Clinic Staff Boosts Cancer Screening Efforts in Kaw Nation

The tribal-run White Eagle Health Center plays an important role in the Ponca Nation community in rural Oklahoma. It offers health care that respects Native culture and traditions. However, the clinic was struggling to improve its breast cancer screening rates.

Although the mobile mammography unit run by the Kaw Women’s Health Program visited the clinic regularly, few women made appointments to get screened. And more than half of those who did make appointments didn’t show up. Clinic staff noted that the same patients set up appointments month after month, but never came. They also reported that the number of women who received clinical breast exams was low.

To address these problems, the staff of the Kaw Women’s Health Program looked for ways to work with the White Eagle clinic staff to improve their screening practices and increase rates. For example:

• Kaw program staff created a colorful information sheet with details about breast cancer screening. The sheets were posted by the telephone to remind clinic staff about the screenings when they answered calls and made other appointments.
• Kaw program staff talked with clinic staff about what was required of them to maintain federal funding for breast cancer screening. Low screening rates would have a negative effect on their program.
• White Eagle staff made a list of patients who met the criteria for breast cancer screening but had not been screened. They also made a list of local women who had not visited the clinic in at least 5 years.
• Staff from both organizations met to brainstorm other ways to increase breast cancer screening rates.

“The staff at White Eagle have been more approachable and now take an interest in helping to schedule our patients. The staff now realize that this is part of their jobs.”

These efforts worked. The number of women who made appointments to get clinical breast exams went up an average of four patients a day. Scheduled screenings for the Kaw mobile mammogram unit also went up, including appointments for new patients. Clinic staff now have a better understanding of the value of the breast cancer screening program, and they are actively working to improve their screening numbers.

Lessons Learned: Like many clinics, White Eagle has a high rate of staff turnover. The Kaw Women’s Health Program has committed to offering ongoing education for new staff. This will help the clinic continue to improve its practices and get more women screened. The proven strategies used in Ponca Nation could be used by programs in other states.