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Expanding Cervical Cancer Screening for Underserved Women in Omaha



Dr. Ochuba of the Charles Drew Health Center treats a patient. Courtesy photo.

Leah Margolis says that one of the most rewarding parts of her job as a community health navigator is empowering the people she serves by educating women about cervical cancer and how to prevent it through screening.

“Their eyes are lighting up,” she said. “That simple knowledge helps them feel they have a lot of control.”

Leah helps support the cervical cancer screening program at the Charles Drew Health Center (CDHC) of Omaha, Nebraska – one of seven community health center winners of the 2014 BD Helping Build Healthy Communities Innovations in Care Awards, which seeks to support innovative approaches that address health disparities affecting underserved and vulnerable populations in the U.S.

Each awardee received $100,000 to allow them to continue and/or expand their models of care. The initiative is funded by global medical technology company BD and implemented together with Direct Relief and the National Association of Community Health Centers (NACHC).

Because of the award, CDHC was able to hire Leah to work one-on-one with people in the community, helping eliminate barriers to getting an appointment for cervical cancer screening.

Screening Saves Lives

Since starting in October 2014, Leah (who has a background in social work and previously worked for the American Cancer Society) has helped craft a campaign for the community to get screened, with the simple, but true message: “Screening Saves Lives.”

Cervical cancer is the easiest female cancer to prevent. Leah said 80-85 percent of women are affected by the human papillomavirus (HPV). Many clear the virus on their own, but for the percentage who don’t, Leah says it can take about 12 years to develop into cervical cancer. However, she said that with regular screening, “it should not be an issue.”

But lack of access to screening prevents some from receiving these life-saving services. Several years ago, CDHC staff recognized that women receiving health care services through its homeless and public housing health centers and women that are uninsured were less likely to receive screening services.

Additionally, the CDHC target patient area is 45 percent African American, and African American women develop cervical cancer more often than white women and are more than twice as likely to die from it, according to the U.S. Department of Health and Human Services’ Office on Women’s Health.

CDHC CEO Kenny McMorris said that these statistics, along with Omaha’s high rate of sexually transmitted diseases, caused the team at CDHC to prioritize a screening program for their patients.

“The opportunity to get screened is a challenge for underserved populations,” he said.

By implementing a team-based approach, using electronic health records to generate notifications for patients past due for their Pap smear, and hiring a Women’s Health Case Manager, the team at CDHC saw a 100 percent increase in the number of patients screened after program implementation.

Reaching the Underserved

Part of the reason for the success of the program is because the team at CDHC works to eliminate barriers to getting a health appointment. This includes financial, transportation, language, and cultural barriers, among others.

Kenny said that Omaha is one of the top five cities in the U.S. for refugee resettlement. In order to help this population receive care, Leah speaks every other week as part of the Lutheran Family Services refugee program, helping inform refugees of how to access the services offered at CDHC.

Once a patient comes to the center, they have a team of nearly 40 translators that speak 25 languages and 36 different dialects who are on hand to help alleviate barriers to care. CDHC also offers a sliding-fee scale pay system to help patients afford the screening services.

But Leah said another less obvious barrier to making an appointment exists – lack of self-esteem.

“If a woman doesn’t feel good about herself, why would she be invested in making the call to get screening?”

She said that’s why the CDHC focus on building personal relationships with their patients in need works.

“Having a one-on-one approach is the best.”

Partnering to Help More People

Kenny said that the BD Helping Build Healthy Communities Award allows CDHC to multiply their efforts around cervical cancer screening services.

“We’re always charged with doing more with less,” he said. “It helps to have partners that get our mission, purpose, and understand that the little things go a long way.”

Opening in 1983, CDHC currently provides comprehensive health services to more than 11,000 patients from the Douglas County area each year. Nearly half of them are uninsured.

Charles Drew Health Center has been a Direct Relief partner since April 2009. Since then, they have received more than $228,000 worth (wholesale) of medicines and supplies to support their ongoing work treating people in need in the Omaha community.

Giving is Good Medicine

You don't have to donate. That's why it's so extraordinary if you do.