Focus Area: Screening Policies, Procedures, and Practices within Health Facilities
Breast Cancer Screening Change Package
The screening policies, procedures, and practices within health facilities focus area includes tools and resources to assess the status of cancer screening, make cancer screening a priority, reduce structural barriers, and use data to identify patients due for screening and opportunities to improve cancer screening rates within a clinical setting or system.

- Change concepts are “general notions that are useful for developing more specific strategies for changing a process.”1
- Change ideas are evidence-based or practice-based “actionable, specific ideas or strategies.”1
- Each change idea is linked to tools and resources that can be used or adapted to improve cancer screening.
Notes
- Tools and resources with a symbol may contain some information that does not reflect the current US Preventive Services Task Force (USPSTF) recommendations for breast cancer screening.
- Tools and resources with a symbol are patient resources.
See a list of acronyms used in this change package.
- Make cancer screening a priority.
- Implement population management strategies for all eligible patients.
- Establish standard operating procedures for screening.
- Use risk assessment tools and follow-up.
- Practice patient education, communication, and shared decision making.
- Implement patient and provider reminder systems.
- Reduce structural barriers in the health care setting.
Change Concept: Make cancer screening a priority.
Tools and Resources, by Change Idea
- Jackson A, Chan K, 2019 — Increasing Breast Cancer Screening Rates in Difficult-to-Engage Patients [PDF-185KB] [journal supplement]
- HRSA — UDS Clinical Quality Measures 2022 [PDF-2.9MB], page 2–3
- Jackson A, Chan K, 2019 — Increasing Breast Cancer Screening Rates in Difficult-to-Engage Patients [PDF-185KB] [journal supplement]
- The Primary Care Coalition of Montgomery County — Breast Healthcare Improvement in the Safety-Net: Change Package Rapid Innovation to Improve Outcomes [PDF-2.9MB], pages 12–15
Change Concept: Implement population management strategies for all eligible patients.
Tools and Resources, by Change Idea
- ACS — Cancer Facts and Figures for African American/Black People 2022–2024 [PDF-8.5MB]
- ACS — Cancer Prevention and Early Detection Facts and Figures 2022 [PDF-2.8MB], (tables and figures only) pages 32–33
- CDC — United States Cancer Statistics: Data Visualizations Tool (see Screening and Risk Factors tab)
- NACHC — Value Transformation Framework: Cancer Screening [PDF-618KB], page 5
- BMC and AVON Foundation for Women — The Boston Medical Center Patient Navigation Toolkit 1st edition [PDF-807KB], pages 10–19
- Evidence-Based Cancer Control Programs (EBCCP) — Friend to Friend, see Program Materials: Training Manual, page 3-1
- Kobetz E, Menard J, Barton B, Pierre L, Diem J, Auguste PD, 2009 — Patnè en Aksyon: Addressing Cancer Disparities in Little Haiti Through Research and Social Action, see Rapid Assessment Survey Questions [full text available]
- CDC — United States Cancer Statistics (USCS): Data Visualizations Tool
- NIH, NCI, and CDC — State Cancer Profiles Interactive Maps
Change Concept: Establish standard operating procedures for screening.
Tools and Resources, by Change Idea
- Jackson A, Chan K, 2019 — Increasing Breast Cancer Screening Rates in Difficult-to-Engage Patients [PDF-185KB], page 5 [journal supplement]
- Smalls TE, Heiney SP, Baliko B, Tavokoli AS, 2019 — Mammography Adherence: Creation of a Process Change Plan to Increase Usage Rates [full text available for purchase]
Change Concept: Use risk assessment tools and follow-up.
Tools and Resources, by Change Idea
Change Concept: Practice patient education, communication, and shared decision making.
Tools and Resources, by Change Idea
- GW Cancer Center — Guide for Patient Navigators: A Supplement to the Oncology Patient Navigator Training: The Fundamentals [PDF-2.7MB], pages 83–88
- Kunneman M, Montori VM, Castaneda-Guarderas A, Hess EP, 2016 — What Is Shared Decision Making? (and What It Is Not)
- ASCO — Mammogram
- Jackson A, Chan K, 2019 — Increasing Breast Cancer Screening Rates in Difficult-to-Engage Patients [PDF-185KB]
- NCI — Understanding Breast Changes: A Health Guide for Women [information booklet]; also available in Spanish
- WPSI — Well-Woman Chart [English and Spanish]
- GW Cancer Center — Health Equity Toolbox: Resources to Foster Cultural Sensitivity and Equitable Care for All [PDF-386KB]
- GW Cancer Center — Practice Patient-Centered Care Posters
- Jackson A, Chan K, 2019 — Increasing Breast Cancer Screening Rates in Difficult-to-Engage Patients [PDF-185KB] [journal supplement]
- GW Cancer Center — Practice Patient-Centered Care Posters
- ACS — Tips for Getting a Mammogram [English and Spanish]
- CDC — What Is a Mammogram? [English and Spanish]
Change Concept: Implement patient and provider reminder systems.
Tools and Resources, by Change Idea
- NIHB — Health Systems Improvement Toolkit: A Guide to Cancer Screenings in Indian Country [PDF-4.2MB], pages 15 and 21–24
Change Concept: Reduce structural barriers in the health care setting.
Tools and Resources, by Change Idea
- Centers for Medicare and Medicaid Services — Accountable Health Communities Model [social needs screening tool]
- Mobile Healthcare Association — Special Interest Group – Mobile Mammography
- President’s Cancer Panel — Closing Gaps in Cancer Screening: Connecting People, Communities, and Systems to Improve Equity and Access [PDF-14MB], pages 3 and 17–19
- BMC and AVON Foundation for Women — The Boston Medical Center Patient Navigation Toolkit 1st edition [PDF-807KB]
- Evidence-Based Cancer Control Programs (EBCCP) — Kukui Ahi (Light the Way): Patient Navigation – Addressing Barriers Worksheet; Implementation Guide
- GW Cancer Center — Guide for Patient Navigators: A Supplement to the Oncology Patient Navigator Training: The Fundamentals [PDF-2.7MB]
- GW Cancer Center — Together, Equitable, Accessible, Meaningful (TEAM) Training [CEU course, free, registration required]
- NIHB — Health Systems Improvement Toolkit: A Guide to Cancer Screenings in Indian Country [PDF-4.2MB], pages 25–26
- Smalls TE, Heiney SP, Baliko B, Tavokoli AS, 2019 — Mammography Adherence: Creation of a Process Change Plan to Increase Usage Rates [full text available for purchase]
- Juckett G, Unger K, 2014 — Appropriate Use of Medical Interpreters
- The Community Guide — Cancer Screening: Reducing Structural Barriers for Clients – Breast Cancer
- BMC and AVON Foundation for Women — The Boston Medical Center Patient Navigation Toolkit 1st edition [PDF-807KB], pages 5–19
- Evidence-Based Cancer Control Programs (EBCCP) — Kukui Ahi (Light the Way): Patient Navigation – Facility Tour Worksheet
Reference
1Centers for Disease Control and Prevention. Tobacco Cessation Change Package. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2019.