Florida State initiative steers rural women toward breast cancer screening

Mia Liza A. Lustria

Women in Gadsden and Wakulla counties can now sign up for a new program offered by The Florida State University and Tallahassee Memorial Healthcare Cancer Center that is designed to increase breast cancer screening and improve access to cancer-care resources for patients in rural areas.

STEER, or System for Tracking, Empowering, Equipping and Reminding, offers an automated health-care notification system that alerts participants to medical appointments and provides them with information about community resources that can help them overcome barriers to keeping appointments, such as transportation, insurance and child-care problems.

Women who participate in the program also will be tracked on how well the alerts affected their treatments and, ultimately, their health.

The project was initiated by Florida State's College of Communication and Information. Assistant Professor Mia Liza A. Lustria, the project director, believes the system will help rural health-care providers give more timely referrals, empower patients to become active participants in their health-care decisions and better track patients at risk. It also will enhance the understanding of how health information technology systems can improve access among underserved populations and reduce disparities in levels of care.

"Similar programs in urban areas have succeeded in increasing screening rates and patient adherence to screening appointments," Lustria said. "In rural settings, people have different health-care challenges."

National Cancer Institute research has shown that rural women, especially those who are of low socioeconomic status, less educated and non-white, have far less access to cancer services and are less likely to have had a mammogram than urban women. Florida ranks third in the United States for the total number of new cases and deaths from breast cancer. Nearly 1 million women in Florida over 40 have never had a mammogram.

Compared to urban women, rural women experience longer delays in recognizing symptoms and in seeking medical help. Perceived barriers to treatment and a lack of reminders from physicians have hindered regular mammography screening, according to Lustria.

The team, which includes researchers from the College of Medicine as well as the College of Communication and Information, conducted focus groups with breast cancer patients as well as health practitioners in Wakulla and Gadsden counties to identify patients' information needs and barriers to care. The team found that the most common barriers for rural women are a lack of transportation and financial or insurance issues. For the majority of these patients, the closest mammography center is 20 to 50 miles from their homes.

To help address these issues, the team has developed a directory that includes a list of local and national resources and support programs, such as transportation and child care, currently available to disadvantaged women.

"This project is one of many health-related initiatives that the college is involved in to improve health-care access and quality in the Big Bend region and across the state," said Ebe Randeree, assistant dean for undergraduate studies at the College of Communication and Information.

Female residents of Gadsden and Wakulla counties who are 40 or older and who have not had a routine mammogram in the past two years can call (850) 644-6237 to determine their eligibility for the STEER program. Eligible individuals can earn up to $20 in gift cards for their participation in STEER.