Breast cancer is the leading cause of cancer among women in the US (excluding non melanotic skin cancers), is the second commonest cause of cancer deaths in women overall and the leading cancer killer among Hispanic women.

Our target area includes nine counties in Public Health Region 1, eight counties in PHR 9 and six counties in PHR 10. Our service area has a population of 1,632,900 people, covers more than 43,592 miles and is larger than 18 States of the US. Our needs assessment reveals that these populations have high rates of poverty, low educational attainment, and low rates of health care coverage. They also have high rates of late stage breast cancer diagnosis, suffer dispropor...

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Breast cancer is the leading cause of cancer among women in the US (excluding non-melanotic skin cancers), is the second commonest cause of cancer deaths in women overall and the leading cancer killer among Hispanic women.

Our target area includes nine counties in Public Health Region 1, eight counties in PHR 9 and six counties in PHR 10. Our service area has a population of 1,632,900 people, covers more than 43,592 miles and is larger than 18 States of the US. Our needs assessment reveals that these populations have high rates of poverty, low educational attainment, and low rates of health care coverage. They also have high rates of late stage breast cancer diagnosis, suffer disproportionate breast cancer mortality and have lower rates of screening than the rest of the US. Furthermore, they are critically medical underserved with major gaps in services across the whole spectrum of breast cancer prevention, detection and treatment.

The proposed project, (BEST 2) is a multicomponent evidence-based program designed to reduce the breast cancer burden among uninsured women in 23 West Texas Counties. It enhances the previous program and expands it to a large area of West Texas. BEST 2 will continue as a community wide partnership led by Texas Tech University Health Sciences Center, El Paso, in collaboration with over 150 organizations including key new partners (West Texas AHEC, Texas DSHS Region 9/10, Family and Community Health Services Program, Cactus Health Services, and Combest Community clinic) as well as ongoing collaborations with the El Paso County Public Hospital system, Texas A & M Western Region Colonias program, federally qualified health center systems, free clinics, student run clinics, TTUHSC Family and Community Medicine Center, local faith-based organizations, El Paso Public Housing Authority, the El Paso County Senior Centers, the YMCA, Food banks, the Susan G Komen Foundation, the American Cancer Society, Rio Grande Cancer Foundation, the BCCS program, the Public Health Department and the State 2-1-1 among others.

BEST 2 program components are: 1) Creating and delivering culturally tailored, theory-based breast cancer education targeted to both Hispanic and rural non-Hispanic populations; 2) Outreach through targeted media, new social media and a network of geographically dispersed community partners; 3) Provision of no-cost mammography and diagnostic testing to eligible women directly and through a new contractual pathway; 4) Development of an improved diagnostic pathway to reduce the mammography recall rate; 5) An enhanced access mammography network for program participants; 6) Patient navigation to facilitate screening, diagnosis, health insurance coverage, PCP access, and treatment; 7) Creation of a new pathway for identification, referral and management of women at high risk; 8) Development of a new in-reach system for repeat screening; 9) New dissemination partners and strategies for education delivery in new target areas; 10) Sustainability through institutionalization of new clinical processes and pathways, the formation of a cohort of well informed women that understand solutions to common barriers, through incorporation of program elements into the learning requirements for students and through the creation of enduring public private partnerships; and 11) a rigorous process, and outcomes evaluation.

The long term goal of BEST 2 is to reduce the burden of breast cancer in West Texas through early detection and treatment. Specific goals are to: 1)Increase access to breast cancer early detection services for eligible women in West Texas. 2) Implement an enhanced breast cancer early detection program to uninsured eligible women in El Paso and Hudspeth counties. 3) Disseminate breast cancer early detection education to West Texas women. Achievable targets, based on our previous experiences, are to directly serve 9,695 people and have 3,695 screening and diagnostic tests completed.

Includes offering the full spectrum of cancer care through a combination of direct service provision, and contracting with key partners, the creation of new public-private partnerships, targeting a broad swath of the population (women in the community, patient populations, and professionals), the tracking database, the strategies employed for achievement of sustainability, and the meticulous evaluation of outcomes. This program will meet the goals of the Texas Cancer Plan which are to reduce the impact of cancer in Texas through the implementation of sustainable and effective programs that target the underserved and reduce disparities in cancer throughout the State.

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