family wellness/breast and cervical cancer program

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1 ywca greater miami-dade family wellness/breast and cervical cancer program hallmark area Racial Justice association information 1) Name: YWCA Greater Miami-Dade 2) Contact Person: Patricia Joassin Director of Family Wellness, ext 222, 3) Regional Council: Southeast program/activity information 4) Name: Family Wellness/Breast and Cervical Cancer Program 5) Brief Description: The YWCA of Greater Miami-Dade s Family Wellness Program has been serving impoverished women for over twelve (12) years in the fight against breast and cervical cancer. This program targets Hispanic, Haitian, Caribbean and African-American uninsured minority women of Broward, Miami-Dade & Monroe Counties. South Florida is a cultural melting pot with large populations from Latin America and Caribbean nations many of whom are undocumented. This program attacks the numerous racial disparities faced by women as they attempt to navigate the health care system to secure necessary preventive services that will help to prolong their lives. The program and its partners provide services that decrease disparities relating to breast and cervical cancer faced by many racial and ethnic groups in our community by promoting health care through clinical service delivery, education, support and advocacy. The services provided are the tools used in the effort to decrease rates of mortality from breast and cervical cancer in the minority populations served. This program aids in the elimination of inequalities in health care experienced by many under-served, minority women by removing the known racial barriers to health care access and promoting effective, culturally sensitive, community based outreach, education and support. 6) How long has the program or activity been in operation: The program has been in operation for 12 years. 1 ywca greater miami-dade

2 7) Describe how the program, activity or initiative meets the hallmark standards for racial justice and/or women s economic advancement: a) What are the intended outcomes or goals of the program? What specific conditions are you intending to influence? The goal of the program is to decrease the morbidity and mortality rates, related to breast and cervical cancers in minority women residing in Miami Dade, Broward, and Monroe Counties by: n Increasing the number of minority women referred to breast and cervical screening services. n Increasing the number of minority women who receive critical information through educational presentations at neighborhood locations and health fairs. n Increasing access to free or low cost screenings/re-screenings/diagnostic services directly from our network of providers to our target population. b) Hallmark activities and programs must have measurable results. Please explain your measurement criteria, program evaluation model or evaluation tools used to measure the criteria and detail the actual results of this initiative. The Family Wellness Program evaluates its effectiveness utilizing the last three phases of the PRECEED/PROCEED model. Process and impact outcomes are measured through an in-house system that collects short-term and long-term data using a health program management computer tracking system. The system tracks different indicators that have been defined by each objective, activity and desired outcome. Upon initial contact, staff documents the client s contact, demographic, financial, and health information. Process evaluations are also measured through internal monthly and quarterly reports. Any problems that are discovered as a result of evaluation are corrected and phased in to the program. Family Wellness staff implements a brief satisfaction survey to measure client satisfaction with us as well as each individual provider to which they are referred for service. To assess impact evaluation our program has designed a pre/post test to measure increases in knowledge on breast and cervical health. All questions from the pre/post test come directly from the staff member s presentation, focusing on key elements related to associated risks, awareness, and prevention for breast and cervical health. Outcomes will be measured by monitoring progress using our in-house tracking system. Since the system is designed to track both short and long term service use and staff activities, we will be able to determine program efficacy and budgeting resource allocation in relation to service population, type and amount of activities conducted by staff quarterly, annually, and over extended time periods, as well as the number of our target population we are able to reach for both outreach and educational activities. The different outcomes that are selected to measure our program s effectiveness are: n Client increase in knowledge on breast and cervical health and preventative measures. n Number of clients who received service monthly, quarterly, annually (clients will be categorized according to race/ ethnicity, and/or age). n Amount and type of outreach activities conducted by Family Wellness staff. n Number of target population reached during outreach and education activities (monthly, quarterly, annually). n Number of clients referred to collaborative partners for services. n Number of clients that have been diagnosed with cancer according to stage at Diagnosis, type, location, race/ethnicity, and age (quarterly, and annually) Both quantitative and qualitative measures are used to determine program effectiveness. Statistical measures that are analyzed are validity, reliability, and t-test to determine significance of various measures. Qualitative measures are assessed through the previously mentioned satisfaction survey that will be given to our service population. c) Hallmark activities and programs must create meaningful, mission-focused change in a condition or set of conditions versus just raising awareness. Identify the intended or actual change. If the identified change is a step along the way to systemic/institutional change, identify next steps in your plan. As many women within the South Florida community have come from countries and/or communities where public health issues go without detection, many of the minority women served are unaccustomed to health care preventative services being provided for free or at reduced charge. Many of the individuals served are undocumented women while in need of services are fearful of accessing them due to issues relating to deportation as well as culturally insensitive providers. 2 ywca greater miami-dade

3 Secondly, while the YWCA of Greater Miami-Dade knows and understands the law provides equal opportunity for all in theory, it is too often denied in practical application. This program aims to preserve and extend constitutionally guaranteed rights to all people who have historically been denied their rights on the basis of race and economic status. The YWCA of Greater Miami-Dade s Family Wellness Program is committed to combating racism in all its forms with the programs advocacy including community organizing and training through the extension of partnering organizations and public education to address the broad spectrum of issues that disproportionately and negatively impact women of color. All of the programs services are delivered in three languages to include English, Spanish, and Creole (the three main languages spoken in South Florida). Examples of these services include: 1 Providing economically disadvantaged, minority women who are uninsured or underinsured, between the ages of with health care services through education, case management, and referrals for needed healthcare services; 2 Providing educational outreach to over 2,400 women currently incarcerated in three women s detention centers throughout Miami-Dade and Broward Counties for whom health care services are denied or ignored; 3 Ensuring that over 10,000 uninsured minority women between the ages of received free or reduced services through our program process; and 4 Providing advocacy towards health care services for uninsured minority women in need of women s health care as it relates to Cancer, HIV/AIDS, STD s, and Diabetes. 8) What number and types of persons have participated? Please specify by gender, age, and race/ethnicity: Since this program s beginning in 1994, this program has facilitated over 6,000 mammograms, over 4,000 cervical screenings, and over 20,000 breast health educational sessions for minority and uninsured women. The women represented are Hispanics (48%), African-American (22.5%), Haitians (8%), Caribbean (6%), and non-hispanics White (15%) between the ages of From 2003 to 2006, 425,752 individuals received education about breast and cervical cancer through radio shows, PSA s, health fairs and Triple Touch sessions. During this period, the program also screened 5,227 women and provided access to clinical breast exams, mammograms, and pap smears. Another 1,772 women were referred to our partners at Project Screen (an extension of the health department) and Jackson Memorial Hospital. 9) Describe why this initiative would be appropriate for replication by other associations: If other organizations were to replicate this initiative, because of the rising cost of insurance premiums, the number of deaths as a result of late detection of cancer among minority women, and lack of education, it would be a tremendous step towards decreasing the mortality rates in minority women as it relates to breast and cervical cancer. 10) What factors have been key to program success: The YWCA Family Wellness Program s success can be attributed to its most salient features; a three tiered design focusing on outreach, education, and service accessibility. This structure, along with a tri-lingual staff, and culturally sensitive materials and programming, has resulted in rapid program expansion and established the YWCA as a community leader in the delivery of breast screening services to minority uninsured women. Many minority women do not trust health care institutions because of immigration issues, lack of cultural sensitivity by medical professionals, and language barriers. These same women also face daily survival issues where employment, housing, transportation, and care of family are the number one priority. The combination of these factors results in many of these women failing to prioritize or aggressively pursue their own health care needs. Being aware of these issues, the YWCA Family Wellness Program through its extensive and sometimes unorthodox outreach efforts (beyond community events, using beauty salons, grocery stores, childcare centers, One-Stop Centers and other locations where women may gather) and education activities have touched and changed many women s lives. The program benefits participants, not only by increasing access to breast and cervical cancer screening services by removing cultural, language and financial barriers; but also by buttressing this essential component with outreach and education to promote awareness and encourage participation in preventative health services. Program successes can 3 ywca greater miami-dade

4 also be attributed to its focus on social support and networking of minority women, expansion of outreach efforts to include family, spouses, and partners of those individuals seeking preventative breast health services, the inclusion of breast cancer survivors and support groups within the program structure itself, and the indispensable collaborative relationships with preventative breast health service providers throughout the community. Another key to our success is the fact that we conduct our outreach activities by community mobilization through health fairs, churches and their congregation, vocational and literacy schools. We also conduct our outreach were our targeted population is most likely to be found; places like Laundromats, factories, temporary employment agencies, supermarkets, public housing as well as street outreach. 11) What resources are required annually for program operations (dollars, number of staff or volunteer hours required, partner organization roles): Our annual operating budget is $396,800 and we have screened over 3200 women. We presently have 5 full time staff members, 1 part-time and 1 outreach consultant. Our program operates seven days a week the majority of the time, and we also work at night. However this program was initiated 12 years ago with a very small budget of $75,000 and because of its success has been able to grow and expand to throughout 3 counties. Our success would not have been realized without a skillful and determined approach to developing relationships with a variety of community health care providers. These providers ultimately become our program partners and advisors. As of this date we have 12 partnerships with local health care providers located within proximity to where our targeted population resides. These partnerships not only guarantee service, they also provide a negotiated reduce rate for each test or screening that they perform for our clients. 12) What funding sources/strategies have supported the initiative: We presently receive funding from the state of Florida Department of Health (Closing the Gap CDC funding), The Susan G. Komen Foundation, the Avon Breast Care Fund (originally secured through the YWCA of the USA Encore Plus Program), the Health Foundation of South Florida, and the United Way of Miami-Dade. We continue to pursue new and expanded funding opportunities year round to support our efforts and ever increasing demand services. We continue to be successful in negotiating reduced rates for the cost of mammograms, Clinical Breast Exams, and other diagnostic testing through our health care partners which results in increased service. Our tri-lingual and culturally sensitive approach gives us access to local media whose market is exactly those women we are trying to reach. We also receive donations of educational materials from the American Cancer Society as well as the Susan G. Komen Foundation which reduces the cost for supplies. 13) What is the annual budget of your association: $7,219, ) Describe your YWCA s relationship to other local organizations that are also programming (or have related missions) in this area: The YWCA s Family Wellness Program has successfully developed strategic community alliances that have enabled us to deliver enhanced services to the diverse minority communities in Miami-Dade and Broward Counties. These include: Project Screen Miami-Dade County s extension of Florida Breast & Cervical Cancer Control Initiative (CDC funding). The program provides services to women ages 50 and older that are uninsured, underinsured, or do not otherwise have the financial resources to seek screening services. They also provide treatment for those clients who have a positive finding with follow-up services as needed. Sistaah Talk/National Black Leadership Organization Initiative on Cancer An organization that targets low-income medically underserved African-American community members; in an effort to provide education in cancer control, prevention and awareness. 85% of the organization is composed of cancer survivors. Our collaboration includes coordinating cancer screening activities at their annual activities and events, as well as providing screening services to women referred by their organization. Haitian- American Association Against Cancer An organization that recruits and refers Haitian women to the YWCA for early breast and cervical cancer screenings and education. Haitian Women of Miami (FANM) Also recruits and refer Haitian women from their program to the Family Wellness for screenings. 4 ywca greater miami-dade

5 The Camillus Health Concern (CHC) A non-profit health care organization sponsored by the Brothers of the Good Shepherd that offers comprehensive medical care to the poor and homeless in Miami-Dade County. CHC provides primary medical care, pediatric health care, specializing in women s medical services and HIV treatment. They provide social services including case management, counseling, assistance in accessing benefits, employment services, housing placement, and legal services. They refer some of their women to us. American Cancer Society We provide breast health education presentations in Creole, Spanish, and English for them as well as participate in community events with them. La Liga a Contra a Cancer a foundation that provides support for treatment services for cancer victims. The organization originally began in Cuba and was reestablished in the Greater Miami area. 15) What are the biggest challenges to implementing this program: Financial cuts systematically Rising needs with minimal resources 5 ywca greater miami-dade

6 program checklist 1. Hallmark area: 3 Racial Justice Women s Economic Empowerment 2. Methodology: 3 Direct Service 3 Advocacy/Public Policy Partnership or Collaboration Internal Capacity Building 3 Modification of Prior YWCA Program 3. Target Audience: Adults Women over 30 Young Women Adolescents Children Public at large Business, Organization, or System 4. Your Local Community Characteristics: Racially/ethnically homogeneous. Specify type: 3 Racially/ethnically diverse. Specify composition: Hispanic, Caribbean, African-American, and white (Majority/Minority Community) 3 Urban Rural Suburban 5. This model would be most appropriate for an association that is: Building internal readiness 3 Integrating hallmarks into ongoing programming Beginning community programming in the hallmark area Highly experienced in the hallmark area 3 Any association could implement this model 6 ywca greater miami-dade

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