for breast healthcare and treatment?
4. How effective are the financial assistance programs in your community in helping women access breast health services?
5. What types of programs do you think would help to improve the current system?
6. If funding was made available, is your organization willing (alone or in partnership) to provide services that expand on existing services or address gaps in services?
7. How can organizations working in the field of breast cancer collaborate more?
8. What are some of the barriers to collaboration in your community?
9. Are there specific breast health partnerships that could be formed to address specific breast health gaps in your community?
10. What would a Komen partnership with your organization look like?
11. What laws or policies make it difficult for women to get breast health services in your community?
12. What efforts, if any, does your organization make to market breast health information in your community?
13. What policies do insurance providers follow related to clinical trial coverage in this community?
Key Informant Sample Questions (Survivorship)
1. When and where was the cancer diagnosed?
2. Were you advised of your treatment options?
3. What stage was the cancer when detected?
4. When did you begin to receive treatment?
5. What stage was the cancer when treatment began?
6. How has this affected your life – physically, financially, and emotionally?
Interviewing Tips
Use probing techniques to encourage conversation without influencing the answer. Two kinds of probes are used for open-ended questions – probing for clarity and probing for additional information.
The best probes for clarity are the ones that tell the respondent exactly what you need to know, or what you want them to do.
· For example: What do you mean? Could you be more specific? Could you tell me more about ____? Could you give me an example?
Once a clear response has been given, the interviewer can probe for additional responses to the question. The best way to do this is to repeat the main point of the question as part of a request for further information.
· For example: What else do you think? What other reason exist?
Avoid asking “is there anything else” because this can be answered with NO.
Appendix C:
Survey Request
April 9, 2009
The Greater Amarillo Affiliate of Susan G. Komen for the Cure is seeking female participants for a research study. You have been randomly selected to participate in this study. The title of this study is:
Factors in Women’s Breast Health: A Survey of Six Texas Panhandle Counties
The purpose of this exploratory, descriptive study is to examine medical and educational resources for women regarding breast cancer in six counties of the Texas Panhandle. The counties that will be explored are Carson, Dallam, Gray, Hansford, Potter and Randall.
There are few risks in participating in this study. You may feel uncomfortable about answering some of the questions in the survey instrument. You may opt out at any time and may choose to leave questions unanswered. Your participation is strictly voluntary and is confidential; there will be no way to link your answers with your name. Data will be reported in aggregate form only.
By participating in this study, you may help us generate a better understanding of what kind of problems women might face, and if their needs are being met regarding breast health and other related variables. These variables have been identified as being important and relevant to social work practice in today’s society and will help in developing new and progressive services in the Komen service area. Participation will require approximately 2-5 minutes of your time. If you agree to participate, please fill the attached survey and return it to:
In order to compile this sensitive data in an effective and efficient manner, we ask you to please return the survey in the attached envelope by April 23, 2009. Your participation in this study is greatly appreciated and we would like to say thanks on behalf of the Greater Amarillo Affiliate of Susan G. Komen for the Cure and the many fighting breast cancer.
Sincerely,
Sara Northrup, M.A., LBSW
West Texas Family and Community Services
A project of West Texas A&M University
601 W. 10th
Amarillo, Texas 79101
Appendix D:
Consent Form
Consent Form for Participation in:
Factors in Women’s Breast Health: A Survey of Six Texas Panhandle Counties
Date: _________________________
I agree to participate in the research project entitled” Factors in Women’s Breast Health: A Survey of Six Panhandle Counties”. I have read the attached informed consent form, and I understand the possible consequences of participation. I also understand that my participation is strictly voluntary and that I may withdraw my consent at any time. By signing below I certify that I am at least 18 years of age or older.
Signed:
___________________________________________________
Printed Name:
_______________________________________________
Appendix E:
Key Informant Survey
(Please mark answers with an X to indicate your responses)
1. Please indicate the current county you live in.
A. Carson____
B. Dallam____
C. Gray____
D. Hansford_____
E. Potter____
F. Randall____
2. What is your date of birth?
Month_____ Day ________Year_________
3. What is your ethnicity?
A. Hispanic/Spanish/Latino
E. Asian Indian________
B. White
F. American Indian_____
C. Black or African American______
G. Other (Specify)
D. Asian or Pacific Islander____
H. Don’t Know
4. What is your highest level of education?
A. GED____
D. Masters degree____
B. High School Diploma____
E. Ph.D.____
C. Associates degree____
F. None of these____
D. Bachelors degree____
5. Is it easy for you to access medical services?
A. Yes____
B. No_____
(If answered Yes, skip to question 7)
6. If No, why not?
(Please check all that apply)
A. Transportation___
B. Financial Troubles___
C. No child care_______
D. No support system_____
E. Other____________
7. Have you ever received information on self-breast exams?
A. Yes____
B. No____
8. Have you ever received information about breast cancer/breast health?
A. Yes____
B. No____
(If answered Yes, skip to question 10)
9. If No, why not?
(Check all that apply)
A. No reason/Never thought about it____
E. Don’t know how____
B. Didn’t know I needed it______
F. The test is unpleasant______
C. Haven’t had any problems______
G. Not important____
D. Put it off/Laziness______
10. Do you have a family history of breast cancer?
A. Yes____
B. No_____
11. How much do you know about breast health/preventative health?
A. Nothing at all___
B. Only a little____
C. More than most____
D. A great deal____
12. Have you ever received information about breast cancer/breast health?
A. Yes_____
B. No______
13. Do you think mammograms are important to your overall health?
A. Yes_____
B. No______
14. Have you ever been/currently diagnosed with any form of cancer?
A. Yes_____
B. No______
(If answered No, skip to question 16)
15. If so, which type?
A. Lung_____
B. Breast_____
C. Colon_____
D. Rectal _____
E. Prostate_____
16. Have you ever had a mammogram?
A. Yes____
B. No_____
(If answer No, skip to question 18)
17. Have you had a mammogram in the last 12 months?
A. Yes______
B. No______
(If answer Yes, skip to question 19)
18. Why not?
(Please check all that apply)
A. No reason/Never thought about it____
E. Too Expensive/No Insurance____
B. Didn’t know I needed it______
F. The test is unpleasant______
C. Haven’t had any problems______
G. No transportation_______
D. Put it off/Laziness______
H. Other_______________
19. Do you receive annual clinical exams?
A. Yes______
B. No______
(If answered Yes, you are finished with the survey!)
20. Why not?
(Please check all that apply)
A. No reason/Never thought about it____
E. Too Expensive/No Insurance____
B. Didn’t know I needed it______
F. The test is unpleasant______
C. Haven’t had any problems______
G. No transportation_______
D. Put it off/Laziness______
H. Other______________
THANK YOU FOR YOUR PARTICIPATION.
Appendix F:
Key Informant Interview Guide
Hello, my name is ______________. May I speak with your clinic manager? I am calling with Susan G. Komen for the Cure. We are working on a project to collect information about breast health education and resources in the Texas Panhandle. We are contacting you because you are a clinic manager and we would like to ask if you would be willing to answer a few questions about your clinic that will help us determine our future funding priorities. It is less than 15 minutes long and would provide essential information that will help our community address breast health. Would you be willing to help with our project?
The first questions I am going to ask you are about breast health education at your clinic.
1) Where are the women you serve likely to go for breast health information?
(You may select more than one option.) (do not read options )
Healthcare providers
Community advocacy group
Online
Printed material such as books or pamphlets
Friends/Family
Other: Please list ______________________________
2) Do you provide breast health education materials through your organization?
No
Yes
Unsure
3) Do you serve a non-English speaking population at your site that would benefit from breast health messages and services?
No (skip to question 7)
Yes
4) Do you provide non-English breast health education materials?
No
Yes (skip to question 5)
Unsure
4a) Do you know where you can access non-English materials if you should need them?
No
Yes
5) I am going to read you a list of languages that patients in your clinic may speak. For each,
please say yes or no to indicate whether your clinic would have a need for breast health education resources in that language.
Spanish Yes No Unsure
Russian Yes No Unsure
Hmong Yes No Unsure
Somali Yes No Unsure
Other: Please list _____________________?
6) Does your site currently use interpreters to provide breast health education in other languages?
No, we are not able to provide interpreters for breast health education in other languages
No, we do not have a need for interpreters to provide breast health education
Yes, we use interpreters to provide breast health education
Unsure
7) I am going to read a list of women that are often targeted for breast health education. Please tell us if your organization targets these populations for breast health education.
women 50 years old and older Yes No Unsure
40 to 49 year old women Yes No Unsure
18 to 39 year old women Yes No Unsure
Women in racial groups that are at high risk for breast cancer Yes No Unsure
Women in ethnic groups that are at high risk for breast cancer Yes No Unsure
Everyone gets materials Yes No Unsure
7a) What populations of women come into your clinic that you believe would benefit from being targeted with additional breast health education or screening services?
___________________________________________________________________________
___________________________________________________________________________
7b) I am going to read you a list of types of health care providers. Please respond to each by telling me if that type of provider offers breast health education at your site.
Physicians Yes No Unsure
Physician assistants Yes No Unsure
Master’s level prepared nurses Yes No Unsure
RNs Yes No Unsure
Community health workers Yes No Unsure
Other, please specify: _______________________________________________
The next questions I am going to ask relate to screening and diagnostic services that are available at your clinic.
9) Do the providers in your organization provide breast screening and diagnostic tests?
No (skip to question 12)
Yes
Unsure (skip to question 12)
9a) Breast health screenings include mammograms and clinical breast exams. I am going to read you a list of types of health care providers. Please respond to each by telling me if that type of provider offers any breast health screenings at your site.
Physicians Yes No Unsure
Physician assistants Yes No Unsure
Master’s level prepared nurses Yes No Unsure
RNs Yes No Unsure
Radiologists Yes No Unsure
Other, please specify: _______________________________________________
10) Please choose the statement that best describes how your clinic prioritizes breast cancer screening and education?
Our clinic addresses breast health at every well woman visit regardless of any other issues that are addressed.
We address breast health at well woman visits if there is not a more prominent concern based on the patient’s medical history.
We address breast health at well woman visits only when there is a specific concern about this issue.
11) Does your organization have formal policies that require providers to conduct clinical breast exams on women during their well woman visits?
No
Yes
Unsure
12) Does your organization provide referrals to other clinics if a woman needs breast health screening and education services that are not available at your site?
No
Yes
Unsure
12a) I am going to read a list of barriers that may prevent women from seeking or obtaining breast health services. Please tell me if you perceive the issue to be a barrier for women in your community.
Income Yes No Unsure
Patients are uninsured Yes No Unsure
Patients are under-insured Yes No Unsure
Transportation Yes No Unsure
Fear Yes No Unsure
Other: Please list ___________________
13) What do you think would help improve the delivery of breast health services in the current healthcare system?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
14) Is your clinic able to provide breast cancer screening services to women with disabilities (i.e. mammography capacity for wheelchair bound women)?
No
Yes
Unsure
The next few questions ask about how women pay for services at your clinic.
15) I am going to read a list of ways people pay for health services. Please tell me if patients at your clinic use the following method to pay for breast health services.
PPO private payer insurance Yes No Unsure
HMOs Yes No Unsure
Public (govt.) insurance Yes No Unsure
Other, please list: _________________________________
16) Does your site offer any type of financial assistance for uninsured, underinsured or low income clients?
No (skip to question 19)
Yes
Unsure (skip to question 19)
17) Please respond yes or no to indicate whether your site provides each service in the list to income qualifying women.
Reduced price mammograms Yes No Unsure
Reduced price appointments including clinical breast exams Yes No Unsure
Free mammograms Yes No Unsure
Free appointments including clinical breast exams Yes No Unsure
Referrals to sources that provide
free/reduced price mammograms/appointments Yes No Unsure
Other, please list: ______________________________________________
18) What is the income threshold for patients to be eligible for those services? Patients must be…
Below the federal poverty line
Between 100% and 200% of the poverty line
Between 200-250% of the poverty line
Unsure
Other, please list: __________________________________________________
19) Do you know of other organizations in your community that offer financial assistance to uninsured or under-insured women for breast health services?
No (skip to question 20)
Yes
19 a) Please list them _______________________________________________
________________________________________________________________________
My final questions today are about partnerships that some organizations are able to form to address breast health needs in the community.
20) Do you presently partner with any other local organizations in providing breast health services to women in your community?
No (skip to closing)
Yes
Unsure (skip to closing)
20a) Please list partnering organizations and describe the partnerships
Organization Type of partnership
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Closing: Thank you for your time and valuable feedback. We greatly appreciate your participation.
Appendix G:
Survey Scripts
The survey introduction serves several purposes:
· Helps establish the nature of the relationship between the interviewer and the respondent.
· Establishes a context for the questions and the respondent’s answers.
· Establishes credibility.
· Provides an incentive for the respondent. The incentive is often the feeling the respondent has in cooperating and knowing that their contribution will help lead to a better community.
The introduction should include:
· An introduction to interviewer and organization behind project
· A statement of purpose
· A thank you statement
· An explanation of the importance of respondent’s input
· A confidentiality statement and
· An overview of how data will be used
Sample Phone Script
Hello, I'm ______ calling on behalf of Susan G Komen for the Cure. We are doing a survey and are asking questions about breast cancer services and your community. The information provided will be used to help Susan G Komen for the Cure’s local office to create a community profile report which will then inform the work we do in the community. Your name and number was obtained (describe how person/organization was chosen). Because you are a community leader and involved in breast cancer we feel your input is valuable and should be included in our report.
Your responses are completely confidential and will only be viewed by the community profile team that is helping us create the community profile report. You don't have to answer any question you don't want to, and you can end the interview at any time. The interview takes about (estimate time). Please feel free to ask any questions you have as we go through the survey and if there is something that I can’t answer today, I will provide you the phone number and email address of the contact person at Susan G Komen for the Cure.
Begin Scripted Survey Questions
Sample In-Person Script
Hello, I'm ______ working with Susan G Komen for the Cure on the community profile project. Thank you for meeting with me today to complete this survey on breast cancer in our community. The information you provide will be used to help Susan G Komen for the Cure’s local office create a community profile report which will then inform the work we do in the community. Your input will help us determine our community’s priorities as they relate to breast cancer and help us determine how our money is best granted, what outreach and advocacy we should be focusing on and in general what areas of focus we need to be aware and involved in. Your name and number was obtained (describe how person/organization was chosen). Because you are a community leader and involved in breast health we feel your input is valuable and should be included in our report.
Your responses are completely confidential and will only be viewed by the community profile team that is helping us analyze the data and put together the community profile report. You don't have to answer any question you don't want to, and you can end the interview at any time. The interview should take about (estimate time). Please feel free to ask any questions you have as we go through the survey and if there is something that I can’t answer today, I will provide you the phone number and email address of the contact person at Susan G Komen for the Cure.
Begin Scripted Survey Questions
Appendix H:
National and Texas Breast Health, Program, and Service Providers
County
Provider
Address
Town
Phone #
Website
Screening
Armstrong
Coalition of Health Services Inc.
201 S. Park
Claude, TX 79019
806-226-5611
Childress
Coalition of Health Services, Inc., Fox Rural Clinic
Highway 83 North
Childress, TX 79201
940-937-9654
Childress Regional Medical Center
PO Box 1030
Childress, TX 79201
940-937-6371
Gray
Pampa Regional Medical Center
1 Medical Plaza
Pampa, TX 79065
806-663-5509
signaturehospital.com
Hutchinson
Golden Plains Community Hospital
200 South McGee
Borger, TX 79007
806-273-1220
Moore
Moore County Hospital District
224 East 2nd St
Dumas, TX 79029
806-935-7171
Ochiltree
Perryton Health Center/ Ochiltree General Hospital
3101 Garrett Dr.
Perryton, TX 79070
806-435-7224
Potter/Randall
Texas Panhandle Family Planning Health Clinic
1501 S. Taylor
Amarillo, TX 79101
806-372-8746
The Don and Sybil Harrington Cancer Center
1500 Wallace Blvd
Amarillo, TX 79106
806-356-1905
Harringtoncc.org
Women's Healthcare Associates
1301 S. Coulter, suite 300
Amarillo, TX 79106
806-355-6330
Comprehensive Breast Center of the Harrington Cancer Center
1310 Wallace Blvd.
Amarillo, TX 79106
806-356-1905
secure.harringtoncc.org
Texas Diagnostic Imagine Center
1000 Coulter
Amarillo Tx 79106
806-358-1010
Northwest Texas Hospital
1501 South Coulter Rd
Amarillo, TX 79106
806-354-1703
Coulter Imaging, LLC
1900 S. Coulter, Suite N
Amarillo, TX 79106
806-358-7149
Amarillo Family Physicians Clinic, PA
suite 100 South 1215 South Coulter
Amarillo, TX 79106
806-354-1703
Amarillo Diagnostic Center
6700 West Ninth
Amarillo, TX 79106
806-358-0228
Northwest Women and Children Clinic
814 Martin Rd.
Amarillo, TX 79107
806-342-4789
Sherman
Stratford Clinic
1220 Purnell PO Box
Stratford, TX 79084
806-396-2852
Treatment
Comprehensive Breast Center
1310 Wallace Blvd.
Amarillo, TX 79106
806-356-1905
Texas Diagnostic Imagine Center
1000 Coulter
Amarillo Tx 79106
806-358-1010
Education
Susan G Komen for the Cure Greater Amarillo Affiliate
PO Box 50610
Amarillo TX 79159
806-354-9706
The Don and Sybil Harrington Cancer Center
1500 Wallace Blvd
Amarillo, TX 79106
806-356-1905
Harringtoncc.org
Comprehensive Breast Center of the Harrington Cancer Center
1310 Wallace Blvd.
Amarillo, TX 79106
806-356-1905
Amarillo Area Breast Health Coalition
301 S. Polk St., Suite 740
Amarillo, TX
806-331-4710
aabhc.org/
American Cancer Society
3915 Bell St
Amarillo, TX 79109
806-353-4306
cancer.org
National Education
National Breast Cancer Coalition
800-622-2839
natlbcc.org
Women's Cancer Network
312-644-6610
wcn.org
Young Survival Coalition
212-916-7667
youngsurvival.org
M.D. Anderson Cancer Center
800-345-6324
American Cancer Society
800-227-2345
cancer.org
Susan G. Komen for the Cure
877-465-6636
komen.org
National Cancer Institute
800-4Cancer
Cancer.gov
Project Aware
project-aware.org
Cancer Treatment Centers of America
800-268-0768
Cancer Care
800-813-4673
U.S. Department of Health & Human Services
hhs.gov
Breast Cancer Network of Strength
Medicine World
Texas Education
Texas Cancer Data Center
txcancer.org
Texas Department of State Health Services
dshs.state.tx.us
Texas Cancer Information
texascancer.info
Texas Department of Health
888-963-7111
tdh.state.tx.us
Texas Oncology
Mobile Mammograms
Hemphill County Hospital
1020 South Fourth
Canadian TX
806-323-6422
Clarendon Church of Christ
301 Carhart
Clarendon, TX
806-874-2495
Coon Memorial Hospital
1411 Denver Avenue
Dalhart, TX
806-246-4571
Medical Center of Dimmitt
300 W. Halsell
Dimmitt, TX
806-647-2194
Plains Memorial Hospital
310 West Halsell Box 278
Dimmitt, TX
806-647-2191 ext. 14
Parmer County Hospital
1307 Cleveland
Friona, TX
806-250-2754
www.pcchtx.com
Hereford South Plains Health Provider
110 N. 25 Mile Ave. Suite A
Hereford, TX
806-364-7688
Hansford County Hospital
707 S. Roland
Spearman, TX
806-659-2535
Swisher Memorial Hospital
539 Southeast Second
Tulia, TX
806-995-3581
Parkview Hospital
901 Sweetwater Street
Wheeler, TX
806-826-5581
Support
Transportation
American Cancer Society/ Road to Recovery
3915 Bell St
Amarillo, TX 79109
877-227-1618
www.cancer.org
Panhandle Community Services- Panhandle Transit
1309 W. 8th
Amarillo, TX 79120
806-372-2531
Medicaid Transportation
877-633-8747
Jan Werner Transit
3108 S Fillmore
Amarillo, TX 79110
806-374-5516
Housing
Ronald McDonald House of Amarillo
1501 Streit
Amarillo, TX
806-358-8177
Circle of Friends Apartments
American Cancer Society
3915 Bell St
Amarillo, TX 79109
806- 353-4306
www.cancer.org
Support Groups
The Don and Sybil Harrington Cancer Center
1500 Wallace Blvd
Amarillo, TX 79106
806-356-1905
www.Harringtoncc.org
Pathways
On-going support group
Journeys
2nd Monday of each month
5:30-7:00 PM
Amphitheater, 2nd floor
Women in Touch
3rd Monday of each month
5:30-7:00 PM
Amphitheater, 2nd floor
Dialogue
Thursdays
noon-1:00 PM
Amphitheater, 2nd floor
Radiation Therapy Class
Tuesdays
9:00-11:30 AM
Pampa Area Cancer Support Group
100 W 30th Ave
Pampa, TX 79065
806- 663-5566
www.prmctx.com
4th Tuesday
6:00 PM
Pampa Regional Medical Center Cafeteria
Hereford Regional Medical Center
801 E. 3rd St
Hereford, TX 79045
806-364-2141
2nd Monday of each month
6:30-7:30
806-364-2121 ext 3370
Breast Cancer Support
www.Bcsupport.org
Network of Strength
2BME
www.2bme.org
Anderson Network
800-345-6324
www.mdanderson.org
Medicine World
Texas Oncology
Susan G. Komen
www.komen.org
Mastectomy Products
Advanced Limb and Brace
1900 S Coulter St # E
Amarillo, TX 79106
806-351-1775
The Woman's Personal Health Resource Inc.
877-463-1343
Breast Forms
800-734-1886
www.Breastform.com
Nearly You Mastectomy Products
866-722-6168
www.nearlyyou.com
Tender Loving Care
800-850-9445
www.tlcdirect.org
Me Again Breast Prosthesis Boutique
Amarillo, TX
806-358-7851
Wigs
Feke Wigs
www.fekewings.com
Best Wig Outlet
www.bestoutlet.com
Hairpieces for Women
www.headcovers.com
Affordable Wigs
1201 Buchanan Street
Amarillo TX 79107
806-372-3541
Evilene's Wigs & Accessories
3701 Plains Blvd
Amarillo TX 79102
806-331-4247
G-Bob's Wigs
3801 Olsen Blvd
Amarillo TX 79109
806-352-1601
Merle Norman Cosmetics
3440 Bell St.
Amarillo, TX 79109
806-352-1022
American Cancer Society
3915 Bell St
Amarillo, TX 79109
877-227-1618
www.cancer.org
Hair Club for Men & Women
6900 West Interstate 40
Amarillo, TX 79106
806-353-4247
Financial Assistance
AVONCares Program for Medically Underserved Women
800-813-4673
www.cancercare.org
National Cancer Institute
www.cancer.gov
Coverage for All-Healthcare Coverage
800-234-1317
www.coverageforall.org
University Medical Center
806-775-9045
Medicaid Hotline
800-422-6237
www.cms.hhs.gov
Medicare Hotline
800-633-4227
Patient's Advocate Foundation's Co-Pay Relief Program
866-512-3861
Health Well Foundation Financial Assistance
800-675-8416
Partnership for Prescription Assistance
888-477-2669
www.pparx.org
Prescription Assistance for Drug Companies
Abbott Laboratories Prescription Assistance
800-444-4106
www.abbott.com
Astra Zeneca Prescription Assistance
800-292-6363
www.astrazeneca.com
Aventis Sanofi-Aventis Prescription Assistance
888-477-2669
www.sanofi-aventis.us
Bayer Prescription Assistance
800-998-9180
www.bayer.com
Biogen Idec Prescription Assistance
800-456-2255
Boehringer Ingelheim Prescription Assistance
800-556-8317
Bristol-Meyers Squibb Prescription Assistance
212-546-4000
www.bms.com
Forest Laboratories Prescription Assistance
800-951-07