Reminders Bring Patients Back for Screening During Pandemic in Iowa

Photo of a woman reading a letter

A community health worker in Iowa sent letters to 110 women reminding them to get screened for breast or cervical cancer.

In March 2020, the COVID-19 pandemic changed health care in Iowa. Women who were enrolled in the Iowa Department of Public Health’s Care for Yourself program (an award recipient in CDC’s National Breast and Cervical Cancer Early Detection Program) couldn’t get routine breast and cervical cancer screenings. Some doctor’s offices were closed or were seeing fewer patients. Also, women said they were afraid it wasn’t safe to go to the doctor. So at the end of March, the program in Butler County had screened only 60% of the women it had planned to screen for the 2020 fiscal year—and it only had 3 months left.

Since many patients didn’t get cancer screening tests, the program allowed its contractors to spend some of its money on outreach. So the Butler County program’s community health worker wrote a reminder letter. She sent it to 110 women in the program who were due for a breast or cervical cancer screening test. The letter recommended that they call their doctor to make an appointment, and to contact the community health worker if they had questions. The letter was translated into Spanish to reach Spanish-speaking people in the seven counties the program serves.

After she sent the letters, the community health worker followed up with a phone call to each woman. She talked about women’s health care, answered questions about COVID-19, and explained how to stay safe during doctor visits. As a result of this outreach, 30 women enrolled in the program from May to July 2020. While the program in Butler County didn’t meet its screening goal, it increased screenings to within 20% of its target.

“The personal connection this community health worker makes with program participants is invaluable,” said Ellen Maahs, Implementation Coordinator for the Care for Yourself program. “The people in this community recognize that she genuinely cares about them and believes their health is a priority.”