Innovative Public Innovative Public Health Strategies for Health Strategies for Reaching WomenReaching Women

Julie Galstad, Health EducatorJulie Galstad, Health EducatorMontana Breast & Cervical Health Program Montana Breast & Cervical Health Program (MBCHP)(MBCHP)Department of Public Health & Human ServicesDepartment of Public Health & Human Services

Background

The Breast and Cervical Cancer Mortality Prevention Act of 1990

(PL-101-354) established a comprehensive, national screening

program for low-income, minority, and underserved women.

The Montana Breast and Cervical Health Program received

comprehensive screening funds in September 1996 from the Centers for Disease Control and Prevention.

Montana Quick Facts

Resident population estimate, July 20051 935,670

Racial composition 20042

White 92.2%American Indian 7.4%Other 0.4%

Unemployment, 20053

Statewide 3.5%Reservations 6.0% to 19.7%

Montana NationalMedian household Income, 20042 $35,201$44,473Per capita income, 20054 $29,387 $34,586People in poverty, 20043 14.3% 12.4%People without health insurance coverage, 20042 17.9% 15.5%1Montana Census and Economic Information Center, http://www.ceic.commerce.state.mt.us/demographics.asp2US Census Bureau, http://www.factfinder.census.gov3Montana Department of Labor and Industry, Research and Analysis Bureau4Bureau of Economic Analysis, US Department of Commerce, http://www.bea.gov

Montana Breast & Montana Breast & Cervical Health ProgramCervical Health Program 13 multi-county administrative sites that 13 multi-county administrative sites that

contract with the state to implement the contract with the state to implement the program in their area.program in their area.

State staff of six to administer and State staff of six to administer and manage program.manage program.

Reservation sub-contracts for American Reservation sub-contracts for American Indian Screening InitiativeIndian Screening Initiative

Target PopulationTarget Population

Women Women Age 50 – 64* for mammogramsAge 50 – 64* for mammograms Age 35 – 64 for Pap testsAge 35 – 64 for Pap tests Are uninsured or underinsuredAre uninsured or underinsured 200% of the Federal Poverty Level200% of the Federal Poverty Level

Approximately, $9,800 - $20,000 annual income, for Approximately, $9,800 - $20,000 annual income, for a family size of one to four.a family size of one to four.

*Women 65 years of age and older who cannot pay *Women 65 years of age and older who cannot pay the premium to enroll in Medicare Part B and meet the premium to enroll in Medicare Part B and meet the income eligibility criteria are eligible for services.the income eligibility criteria are eligible for services.

How big is Montana ?How big is Montana ?

Where are they?Where are they?

Determine in what part of the state the target Determine in what part of the state the target population resides inpopulation resides in Rural? Rural? Montana has 56 counties and 2/3 are frontier with Montana has 56 counties and 2/3 are frontier with

1/3 rural (Frontier is defined as fewer than 6 people 1/3 rural (Frontier is defined as fewer than 6 people per square mile)per square mile)

Largest city is Billings – population 89,847Largest city is Billings – population 89,847 Bozeman – 27,509Bozeman – 27,509 Butte – 33,892Butte – 33,892 Great Falls – 56,690Great Falls – 56,690 Helena – 25,780Helena – 25,780 Missoula – 57,053Missoula – 57,053

How do I reach them?How do I reach them?

Consumer Health Profiles – National Cancer Consumer Health Profiles – National Cancer Institute (NCI)Institute (NCI) Provides a combination of behavioral data and Provides a combination of behavioral data and

demographics with social marketing datademographics with social marketing data

Use state agreements to share information/lists Use state agreements to share information/lists of LI clientsof LI clients

Personal experiencePersonal experience Thinking outside of the boxThinking outside of the box

Successful StrategiesSuccessful Strategies

Pharmacy prescription bagsPharmacy prescription bags Product stickers/Provider Post-It notesProduct stickers/Provider Post-It notes Quilt Trunk showQuilt Trunk show 1:1 outreach – material distribution on 1:1 outreach – material distribution on

doorsdoors 50% of referrals come from providers50% of referrals come from providers Statewide toll free numberStatewide toll free number

Toll Free Number Toll Free Number ReferralsReferrals

Toll Free Sources

53%

9%8%

6%

12%

9% 3%

Healthcare Word of Mouth In the Program

Partnership referrals Program Materials Media

Unknown

Future StrategiesFuture Strategies

Develop relationship with Montana Develop relationship with Montana Tavern AssociationTavern Association Program info on cocktail napkinsProgram info on cocktail napkins

Develop relationship with casinosDevelop relationship with casinos Table tents and posters Table tents and posters

Develop relationship with national Develop relationship with national manufacturer of tobacco productsmanufacturer of tobacco products Product stickers on cigarettesProduct stickers on cigarettes

SummarySummary

Be flexible, if one strategy does not work, try Be flexible, if one strategy does not work, try anotheranother

Be prepared for failure, but don’t let it slow Be prepared for failure, but don’t let it slow down the ideasdown the ideas

Have regular brainstorming sessions, with no Have regular brainstorming sessions, with no restrictions on strategiesrestrictions on strategies

Think outside of the boxThink outside of the box Evaluate, evaluate, evaluate!Evaluate, evaluate, evaluate! Be positive, enthusiastic and motivatedBe positive, enthusiastic and motivated