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Organizational Change | Breast Cancer Evaluation Measures

Organizational change measures for breast cancer screening1-5

Breast cancer screening and clinical follow-up requires ongoing support from employers. New programs can be added over time and evaluated periodically for their effectiveness. For best results, recognition of the benefits of breast cancer screening should become an inherent part of organizational change and corporate culture.

Measuring organization change is an assessment of company-initiated programs and policies that affect most employees regardless of their health status (e.g., mobile mammography vans). These efforts need to be integrated for greatest effectiveness and will require time for full implementation. Regular measures of employee attitudes and program development are key in determining whether new programs are effective or require further adaptation to prevent continuing investment in ineffective efforts.

Baseline

  • Determine workplace barriers to employee’s engagement in breast cancer screening
  • Assess current workplace breast cancer prevention and screening programs
    • List current breast cancer screening options for employees through worksite and identify number of employees (i.e., participation) using each option. Examples:
      • Number of breast cancer screening programs (e.g., education seminars, individual education) and participation in these programs
      • Availability of educational materials on breast cancer screening
      • Number of communications/media campaigns regarding breast cancer screening. Examples:
        • Percentage of women receiving a telephone call (or a reminder) to obtain a mammogram among:
          • Women due or overdue for a mammogram
          • Women turning age 50 years
          • Women 50 years and older who are new health plan members
        • Percentage of women who scheduled a mammogram appointment during a telephone reminder call
      • Number of breast cancer prevention and screening related policies
      • Number of environmental strategies to reduce structural barriers
      • Number of partnerships with community resources for breast cancer screening such as the American Cancer Society or a local health department
    • Determine costs of current company breast cancer screening programs such as:
      • Staffing, equipment, and space
      • Employee time to participate in breast cancer screening programs during work hours (e.g., education or mobile mammography)
      • Reimbursements and subsidies for breast cancer screening to reduce out-of-pocket costs and structural barriers, such as classes, counseling, reducing co-payments, or transportation (see implementation for health benefits examples)
      • Incentives tied to breast cancer screening programs
      • Contracts with mobile mammography providers
    • Conduct survey of employee satisfaction with current workplace supported breast cancer screening programs

Process

  • Reassess barriers to employee engagement in breast cancer screening programs
  • Document steps taken and progress toward implementing each intervention selected
    • List numeric goals (e.g., desired increases in employee screening rates) in each form of intervention within a designated time period (e.g., 12 months from startup):
      • Employee reach (e.g., number of educational pamphlets distributed; number of employee reminders sent)
      • Employee participation (e.g., number of desired participants in breast cancer screening; number of mammogram appointments scheduled; number of mammograms delivered; number of one-on-one education sessions conducted)
    • Describe timeline for implementation of each planned intervention (e.g., length of time and timing of tasks to develop, initiate, and conduct a mass campaign)
    • Create a baseline budget for new interventions including classes, instructors, classroom space, materials, incentives, mobile mammography contracts, etc
    • Identify opportunities for new partnerships with community groups who provide breast cancer screening programs (e.g., The American Cancer Society, local health department, local hospital, etc.)
  • Reassess employee satisfaction regarding workplace supported breast cancer screening programs

Outcome

  • Measure reductions in the number and type of employee barriers to breast cancer screening
  • Assess changes in workplace breast cancer prevention and screening programs including progress in achieving goals and in implementation of each intervention (e.g., length of time and timing of tasks to develop, initiate, and conduct a mass campaign)
    • Measure changes in the number of breast cancer screening options for employees through the worksite and changes in employee participation using each option before and after the breast cancer screening program or campaign. Examples:
      • Number of new programs developed and offered to employees
        • Measure attendance (e.g., number of mammograms delivered) at onsite mobile mammography screening programs
        • Number of employees identified as recommended for breast cancer screening who have been sent a reminder for screening
        • Number of employees sent reminder who actually scheduled a mammogram and received the screening
      • Number of new educational materials developed and made available to employees
      • Number of new workplace communications/media campaigns, including posters, brochures,  etc., established
        • Was there an increase in mammogram appointments directly following an informational or awareness campaign
        • What was the percentage increase in mammogram appointments
      • Number of new workplace policies regarding breast cancer screening developed and implemented compared to baseline
      • Number of new environmental strategies to reduce structural barriers developed and implemented compared to baseline
      • Number of new partnerships with community groups created to enhance access and opportunity for employee breast cancer screening
    • Assess changes in program costs from baseline
      • Increases in staffing or equipment needs due to new program offerings
      • Changes in employee participation time during work hours (e.g., education or mobile mammography)
      • Changes in reimbursement/subsidy for breast cancer screening to reduce out-of-pocket costs and structural barriers such as classes, counseling, reducing co-payments, or transportation
      • New incentives or benefits or changes in existing incentives or benefits based on employee participation
      • New contracts with mobile mammography providers
    • Assess changes in survey responses for employee satisfaction following implementation of a workplace supported breast cancer screening program and compare with baseline

Depending on goal success, evaluate the need to adjust workplace programs.

References

1.  Centers for Disease Control and Prevention with the Prudential Center for Health Care Research. The manual of intervention strategies to increase mammography rates. 1997. Available from: http://www.cdc.gov/cancer/nbccedp/pdf/prumanual.pdf [PDF – 4.4MB]

2.  Campbell KP, Lanza A, Dixon R, Chattopadhyay S, Molinari N, Finch RA, editors. A Purchaser’s Guide to Clinical Preventive Services: Moving Science into Coverage. Washington, DC: National Business Group on Health; 2006.

3.  Centers for Disease Control and Prevention. Framework for program evaluation in public health. Morbidity and Mortality Weekly Report 1999;48(No. RR-11): 1-40.

4.  Goetzel RZ, Ozminkowski RJ. Program evaluation. In: O’Donnell MP, editor. Health promotion in the workplace, 3rd edition. Albany, NY: Delmar Thomson Learning; 2002. p 116-165.

5.  Matson Koffman DM, Lanza A, Campbell KP. A Purchaser’s Guide to Clinical Preventive Services: A tool to improve health care coverage for prevention. Preventing Chronic Disease, April 2008; 5(2).

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