Dr. Electra Paskett, Ph.D., has dedicated her career to serving people in the margins – championing high-quality health care for historically marginalized communities in rural North Carolina and most recently in Appalachia and rural Ohio. In her role as Director of the Center for Cancer Health Equity at Ohio State University’s James Cancer Hospital, her research program is nationally recognized for studying cancer health disparities.
While Dr. Paskett’s program previously used community health workers as patient navigators at in-person clinics, her program recently completed a major study in partnership with Vicki Champion, Ph.D., of Indiana University to use telephone navigation to promote the use of early-detection exams like screening mammograms and improve access to diagnostic and treatment services for people at high risk of breast cancer.
Dr. Paskett and Dr. Champion recruited nearly 1,000 women from 96 rural counties between the ages of 50 to 75 who needed breast, cervical and/or colon cancer screenings.
“One group received a tailored DVD about the tests they might need that was mailed to them,” Dr. Paskett explained. “The second group received the tailored DVD and telephone navigation from a navigator who was from a rural area. The navigator would call and say, ‘Did you receive the DVD? Do you have questions? What tests do you need?’”
The second intervention that provided the tailored DVD and a follow-up phone call from a patient navigator significantly increased the proportion of women who became up to date with their screening tests.
“For me, that says that we don’t have to do our interventions based in a clinic,” Dr. Paskett said. “We can reach out to women who don’t usually go to clinics, and clinics can use these strategies to reach people who need a screening test or haven’t been coming in.”
Dr. Paskett also examined the area deprivation index, a geographical tool that measures socioeconomic status, and how this is linked to health outcomes as part of the study.
“Women who were in the higher deprivation areas were less likely to get screened, so the intervention didn’t work any differently in those areas that had the higher deprivation,” Dr. Paskett said. “The intervention will work, but it’s going to take a lot more work with women in areas with high deprivation. What really impacted me was thinking, ‘what are we going to do now for people who live in really high deprivation areas?’”
Dr. Paskett added that while her team has long focused on screening for social determinants of health, she believes more interventions are needed to truly expand the reach of patient navigation and connect with people in the margins, especially in rural areas.
“How can we get more help for those who have issues related to social determinants of health, and how can we extend the reach of navigation by using telephone navigation or even Zoom? How could we do that? These are the questions we are trying to answer,” Dr. Paskett said.
Susan G. Komen’s Breast Care Helpline
To answer the question of how to reach people to connect them with education, support and access to evidence-based resources in their breast cancer journey, Susan G. Komen® created the Breast Care Helpline. The Breast Care Helpline provides psychosocial support, breast health and breast cancer education, access to screening and diagnostic services and financial assistance, referrals to local or national resources, and information on clinical trials. Helpline specialist Viridiana Medellin joined Komen in 2021 and said every day is different; she never knows who might call in asking for help.
“A lot of patients who are not familiar with the health care system may not know how important is to mention to their health care provider if they have a history of breast cancer in their family,” Viridiana continued.
If callers don’t have a family history of breast cancer but are experiencing signs or symptoms, Viridiana frequently points them to Komen’s Breast Self-Awareness Messages.
“We will talk about warning signs, and I will also let them know that without proper tests, there is no way of really telling what it could be unless they schedule an appointment with their health care provider,” Viridiana said.
“When it comes to educating patients and connecting them to resources, I really appreciate that Komen has a team of culturally responsive specialists able to do that, because I think sometimes service providers have an assumption that people have the same skill set to identify information quickly,” Viridiana continued. “Most people don’t have that level of experience or access to this information Being able to walk patients through the website and break down that information so it’s digestible and easy to understand is so important when navigating healthcare.”
To contact Susan G. Komen’s Breast Care Helpline, call 1-877-GO KOMEN (1-877-465-6636) or email firstname.lastname@example.org. All calls are answered by a trained specialist or oncology social worker, Monday through Friday from 9:00am to 10:00pm ET.