By Phil Manning, Client Services Supervisor, BreastCheck Southern Unit
We recently worked with our community champions to support Ukrainian women to come for breast screening. This was a pilot initiative to support our work to improve access to BreastCheck and to improve equity in screening.
Background
Our Community Champions project provides training to community health workers to support people in their community to take part in screening.
Following the delivery of training, some of our community champions in Cork contacted our health promotion team to ask if we could assist them in supporting Ukrainian women to attend BreastCheck for breast screening. This included a HSE community worker and three Ukrainian integration support workers.
What we did
We put together a project team to work with our partners in the community. This included staff from our BreastCheck Southern Unit in Cork including administration staff, our appointment scheduler, client services supervisor, our radiographer services manager and radiographers; our health promotion team; translators; and our community champions.
We listened to feedback and answered questions from our champions from the work they were doing in their communities with Ukrainian women. This helped us to identify the barriers to screening for these women.
These included:
- not being on the BreastCheck register to get an appointment for screening
- difficulties understanding the appointment letter
- potential changes of address at short notice and not getting the appointment letter
- language barriers
- transport to get to the appointment.
We worked together to develop a plan and put supports in place to address these barriers.
How we did it
- Our community champions gathered information from eligible Ukrainian women who were interested in attending for breast screening.
- We registered all women who were not already on our database.
- We updated details for women who were already registered.
- We prepared and printed information in Ukrainian including our consent form, our breast screening information booklet, results information, and signage in our BreastCheck unit for our mammogram rooms.
- We set aside a 3-hour period over three mornings to allow for block booking of appointments for these women, ensuring that we had enough radiography staff on duty on those days.
- We worked with our community champions to make sure women had access to transport on the days and times of their appointments including public transport. A bus was organised for one group of women.
- We booked a translator for the screening dates (and for any follow-up appointments needed). The Ukrainian integration support workers also helped with translations. Translators worked with individual women and with small groups of women.
- We sent the appointment letters and translated resources.
- We briefed and prepared all staff in the unit on a suitable workflow for these screening sessions.
- We provided guidance to our community champions regarding next steps in relation to results letters, any recalls to assessments, and follow-ups needed if results letters were returned.
Outcomes
- 39 Ukrainian women from three accommodation centres were screened over three separate screening sessions.
What we learned
- On the first screening day, some women did not bring their translated consent forms with them to the appointment. This slowed the process down at check-in. We adapted for the other screening days, making sure we had translated consent forms printed, more time for women to read them, and translators available to go through them with women who needed it.
- Some women could not be screened on the day as they had a previous mammogram in last 12 months. We briefed our community champions about why it is important to communicate this to women and why it is important for us to know this in advance of screening, so that they could bring this information back to their communities.
- When screening sessions were held on the same day as assessment and results clinics, it took more management of people coming into the building for appointments. We will adjust future sessions around the most suitable days for screening.
- Some results letters were returned due to change of addresses. We followed up with our community champions to get up-to-date information to allow the results letters to be sent to the correct addresses.
- Some women did not know who their GP was. This is needed when a recall to assessment or further treatment is indicated. We were able to link in with GP practices to confirm if women were registered there.
Next steps
- We will share our learnings with our other BreastCheck units, communities and screening programmes.
- We will consider this project model for other BreastCheck locations, including our mobile units.
- We will continue to work with our community champions and are looking into the possibility of supporting other communities who experience barriers to attend breast screening.
Working with our community champions helped us to break down barriers and provide access to breast screening for women who are often more difficult to reach. This is a valuable partnership in helping to improve equity in screening. Everyone played an important role in the success of the project and we were proud to pilot the initiative in Cork.
Speaking about the project, one of our community champions, Tania Baliukonis, who works as an Information and Support Officer with Nasc, the Migrant and Refugee Rights Centre, said: “It was a pleasure working with the staff at the BreastCheck unit. Everything was so well organised, and they were incredibly kind and accommodating. They paid attention to every detail, including ensuring that a translator was present at the clinic at the appointed times, which made a big difference for the Ukrainian women attending. You could see they really cared and wanted to make everyone feel comfortable and supported.”