By Addie Backlund, March 2012
The American-Italian Cancer Foundation (AICF) provides mobile, no-cost breast cancer screening services for economically disadvantaged, medically underserved women, age 40 and over, in New York City's five boroughs. These women reside in neighborhoods with high poverty rates, low screening rates, and high incidences of breast cancer and are fearful, ambivalent, or distrustful of the health care system; 59% are uninsured. The majority would not be getting screened for breast cancer, were it not for our convenient service and proactive, personalized approach to patient outreach.
Recently, a young Latino woman saw a flyer in the neighborhood and scheduled a screening with AICF for her mother, a breast cancer survivor, who was afraid to be screened at the doctor's office for fear of learning that the cancer had come back. The daughter took the mother for a walk to where AICF's mobile clinic was parked and before her mother had time to think about it, she was screened for breast cancer. Both mother and daughter were relieved.
A Russian woman in her fifties was contacted by AICF to schedule an appointment. She had never had a mammogram, did not have health insurance, and was concerned about what it might cost. When we explained there would be no out-of-pocket cost, she replied, "In my country, no one helps you if you are sick. I am not even a citizen of this country, yet you care about me enough to help me find out if I am well or not. This is why everyone wants to come to America."
AICF's patient navigator spent 45 minutes on the telephone, convincing one woman to make an appointment. The woman was terrified of getting a mammogram because she said it would be too painful. The patient navigator replied, "The treatment for breast cancer is a lot more unpleasant than any discomfort you may experience by getting a mammogram." The woman finally agreed to schedule the appointment. AICF promotes its screening days in English, Spanish, Chinese, Bengali, Russian, Korean, and Haitian Creole, and through local media. We screen approximately 5,000 women annually at 20 sites per month. On February 27, 2012, AICF staff attended the inaugural meeting of the NYC/Metro Area Mobile Health Clinics Coalition, hosted by the Mobile Health Clinics Network. This was a terrific opportunity to learn about other mobile health programs and discuss challenges. Subcommittees will be formed to address the needs of underserved populations, share information on equipment maintenance, and broaden awareness among elected officials in terms of the gap mobile health programs fill in expanding access.