Vermont Clinics Become More Accessible to Increase Cancer Screening

Patients with disabilities are less likely than the general population to be current on their cancer screenings. Health officials in Vermont set out to reduce the barriers that may discourage patients with disabilities from seeking and completing screenings.

In Vermont, only 72% of women with a disability aged 50 to 74 have had a mammogram in the last 2 years, compared to 81% of all women in this age group. Vermont’s Breast and Cervical Cancer Early Detection Program sought to increase these rates by collaborating with the Improving the Health of Vermonters with Mobility Limitations and Intellectual Disabilities project.

Staff in Vermont’s cancer program started by contacting mammography clinics across the state and asking if they could evaluate how accessible they were for people with disabilities. They assessed 14 of the state’s 16 mammography clinics with a survey tool that takes less than 2 hours to conduct. They looked for barriers faced by patients in wheelchairs and those with limited vision or development disabilities. They also looked at the accessibility of parking lots, waiting rooms, clinics, changing rooms, mammography rooms, and bathroom facilities.

Barriers found included:

• Lack of accessible parking spaces.
• Waiting room seating arrangements that did not allow room for wheelchairs.
• Directional signs that were hard to see or read, did not include Braille lettering, or were not mounted at the correct height or location.
• Changing rooms that were too small for a wheelchair.
• Doors that were hard to open.

Each clinic received a report that outlined its strengths and problems and recommended ways to improve their facility. The University of Vermont Medical Center, which provides the most mammograms in the state, agreed to improve the accessibility in three of its facilities. These changes will help all patients who use mammography clinics in Vermont.

This project also helped Vermont’s cancer program strengthen its relationship with mammography clinics across the state. Health officials plan to use these connections to coordinate ongoing professional development for clinic staff and find other ways to increase cancer screenings for all Vermonters.

Lessons Learned: Creating and maintaining positive relationships with partners can reap long-term benefits. Getting buy-in from partners and emphasizing collaboration and problem-solving can help increase screening rate. The proven strategies used in Vermont could be used by programs in other states.