COMMUNITY PROFILE REPORT
Susan G. Komen for the Cure ®
Greater Amarillo Affiliate
2009
Acknowledgements
The Greater Amarillo Affiliate of Susan G. Komen for the Cure wishes to thank
everyone who helped to research, compile, and write this community profile. Many
thanks to West Texas Family and Community Services, a project of the Psychology,
Sociology and Social Work departments of West Texas A&M University, led by Sara E.
Northrup, M.A., LBSW with assistance from Michael D. Nino, B.S. Without their
research, this project could not have been successful. We also thank our current
grantees, service providers, and key informants for their participation.
Additionally, the affiliate thanks Lisa Hoff Davis, Executive Director, and Brandi
Ruiz, Mission Coordinator, for their work leading the project and compiling information.
Finally, thanks to Whitney Kelly, Affiliate President, for writing the words around the
data.
2
Table of Contents
Executive Summary ........................................................................................................ 4
Introduction .................................................................................................................. 4
Overview Demographic and Breast Cancer Statistics Key Findings ............................ 4
Overview of Programs and Services Key Findings ...................................................... 4
Overview of Exploratory Data Key Findings ................................................................ 5
Narrative of Affiliate Priorities ...................................................................................... 5
Affiliate Action Plan ...................................................................................................... 5
Introduction ..................................................................................................................... 6
Affiliate History ............................................................................................................. 6
Organizational Structure .............................................................................................. 6
Description of Service Area ......................................................................................... 6
Purpose of Report........................................................................................................ 6
Demographic and Breast Cancer Statistics ..................................................................... 7
Data Source and Methodology Overview .................................................................... 7
Overview of Key Demographic & Breast Cancer Statistics at State and County Level 7
County/Counties of Interest: What the Data Shows .................................................. 10
Demographic and Breast Cancer Findings ................................................................ 11
Programs and Services ................................................................................................. 13
Data Source and Methodology Overview .................................................................. 13
Programs and Services Overview.............................................................................. 13
Partnerships and Grant Opportunities ....................................................................... 16
Promising Practices and Evidence-Based Programs................................................. 17
Public Policy Perspectives ......................................................................................... 17
Programs and Service Findings ................................................................................. 18
Exploratory Data ........................................................................................................... 19
Data Sources and Methodology Overview ................................................................. 19
Exploratory Data Overview ........................................................................................ 19
Exploratory Data Findings ......................................................................................... 20
Conclusions................................................................................................................... 21
Putting the Data Together .......................................................................................... 21
Selecting Affiliate Priorities ........................................................................................ 22
Affiliate Action Plan .................................................................................................... 22
Community Partnerships ........................................................................................ 22
Existing Grant Solutions ......................................................................................... 22
Needed Grant Opportunities .................................................................................. 22
Public Policy Efforts ............................................................................................... 23
Education and Outreach ........................................................................................ 23
List of Figures ............................................................................................................ 24
List of Tables ............................................................................................................. 24
List of Appendices ..................................................................................................... 24
3
Executive Summary
Introduction
The Greater Amarillo Affiliate of Susan G. Komen for the Cure has held races for
the past nineteen years and became an affiliate in 2003. The paid staff of the affiliate
consists of the Executive Director, Lisa Hoff Davis, and Mission Coordinator, Brandi
Ruiz (Ms. Ruiz’ position began in the 2009-2010 fiscal year, reporting to the Executive
Director). The chapter serves the top twenty-six counties of the Texas Panhandle, an
extremely large and mainly rural area. The population of the area is clustered in a few
of the cities with a total population of approximately 413,000.
This profile discusses in detail the characteristics of the service area and breast
cancer statistics for the area. It also provides an overview of programs and services
available for breast health, explores findings of breast cancer incidence and mortality for
the area, lists the affiliate’s priorities for programs and grant funding, and details the
affiliate’s plan of action for the next two years.
Overview Demographic and Breast Cancer Statistics Key Findings
The initial data used was provided by Claritas Inc (2007) through the Greater
Amarillo Affiliate of Susan G. Komen for the Cure. The secondary data provided
qualitative and quantitative data for twenty-six counties in the Texas Panhandle. The
figures provided by Claritas Inc (2007) also provided quantitative data regarding breast
cancer and breast health throughout the United States.
Key Findings:
1. Twenty-two out of the twenty-six counties in the Greater Amarillo Affiliate area
are over the highest (113.7) state average incidence rates. The affiliate should
prioritize screening and support for these 22 counties: Armstrong, Donley,
Briscoe, Childress, Collingsworth, Roberts, Hall, Wheeler, Carson, Gray,
Swisher, Oldham, Lipscomb, Randall, Hutchison, Hemphill, Sherman, Castro,
Potter, Hartley, Hansford, and Moore.
2. Almost 40 percent (39.4%) of women over the age of 40 reported not receiving a
mammogram in the last twelve months.
3. Caucasian women are represented consistently in all four stages of breast
cancer. However, African American women have higher rates of stage 3 and 4
breast cancer when compared to other ethnic groups.
Overview of Programs and Services Key Findings
Information for the breast cancer programs and services of the service area was
collected through internet research, key informant interviews, and historical review of
service providers. Information was collected at the county, city, and service area levels.
After collecting all sources of breast cancer programs, staff reviewed all of the data for
detailed schedules, services, program availability, and funding sources. The profile
includes a listing of all service providers.
Services are scattered across the Panhandle, and treatment facilities are located
only in Amarillo. Due to the small number of service and treatment providers, many
4
women do not have access or have limited access to education, screening, and
treatment for breast health.
Overview of Exploratory Data Key Findings
The exploratory data collected for the profile has helped the affiliate identify
barriers to services, the cultural and behavioral considerations related to health care,
the effect of location on services (rural vs. urban), and the best methods to supplement
the statistical information as topics for further exploratory research.
Narrative of Affiliate Priorities
After consideration of the statistical and community data coupled with a review of the
available programs and services, the affiliate has identified four priorities for the
upcoming two years:
1. Fund programs for underserved women: 10% of families fall below the
poverty line and 31% of women are uninsured.
2. Focus funding in six counties: Gray, Hansford, Potter, Randall, Dallam,
and Carson. These counties are home to 67% of the Panhandle’s
population while also representing high incidence and counties with
service providers. The counties are also adjacent to counties without
service providers so the affiliate can investigate rural versus urban
obstacles to service.
3. Encourage partnerships: The expected success of the WISE Woman
Project and the coordination of services created by the project highlight
the potential for additional partnerships. Increased partnership and
coordination with the BCCCP will stretch funding dollars and ensure more
women have access to screening and diagnosis.
4. Address cultural and ethnic obstacles to education, screening, and
diagnosis: Although Caucasian women are more than half of the
population, the minority groups of the Panhandle are expected to grow
faster than the Caucasian group during the upcoming census. Caucasian
women have traditionally had better access to healthcare, so emphasis
on minority groups will provide data for future programs and grant
opportunities.
Affiliate Action Plan
The affiliate’s action plan details how it will increase success in the areas of
community partnerships, building on best practices in existing grants, improving public
policy efforts (especially with the BCCCP), and increase education and outreach
opportunities.
5
Introduction
Affiliate History
The Greater Amarillo Affiliate of Susan G. Komen for the Cure has held races for
the past nineteen years, but became an affiliate in 2003. Two paid staff shared the
Executive Director position 2003-2005 and the current Executive Director was hired in
2005. The chapter has sustained continuous and admirable growth throughout its
history. For grant year 2009-2010, the chapter awarded $217,000 to its grant
recipients.
Organizational Structure
The paid staff of the affiliate consists of the Executive Director, Lisa Hoff Davis,
and Mission Coordinator, Brandi Ruiz (Ms. Ruiz’ position began in the 2009-2010 fiscal
year, reporting to the Executive Director). Ms. Davis reports to the eleven-member
board of directors.
Description of Service Area
The chapter serves the top twenty-six counties of the Texas Panhandle: an
extremely large and mainly rural area. The population of the area is clustered in a few
of the cities with a total population of approximately 413,000. Area service providers
draw clients from across the service area. Treatment providers are located in the center
of the service area in Amarillo, so patients seeking treatment for breast cancer must
travel to Amarillo for radiation or chemotherapy.
Figure 1
Purpose of Report
This profile will discuss in detail the characteristics of the service area and breast
cancer statistics for the area. It will also provide an overview of programs and services
available for breast health, explore findings of breast cancer incidence and mortality for
the area, list the affiliate’s priorities for programs and grant funding, and detail the
affiliate’s plan of action for the next two years.
6
Demographic and Breast Cancer Statistics
Data Source and Methodology Overview
Breast cancer is the most common form of cancer in women throughout the
world. A recent study estimated 1.15 million women were diagnosed with breast cancer
and 411,000 died from it in 2002. Currently, there are approximately 4.4 million women
living who have been diagnosed with breast cancer in the past five years throughout the
world. Breast cancer incidence rates continue to rise with a 30-40 percent increase from
1970s to the 1990s, but more rapidly in developing counties. Just in the United States
alone over 192,000 women will be diagnosed with breast cancer this year (American
Cancer Society). Breast cancer and breast cancer awareness continues to be a major
concern in the United States.
However, increased public discussion concerning breast health does not always
translate into improved breast health practices—although research has shown early
detection of cancer through mammography can improve a person’s survival rate. The
following examines breast health, breast health practices, knowledge of breast health
and willingness to seek out medical information regarding breast health in twenty-six
counties in the Texas Panhandle. The objective is to identify gaps in services in the
twenty-six counties, in order to lessen breast cancer mortality rates in the Texas
Panhandle.
Data Source and Methodology Review:
The initial data used was provided by Claritas Inc (2007) through the Greater
Amarillo Affiliate of Susan G. Komen for the Cure and West Texas A & M University.
The secondary data provided qualitative and quantitative data for twenty-six counties in
the Texas Panhandle. The figures provided by Claritas Inc (2007) also provided
quantitative data regarding breast cancer and breast health throughout the United
States. The study is exploratory, so the raw data was first reviewed. Once the data was
reviewed specific questions began to emerge just purely from observation. As the data
was thoroughly reviewed staff utilized multiple methods of research to complete the
community profile. The affiliated used various types of data; specifically:
1. Demographic Data (age, race, education etc)
2. Specific breast health/cancer data (Incidence, Morality, and Prevalence)
3. Community Resources data obtained from a self-reported survey (N= 58)
Overview of Key Demographic & Breast Cancer Statistics at State and County
Level
In order to understand the severity of breast cancer in the Texas Panhandle the
affiliate first examined breast cancer rates at a national level. For the purposes of this
study the total female population and the prevalent breast cancer cases for the 10
largest states were examined. The prevalent breast cancer rates compared to states
total population are fairly small; however, when examining prevalent breast cancer
cases for Texas and California, Texas had a higher ratio rate than California. The ratio
for females diagnosed with breast cancer in California for 2007 is approximately 1 out of
7
every 244; comparatively in Texas 1 out of every 222 were diagnosed with breast
cancers in 2007. (See picture below.)
Figure 2
The Greater Amarillo Affiliate of Susan G. Komen for the Cure covers twenty-six
counties in the Texas Panhandle. For the purposes of this study all twenty-six counties
were analyzed. Once the initial data was analyzed for all twenty-six counties, six
primary counties were identified for a deeper analysis using a survey developed by the
profile team. The twenty-six counties are: Potter, Randall, Hutchison, Gray, Moore, Deaf
Smith, Parmer, Ochiltree, Dallam, Swisher, Childress, Castro, Carson, Hansford,
Wheeler, Donley, Hall, Hemphill, Lipscomb, Collingsworth, Hartley, Sherman, Oldham,
Armstrong, Briscoe and Roberts.
8
The chart below shows breast cancer rates for all of the counties of the
Panhandle:
FIPS
County
Code
48381
48375
48179
48233
48117
48341
48369
48437
48111
48357
48069
48075
48065
48483
48129
48195
48191
48087
48211
48295
48011
48421
48359
48045
Breast Cancer Prevalence by County
Area: Greater Amarillo Affiliate
Ranked by Prevalent Breast Cancer Cases (Desc)
National Average Age for
Prevalence of Breast Cancer: 59.1
Prevalent
2007 Female
Breast Cancer
County
Randall
Potter
Gray
Hutchinson
Deaf Smith
Moore
Parmer
Swisher
Dallam
Ochiltree
Castro
Childress
Carson
Wheeler
Donley
Hansford
Hall
Collingsworth
Hemphill
Lipscomb
Armstrong
Sherman
Oldham
Briscoe
State
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
Population
57,044
59,940
10,581
11,214
9,507
10,077
4,890
3,646
4,461
4,730
3,674
2,984
3,267
2,403
2,034
2,691
1,928
1,532
1,665
1,550
1,153
1,327
1,073
805
Cases
271
271
56
56
39
36
21
19
19
19
17
17
17
13
12
12
11
9
8
8
7
6
5
5
Avg Age for
Prevalence of
Breast
Cancer
58.2
59.7
61.7
60.3
59.5
58.7
60.1
61.4
59.7
59.0
60.3
61.4
60.3
61.7
62.0
60.9
62.4
62.3
60.1
61.4
61.6
59.8
59.3
61.7
Table 1
Based on population and reported breast cancer information, twenty counties
were excluded from further study. For many of the counties, cancer information was
suppressed due to the small number of cases. For other counties, their small
populations coupled with the small number of cases of breast cancer made them unable
to be examined with statistical accuracy.
Below are the counties (with their female population) that were excluded from statistical
analysis:
9
County/Counties of Interest: What the Data Shows
Table 2
It is important to understand the target population for this current study. Most
community profiles focus only on women age from 40-65; however, the affiliate believes
this limits the study significantly and shuts the door on the young age groups. Although
the risk of breast cancer is lower for women under the age of forty, there is still much to
be learned about these younger populations and their knowledge of breast cancer and
breast health. As a result, the following study focused in women ranging from ages 18
to 65<.
When examining the twenty-six primary counties, pertinent gaps were identified
that must be addressed. First, almost forty percent (39.4%) of women over the age of
forty reported not receiving a mammogram in the last twelve months. The most reported
response for not receiving routine mammograms was other (15.7%).
10
Demographic and Breast Cancer Findings
The average incidence rates for the state of Texas range anywhere from 96.4 to
113.7 according the Centers of Disease Control and Prevention. The second gap that is
the most alarming is twenty-two out of the twenty-six counties in the Greater Amarillo
Affiliate area are over the highest (113.7) state average incidence rates. The affiliate
should prioritize screening and support for these 22 counties: Armstrong, Donley,
Briscoe, Childress, Collingsworth, Roberts, Hall, Wheeler, Carson, Gray, Swisher,
Oldham, Lipscomb, Randall, Hutchison, Hemphill, Sherman, Castro, Potter, Hartley,
Hansford, and Moore.
Race:
Racial disparities in breast cancer cases for all four phases were examined using
data provided by Claritas Inc (2007). Once the necessary data was complied and
analyzed, the results showed Caucasian women have the most consistency across all
counties with all four stages of breast cancer. The results also showed African American
women have a higher rate of stages 3 and 4 of breast cancer compared to the other
ethnic groups. The overall results of the data helped to develop more in-depth questions
regarding race that would be administered in the survey of six counties mentioned
earlier. It is apparent that there are some disparities among ethnic groups; however,
further research must be employed to explore these disparities.
Six Primary Counties:
A basic questionnaire was developed to attempt to fill in some of the gaps
observed in the initial data analysis. The survey instrument assessed basic
demographic information; as well as pertinent questions regarding access to health care
and health care/breast health practices. In order to obtain the most accurate and nonbiased results 525 questionnaires were sent out the six primary counties via mail.
Attached in the envelope was a consent form outlining the objective of the study and a
post marked return envelope. This was to ensure a high return rate of completed
questionnaires. Respondents were limited on the amount of time they had to return the
filled questionnaire and signed consent. Unfortunately we were only able to obtain 58
completed questionnaires. This could have been for a number of reasons; the amount
of time allotted, the subject matter, not of interest, etc.
The basic demographic data showed age ranged from 26 to 86 years of age with
51 being the median age. The majority of the respondents were from Gray County
(41.4%); however, Hansford (17.2%), Potter (15.5%), Randall (10.3%), Dallam (10.3%),
and Carson (5.2%) produced respondents. The majority of the respondents were
Caucasian (91.4%), with Hispanic (6.9%) and American Indian (1.7%) representing the
rest of the total population. The respondents educational background varied with the
majority have a high school diploma (46.6%), followed by Bachelors Degree (20.7%),
Associates Degree (13.8%), Masters Degree (8.6%), GED (5.2%), PhD/M.D (3.4%) and
No formal education (1.7%).
Findings:
This study set out to examine breast health issues in the upper twenty-six
counties of the Texas Panhandle. The survey data and data provided by Claritas Inc.
11
(2007) provided the framework for the following conclusions.
First, twenty-two out of the twenty-six counties were found to have among the
highest average incidence rate of breast cancer in the state. Additionally, these rates
played out in comparison with another state. As previously mentioned, Texas has a
higher ratio rate for women diagnosed with breast cancer than California. Even though
California is more densely populated, Texas has more breast cancer cases.
These high rates of incidence beg further examination. The study found, among
those surveyed, 40% of women over forty were not receiving annual mammograms for
a variety of reasons. This is only one of three recommended steps for early detection.
Targeted, continued education is a clear indication for this age group.
Finally, Caucasian women are represented consistently in all four stages of
breast cancer. However, African American women have higher rates of stage 3 and 4
breast cancer when compared to other ethnic groups. Targeted educational campaigns
could assist in a rate reduction in this particular group.
12
Programs and Services
Data Source and Methodology Overview
Information for the breast cancer programs and services of the service area was
collected through internet research, key informant interviews, and historical review of
service providers. Information was collected at the county, city, and service area levels.
After collecting all sources of breast cancer programs, staff reviewed all of the data for
detailed schedules, services, program availability, and funding sources.
Information and additional sources of information were collected from the
Lubbock Affiliate of Susan G. Komen for the Cure, Texas Department of State Health
Services, M.D. Anderson Hospital, American Cancer Society, Harrington Cancer
Center, Baptist St. Anthony’s Health System, and United Way of Amarillo and Canyon.
Programs and Services Overview
For this project, staff collected all breast healthcare providers in the twenty-six
county service area and compiled the contact information. This list represents fewer
providers than are usually found in a large metropolitan area and shows how important
the few providers are to this large region. Because the Comprehensive Breast Center
of the Harrington Cancer Center and Texas Oncology are the only providers of
chemotherapy and radiation treatment for breast cancer in the Panhandle, some women
may drive more than 100 miles for treatment.
Although there are a few locations for mammography and mobile mammography
programs, they are scattered across the service area and may still require women to
drive more than an hour for screening. The scarcity of service providers creates many
problems for access to healthcare due to transportation issues and difficulty for followup care.
13
Below is a listing of all breast healthcare providers in the twenty-six counties of the Texas
Panhandle:
Breast Healthcare Providers by County
County (or service area)
Armstrong County
Childress
Gray
Hall
Hansford
Hemphill
Ochiltree
Potter/ Randall (Amarillo and
Panhandle region)
Sherman
Program/Service Provider
Coalition of Health Services Inc. Claude Medical Clinic
201 S. Park
Claude, TX 79019
(806) 226-5611
Coalition of Health Services, Inc., Fox Rural Health Clinic
Highway 83 North
Childress, TX 79201
(940) 937- 9654
Pampa Regional Medical Center-Women’s Health Clinic
1 Medical Plaza
Pampa, TX 79065
(806) 663-5663
Fox Rural Health Clinic
Highway 83 North
Childress, TX 79201
(940) 937-9654
Family Medical Center of Hansford County
702 S. Roland
Spearman, TX 76081
(806) 659-2846
Hemphill County Hospital-Harrington Cancer Center Mobile
Mammography
1020 S. 4th Canadian, TX 79014
(806) 359-4673
Perryton Health Center
3101 Garrett Dr. Perryton, TX 79070
(806) 435-7224
Texas Panhandle Family Planning Health Centers
1501 S. Taylor
Amarillo, TX 79101
(806) 372- 8746
Comprehensive Breast Center of the Harrington Cancer Center
1310 Wallace Blvd.
Amarillo, TX 79106
(806) 356-1905
Northwest Women and Children Clinic
814 Martin Rd.
Amarillo, TX 79107
(806) 342-4789
Texas Oncology
1000 S Coulter St # 100, Amarillo, TX 79106
(806) 358-8654
Northwest Texas Hospital Women’s Imaging Center
1501 S. Coulter
Amarillo, TX 79106
(806) 354-1000
Women’s Healthcare & Associates
1301 S. Coulter Amarillo, TX 79106
(806) 355-6330
Stratford Clinic
1220 Purnell PO Box 1107 Stratford, TX 79084
14
Table 3
As a graphical representation of these service providers as well as incidence and
mortality of breast cancer, the map below illustrates incidence of breast cancer with blue
pins, mortality with red pins, and service providers with yellow pins:
Figure 3
Because of the scarcity of providers for breast healthcare, the women of the
Texas Panhandle have many impediments to service. Only eleven of the twenty-six
counties have service providers, so a woman is more likely to have to travel outside her
county than to receive service in her home county. Mammograms are provided in
Amarillo, Hereford, and Dumas only. For mammograms in other towns, women rely on
the mobile mammography unit of Harrington Cancer Center (For a detailed schedule of
locations, see
https://secure.harringtoncc.org/fileadmin/files/forms/comprehensive_breast_center/OUT
REACH_DATES_2009.pdf). For women diagnosed with breast cancer, they have only
two locations for treatment, both in Potter County. This scattering of service providers
mirrors the problems identified through surveys and key informant interviews: many
women do not have regular mammograms which leads to higher mortality rates
throughout the area.
15
Partnerships and Grant Opportunities
The Greater Amarillo Affiliate of Susan G. Komen for the Cure currently partners
with the Amarillo Area Breast Health Coalition to fund and support the WISE (Women
Inspiring, Serving, and Educating) Woman Project. This project trains selected women
in low income housing communities to educate their neighbors and friends about access
and use of available breast health programs. The project began in August 2008 and the
first women were trained in April 2009. The project has the potential to reach hundreds
of women and builds additional partnerships with American Cancer Society, American
Housing Foundation, Texas Tech University Health Sciences Center (Laura W. Bush
Center for Women’s Health and School of Medicine), Baptist St. Anthony’s Health
System, and Harrington Cancer Center. For the project, Komen for the Cure acts as the
funding source for most of the program with other partners providing staff, services, and
in-kind donations. It also provides seamless services for traditionally underserved
women who do not regularly receive mammograms.
Through the WISE Woman Project, a woman can receive breast health
information and instruction about access to mammograms, participate in “mammogram
events” to receive a Komen-funded mammogram, and then be referred to another
partner for treatment and support. The project includes transportation and child care in
order to remove the two most frequently cited reasons for not being able to access
services.
In addition to this project, Komen Amarillo is excited about its current grantees
and its increased reach across the service area. Beginning in the 2009-2010 grant
cycle, the affiliate has granted funding for a project of the Texas A & M Agrilife
Extension to educate older, rural women about breast health screening and funding for
appropriate services. The Agrilife Extension has offices in all counties of the Panhandle
and will be able to reach women who have not been served by other grants.
Another grant that is reaching across the Panhandle is being conducted by
Amarillo College’s public broadcasting television station, KACV. KACV will produce and
16
broadcast public service announcements about breast health in both English and
Spanish. Because KACV’s service area mirrors Komen Amarillo’s, the affiliate sees this
grant as a great way to both publicize Komen’s impact on the area and make breast
health information available to all women in the Panhandle.
Other current grantees include Amarillo Girl Scouts and Harrington Cancer
Center. Under the Girl Scouts’ grant one event will educate girls and women about
breast cancer risk factors and early detection methods. Under the Harrington Cancer
Center grant, Komen provides screening and diagnostic mammography for medically
underserved women. It especially targets women who are 18-35 years old and have
high risk factors for breast cancer. Because Harrington is a BCCCP provider, the center
maximizes available funding by determining which funding source better serves the
patient. Because BCCCP funds have been decreasing, Komen funds have become
critical for providing mammograms for underserved women.
Based on current grants, Komen Amarillo is successfully attempting to reach all
of its service area and women who can benefit from breast health education, programs,
and services. However, the performance of the grants will determine the success of the
programs. The affiliate will continue to encourage entities that serve the entire
Panhandle to apply for funds. Until additional service providers can be found, Komen
Amarillo hopes to continue to fund Harrington Cancer Center and its programs for low
income, underserved women.
Promising Practices and Evidence-Based Programs
For this funding cycle, grantees, medical professionals, and community members
attended a grant workshop hosted by the affiliate and facilitated by the National Cancer
Institute; most of them have included evidence-based objectives in their grants. The
affiliate has already begun to plan the workshop for 2010 and expects to conduct it
yearly for existing and potential grantees. This will ensure all grantees incorporate
evidence-based programs and best practices from other grantees.
The WISE Woman Project, Agrilife grant, and Harrington Cancer Center grant
have strong components of objective measurement and community impact: the affiliate
will know exactly how many women receive education, screening, diagnosis, and
treatment.
Public Policy Perspectives
Komen Amarillo coordinates services with the BCCCP through the services of
Harrington Cancer Center, the main provider of cancer screening and treatment for the
Texas Panhandle. For the past few years, funding from BCCCP has been declining, so
Komen Amarillo has recently allowed the Cancer Center to revise its grant to include
women of all ages.
Although more than 134,000 women have been served since 1992 through the
BCCCP (Dorothy Marley, BCCCP representative), only about 20,000 Texas women are
served each year, reaching a mere 3% of those who are eligible for services. The
director of BCCCP for Texas is Emelda Garcia. The affiliate has not built a relationship
with her, but will plan to begin to coordinate with her during the next few years to
improve women’s access to the BCCCP funding and services.
17
The affiliate has a much better relationship with all of its elected officials. The
Amarillo mayor, Debra McCartt has been a regular supporter and participant in the
Race for the Cure. The Executive Director has recently lobbied both state and national
representatives. In January 2009, Ms. Davis met with Senator Kel Seliger and
Representatives David Swinford, John Smithee, and Warren Chisum. In April 2009, she
travelled to Washington, D.C. to meet with Senators Kay Bailey Hutchison and John
Cornyn and Representatives Mac Thornberry and Randy Neugebaur.
The affiliate has good working relationships with state representatives and will
strive to improve the relationships with its national elected officials.
Programs and Service Findings
From a thorough review of the available programs and services of the Texas
Panhandle, the affiliate affirmed its understanding of the thin coverage of its service
area. Many women do not have access to basic services and programs. The affiliate
continues to initiate discussions with the region’s healthcare centers about grant
opportunities through Komen for the Cure. During the collection of exploratory data, the
researchers investigated how women accessed healthcare and what the women
perceived as barriers to service.
18
Exploratory Data
Data Sources and Methodology Overview
The SGK data packs provided by Thomson Reuters have given an excellent
insight into local cancer estimates.
There are questions that require further exploration in the overall assessment
process. This additional, subjective data will be collected from surveys, focus groups
and other methods identified in community data. The following are identified for further
study:
 What are the barriers to services?
 What are the cultural and behavioral considerations related to health care?
 What effect does location have on services (rural vs. urban)?
 What is the best method to supplement the statistical information?
As this information is preliminary, further study will produce more conclusive results.
Exploratory Data Overview
The section of the survey dedicated to the breast health and breast cancer
knowledge produced some interesting results. Of the 58 respondents 86.2% reported
having easy access to medical services, 96.6 % reported having received information
concerning self-breast exams, and 91.4% receiving information on breast cancer and
breast health, 100% reported that mammograms are important to women’s overall
health. When respondents were asked if they had ever received a mammogram
(82.8%) and if they had received a mammogram in the last twelve months (60.3), an
overwhelming majority reported yes. Also, almost ninety percent (87.7) of respondents
reported receiving annual physical exams.
Those respondents who reported never receiving a mammogram or not receiving
19
a mammogram in the last twelve months were asked why not: interestingly, the majority
of the responded to the “other” category (26.7%), followed by to expensive/no insurance
(20%), haven’t had any problems (20%), put it off/ too lazy (16.7%), didn’t know I
needed it (3.3%), and never thought about it (3.3%). Those who marked the other
category were given the opportunity to specify their reason here were some of the most
common responses:
“Dr. suggested waiting until age 40”
“It was not due”
“Needs to be done every two years”
“Breast Feeding”
“Scared”
“Dr. Moved Away”
Exploratory Data Findings
The exploratory data collected for the community profile brought up more
opportunities for research. The affiliate understands that a larger sample size would
produce statistically relevant information. However, addressing the response rate to
surveys will have to be improved first. The affiliate has identified barriers to services,
the cultural and behavioral considerations related to health care, effect of location on
services (rural vs. urban), and best methods to supplement the statistical information as
topics for further exploratory research.
20
Conclusions
Target Area Findings
From the quantitative and qualitative data collected for the community profile, the
affiliate discovered many areas of attention in the Texas Panhandle. First, twenty-two
out of the twenty-six counties were found to have among the highest average incidence
rate of breast cancer in the state.
These high rates of incidence beg further examination. The study found, among
those surveyed, 40% of women over 40 were not receiving annual mammograms for a
variety of reasons. Clearly, targeted and continued education is indicated for this age
group.
Additionally, Caucasian women are represented consistently in all four stages of
breast cancer. However, African American women have higher rates of stage 3 and 4
breast cancer when compared to other ethnic groups. Targeted educational campaigns
could assist in a rate reduction in this particular group.
Research also confirmed the affiliate’s understanding of the thin service
coverage of the area: Many women do not have access to basic services and programs.
The affiliate continues to initiate discussions with the region’s healthcare centers about
grant opportunities through Komen for the Cure. Barriers to service and rural versus
urban access will become a priority for further investigation during the next two years.
Finally, the exploratory data helped the affiliate identify barriers to services, the
cultural and behavioral considerations related to health care, effect of location on
services (rural vs. urban), and best methods to supplement the statistical information as
topics for further exploratory research.
Putting the Data Together
Because of the suppressed data (due to small numbers) in many of the service
area counties, the affiliate removed many of the counties from further study.
Additionally, the small number of service providers also limited the opportunities for
further investigation. After examining incidence and mortality for available counties, the
affiliate paired the service providers to counties with high incidence or mortality from
breast cancer. Then, based on responses to surveys, the affiliate uncovered the
recurring themes of high incidence and mortality due to limited access to services and
educational needs based on the sparse service providers and few education
opportunities.
21
Selecting Affiliate Priorities
After reviewing breast cancer statistics for the twenty-six counties of the Texas
Panhandle, examining the available programs and services, and incorporating
exploratory data, the affiliate has identified the following priorities for the upcoming two
years:
1. Target underserved women: 10% of families fall below the poverty line, 31%
of women are uninsured, and 40% of women over forty did not get an annual
mammogram.
2. Focus funding in six counties: Gray, Hansford, Potter, Randall, Dallam, and
Carson. These counties are home to 67% of the Panhandle’s population
while also representing high incidence and counties with service providers.
The counties are also adjacent to counties without service providers so the
affiliate can investigate rural versus urban obstacles to service.
3. Encourage partnerships: The expected success of the WISE Woman Project
and the coordination of services created by the project highlight the potential
for additional partnerships. Increased partnership and coordination with the
BCCCP will stretch funding dollars and ensure more women have access to
screening and diagnosis.
4. Address cultural and ethnic obstacles to education, screening, and
diagnosis: Although Caucasian women are more than half of the population,
the minority groups of the Panhandle are expected to grow faster than the
Caucasian group during the upcoming census. Caucasian women have
traditionally had better access to healthcare, so emphasis on minority groups
will provide data for future programs and grant opportunities.
Affiliate Action Plan
Community Partnerships
The affiliate will pursue additional community partnership opportunities and will
encourage grantees to engage in partnership activities. This supports item 3 of the
priority list and ensures grant funding makes the greatest impact on the community.
Existing Grant Solutions
The affiliate has already begun to address some of the issues uncovered by the
community profile. The WISE Woman Project is a new partnership of both new and
previous grantees working together to serve low income, minority women in two of the
target counties. Also, the Texas Agrilife grant is providing education opportunities
across the entire service area. Both grants provide opportunities for future best
practices to address the affiliate’s priorities.
Needed Grant Opportunities
Future grant opportunities should expand existing grant work. Future grants should
bring more education and screening to rural areas (like the Texas Agrilife grant), focus
on serving low income and minority women (like the WISE Woman Project), or address
22
the high incidence and mortality of the targeted counties (like all of the existing
grantees). The affiliate ensures future grantees will understand and address these
needs by conducting annual grant writing workshops with the help of the Cancer
Information Service of the National Cancer Institute.
Public Policy Efforts
In order to improve the affiliate’s coordination with the BCCCP funding, staff will begin
work with the Texas Director (or her designee) to discuss ways to improve the 3% of
women who are eligible for services.
Education and Outreach
Education and outreach continue to be high priorities for the affiliate. Through both
quantitative and qualitative data, the affiliate learned that women throughout the service
area did not know how to access services or were ignorant of basic breast health
concepts. The affiliate will continue to work for additional education opportunities: its
recent hiring of a Mission Coordinator demonstrates its commitment to education. The
community profile uncovered the need to address cultural and ethnic barriers to service
which the affiliate will incorporate into future grant requests.
23
List of Figures
Figure 1: Service Area Map
Figure 2: Incidence Rates for Texas
Figure 3: Resource Map
List of Tables
Table 1: Breast Cancer Prevalence by County
Table 2: 20 Remaining Counties
Table 3: Breast Healthcare Providers by County
List of Appendices
Appendix A: Focus Group Sample Questions
Appendix B: Key Informant Interview Sample Questions
Appendix C: Survey Request
Appendix D: Consent Form
Appendix E: Key Informant Survey
Appendix F: Key Informant Interview Guide
Appendix G: Survey Scripts
Appendix H: National and Texas Breast Health Program and Service Providers
24
Appendices
Appendix A:
Focus Group Sample Questions
1. Do you go to the doctor regularly? Do you have a local healthcare provider?
2. Where is someone most likely to go for breast health information?
3. What does breast health screening mean to you? Do you know the recommended
guidelines for breast health screening?
4. If you didn’t have insurance, what would you expect to pay for a mammogram?
5. What do you think are the barriers that prevent women from seeking or getting breast
health screening in your community?
Examples if no one is responding:
a. Transportation
b. Financial/Uninsured
c. Lack of facilities/providers for your community
6. What could your doctor do to encourage women to seek breast health services?
Examples if no one is responding:
a. Reminder at each visit
b. Link you to program/service that would help pay
c. Nothing, I would need insurance first
7. What type of program could we provide to make it easier for women to access breast
health services?
Examples if no one is responding:
a. Mobile Mammogram Units
b. Transportation/Vouchers
c. Awareness Campaigns
d. Helpline/Hotline (with translators)
8. Who could we partner with in your community to best get the word out about breast
health to women in this community?
9. What does Susan G Komen for the Cure mean to you?
a. Do you know what we do in the Columbus Community?
Survivors
1. Did you have any difficulty finding providers/services?
2. What was the most difficult and most beneficial aspect of your breast cancer
experience?
3. What programs/services would you recommend to other survivors? What advice would
you give them?
4. How much did financial considerations affect your treatment decisions? Did your work
schedule impact your decisions?
5. What services were missing? Support Groups, survivorship programs, after-care, etc
6. In your community, where should Komen prioritize its funding: Education, Screening,
Treatment, Survivorship?
25
Appendix B:
Key Informant Interview Sample Questions
Key informant interviews should include five to ten questions that provide in-depth
understanding to specific areas of focus. Initial scripted questions start the discussion,
but the interviewer should always probe and ask more questions to clarify dialogue and
get as much information as possible on the topic.
The questions created by the community profile team should always be tailored to who
is being interviewed. Additionally, the questions should address the gaps in knowledge
that still exist after collecting and reviewing demographic data, breast cancer statistics
and program and services reports. Data collected using key informant interviews will
only be as good as the questions the community profile team creates to address the
real issues in the community.
When creating the questions, the team should always ask the following:




Why do we want to know this?
Who will be interviewed? i.e. provider, community member, etc.
Is this going to lead to areas we can address?
How will this inform our (grants process, marketing, education) efforts in the
community?
When creating the questions, the team should remember these rules:



Use open-ended questions
Avoid questions that can be answered with yes or no
Focus the questions from general to specific
The questions provided here are examples that may help the community profile team
understand what types of questions to create for and ask of a key informant.
Key Informant Sample Questions (Providers)
1. How would you describe the women who are least likely to be getting regular breast
health screening?
a. What neighborhoods do these women live in?
b. Where do they work?
c. What businesses do they frequent?
d. Describe their ethnic background.
e. What are their family situations like?
2. How would you describe the women who are least likely to receive effective breast
health services? * see above probing questions
3. How successful is the current healthcare system in meeting the needs for breast
healthcare and treatment?
26
4. How effective are the financial assistance programs in your community in helping
women access breast health services?
5. What types of programs do you think would help to improve the current system?
6. If funding was made available, is your organization willing (alone or in partnership) to
provide services that expand on existing services or address gaps in services?
7. How can organizations working in the field of breast cancer collaborate more?
8. What are some of the barriers to collaboration in your community?
9. Are there specific breast health partnerships that could be formed to address
specific breast health gaps in your community?
10. What would a Komen partnership with your organization look like?
11. What laws or policies make it difficult for women to get breast health services in your
community?
12. What efforts, if any, does your organization make to market breast health information
in your community?
13. What policies do insurance providers follow related to clinical trial coverage in this
community?
Key Informant Sample Questions (Survivorship)
1.
2.
3.
4.
5.
6.
When and where was the cancer diagnosed?
Were you advised of your treatment options?
What stage was the cancer when detected?
When did you begin to receive treatment?
What stage was the cancer when treatment began?
How has this affected your life – physically, financially, and emotionally?
Interviewing Tips
Use probing techniques to encourage conversation without influencing the answer. Two
kinds of probes are used for open-ended questions – probing for clarity and probing for
additional information.
The best probes for clarity are the ones that tell the respondent exactly what you need
to know, or what you want them to do.
 For example: What do you mean? Could you be more specific? Could you tell
me more about ____? Could you give me an example?
Once a clear response has been given, the interviewer can probe for additional
responses to the question. The best way to do this is to repeat the main point of the
question as part of a request for further information.
 For example: What else do you think? What other reason exist?
Avoid asking “is there anything else” because this can be answered with NO.
27
Appendix C:
Survey Request
April 9, 2009
The Greater Amarillo Affiliate of Susan G. Komen for the Cure is seeking female
participants for a research study. You have been randomly selected to participate in
this study. The title of this study is:
Factors in Women’s Breast Health: A Survey of Six Texas Panhandle Counties
The purpose of this exploratory, descriptive study is to examine medical and
educational resources for women regarding breast cancer in six counties of the Texas
Panhandle. The counties that will be explored are Carson, Dallam, Gray, Hansford,
Potter and Randall.
There are few risks in participating in this study. You may feel uncomfortable about
answering some of the questions in the survey instrument. You may opt out at any time
and may choose to leave questions unanswered. Your participation is strictly voluntary
and is confidential; there will be no way to link your answers with your name. Data will
be reported in aggregate form only.
By participating in this study, you may help us generate a better understanding of what
kind of problems women might face, and if their needs are being met regarding breast
health and other related variables. These variables have been identified as being
important and relevant to social work practice in today’s society and will help in
developing new and progressive services in the Komen service area. Participation will
require approximately 2-5 minutes of your time. If you agree to participate, please fill the
attached survey and return it to:
In order to compile this sensitive data in an effective and efficient manner, we ask you to
please return the survey in the attached envelope by April 23, 2009. Your participation
in this study is greatly appreciated and we would like to say thanks on behalf of the
Greater Amarillo Affiliate of Susan G. Komen for the Cure and the many fighting breast
cancer.
Sincerely,
Sara Northrup, M.A., LBSW
West Texas Family and Community Services
A project of West Texas A&M University
601 W. 10th
Amarillo, Texas 79101
28
Appendix D:
Consent Form
Consent Form for Participation in:
Factors in Women’s Breast Health: A Survey of Six Texas Panhandle Counties
Date: _________________________
I agree to participate in the research project entitled” Factors in Women’s Breast Health: A
Survey of Six Panhandle Counties”. I have read the attached informed consent form, and I
understand the possible consequences of participation. I also understand that my participation
is strictly voluntary and that I may withdraw my consent at any time. By signing below I certify
that I am at least 18 years of age or older.
Signed:
___________________________________________________
Printed Name:
_______________________________________________
29
Appendix E:
Key Informant Survey
(Please mark answers with an X to indicate your responses)
1. Please indicate the current county you live in.
A.
B.
C.
D.
E.
F.
Carson____
Dallam____
Gray____
Hansford_____
Potter____
Randall____
2. What is your date of birth?
Month_____ Day ________
Year_________
3. What is your ethnicity?
A. Hispanic/Spanish/Latino
E. Asian Indian________
B. White
F. American Indian_____
C. Black or African American______
G. Other (Specify)
D. Asian or Pacific Islander ____
H. Don’t Know
4. What is your highest level of education?
A. GED____
D. Masters degree____
B. High School Diploma____
E. Ph.D.____
C. Associates degree____
F. None of these____
D. Bachelors degree____
5. Is it easy for you to access medical services?
A. Yes____
B. No_____
(If answered Yes, skip to question 7)
30
6. If No, why not?
(Please check all that apply)
A. Transportation___
B. Financial Troubles___
C. No child care_______
D. No support system_____
E. Other____________
7. Have you ever received information on self-breast exams?
A. Yes____
B. No____
8. Have you ever received information about breast cancer/breast health?
A. Yes____
B. No____
(If answered Yes, skip to question 10)
9. If No, why not?
(Check all that apply)
A. No reason/Never thought about it____
E. Don’t know how____
B. Didn’t know I needed it______
F. The test is unpleasant______
C. Haven’t had any problems______
G. Not important____
D. Put it off/Laziness______
10. Do you have a family history of breast cancer?
A. Yes____
B. No_____
11. How much do you know about breast health/preventative health?
31
A.
B.
C.
D.
Nothing at all___
Only a little____
More than most____
A great deal____
12. Have you ever received information about breast cancer/breast health?
A. Yes_____
B. No______
13. Do you think mammograms are important to your overall health?
A. Yes_____
B. No______
14. Have you ever been/currently diagnosed with any form of cancer?
A. Yes_____
B. No______
(If answered No, skip to question 16)
15. If so, which type?
A. Lung_____
B. Breast_____
C. Colon_____
D. Rectal _____
E. Prostate_____
16. Have you ever had a mammogram?
A. Yes____
B. No_____
(If answer No, skip to question 18)
17. Have you had a mammogram in the last 12 months?
A. Yes______
B. No______
(If answer Yes, skip to question 19)
18. Why not?
(Please check all that apply)
A. No reason/Never thought about it____
Insurance____
E. Too Expensive/No
B. Didn’t know I needed it______
F. The test is unpleasant______
C. Haven’t had any problems______
G. No transportation_______
32
D. Put it off/Laziness______
H. Other_______________
19. Do you receive annual clinical exams?
A. Yes______
B. No______
(If answered Yes, you are finished with the survey!)
20. Why not?
(Please check all that apply)
A. No reason/Never thought about it____
E. Too Expensive/No Insurance____
B. Didn’t know I needed it______
F. The test is unpleasant______
C. Haven’t had any problems______
G. No transportation_______
D. Put it off/Laziness______
H. Other______________
THANK YOU FOR YOUR PARTICIPATION.
33
Appendix F:
Key Informant Interview Guide
Hello, my name is ______________. May I speak with your clinic manager? I am calling
with Susan G. Komen for the Cure. We are working on a project to collect information
about breast health education and resources in the Texas Panhandle. We are
contacting you because you are a clinic manager and we would like to ask if you would
be willing to answer a few questions about your clinic that will help us determine our
future funding priorities. It is less than 15 minutes long and would provide essential
information that will help our community address breast health. Would you be willing to
help with our project?
The first questions I am going to ask you are about breast health education at your
clinic.
1) Where are the women you serve likely to go for breast health information?
(You may select more than one option.) (do not read options )
� Healthcare providers
� Community advocacy group
� Online
� Printed material such as books or pamphlets
� Friends/Family
� Other: Please list ______________________________
2) Do you provide breast health education materials through your organization?
� No
� Yes
� Unsure
3) Do you serve a non-English speaking population at your site that would benefit from
breast health messages and services?
� No (skip to question 7)
� Yes
4) Do you provide non-English breast health education materials?
� No
� Yes (skip to question 5)
� Unsure
4a) Do you know where you can access non-English materials if you should need
them?
� No
� Yes
5) I am going to read you a list of languages that patients in your clinic may speak. For
each,
please say yes or no to indicate whether your clinic would have a need for breast health
education resources in that language.
Spanish Yes No Unsure
Russian Yes No Unsure
Hmong Yes No Unsure
Somali Yes No Unsure
34
Other: Please list _____________________?
6) Does your site currently use interpreters to provide breast health education in other
languages?
� No, we are not able to provide interpreters for breast health education in other
languages
� No, we do not have a need for interpreters to provide breast health education
� Yes, we use interpreters to provide breast health education
� Unsure
7) I am going to read a list of women that are often targeted for breast health education.
Please tell us if your organization targets these populations for breast health education.
women 50 years old and older Yes No Unsure
40 to 49 year old women Yes No Unsure
18 to 39 year old women Yes No Unsure
Women in racial groups that are at high risk for breast cancer Yes No Unsure
Women in ethnic groups that are at high risk for breast cancer Yes No Unsure
Everyone gets materials Yes No Unsure
7a) What populations of women come into your clinic that you believe would benefit
from being targeted with additional breast health education or screening services?
______________________________________________________________________
_____
______________________________________________________________________
_____
7b) I am going to read you a list of types of health care providers. Please respond to
each by telling me if that type of provider offers breast health education at your site.
Physicians Yes No Unsure
Physician assistants Yes No Unsure
Master’s level prepared nurses Yes No Unsure
RNs Yes No Unsure
Community health workers Yes No Unsure
Other, please specify: _______________________________________________
The next questions I am going to ask relate to screening and diagnostic services that
are available at your clinic.
9) Do the providers in your organization provide breast screening and diagnostic tests?
� No (skip to question 12)
� Yes
� Unsure (skip to question 12)
9a) Breast health screenings include mammograms and clinical breast exams. I am
going to read you a list of types of health care providers. Please respond to each by
telling me if that type of provider offers any breast health screenings at your site.
Physicians Yes No Unsure
Physician assistants Yes No Unsure
Master’s level prepared nurses Yes No Unsure
RNs Yes No Unsure
Radiologists Yes No Unsure
Other, please specify: _______________________________________________
35
10) Please choose the statement that best describes how your clinic prioritizes breast
cancer screening and education?
� Our clinic addresses breast health at every well woman visit regardless of any other
issues that are addressed.
� We address breast health at well woman visits if there is not a more prominent
concern based on the patient’s medical history.
� We address breast health at well woman visits only when there is a specific concern
about this issue.
11) Does your organization have formal policies that require providers to conduct
clinical breast exams on women during their well woman visits?
� No
� Yes
� Unsure
12) Does your organization provide referrals to other clinics if a woman needs breast
health screening and education services that are not available at your site?
� No
� Yes
� Unsure
12a) I am going to read a list of barriers that may prevent women from seeking or
obtaining breast health services. Please tell me if you perceive the issue to be a barrier
for women in your community.
Income Yes No Unsure
Patients are uninsured Yes No Unsure
Patients are under-insured Yes No Unsure
Transportation Yes No Unsure
Fear Yes No Unsure
Other: Please list ___________________
13) What do you think would help improve the delivery of breast health services in the
current healthcare system?
______________________________________________________________________
________
______________________________________________________________________
________
______________________________________________________________________
________
14) Is your clinic able to provide breast cancer screening services to women with
disabilities (i.e. mammography capacity for wheelchair bound women)?
� No
� Yes
� Unsure
The next few questions ask about how women pay for services at your clinic.
15) I am going to read a list of ways people pay for health services. Please tell me if
patients at your clinic use the following method to pay for breast health services.
PPO private payer insurance Yes No Unsure
HMOs Yes No Unsure
Public (govt.) insurance Yes No Unsure
36
Other, please list: _________________________________
16) Does your site offer any type of financial assistance for uninsured, underinsured or
low income clients?
� No (skip to question 19)
� Yes
� Unsure (skip to question 19)
17) Please respond yes or no to indicate whether your site provides each service in the
list to income qualifying women.
Reduced price mammograms Yes No Unsure
Reduced price appointments including clinical breast exams Yes No Unsure
Free mammograms Yes No Unsure
Free appointments including clinical breast exams Yes No Unsure
Referrals to sources that provide
free/reduced price mammograms/appointments Yes No Unsure
Other, please list: ______________________________________________
18) What is the income threshold for patients to be eligible for those services? Patients
must be…
� Below the federal poverty line
� Between 100% and 200% of the poverty line
� Between 200-250% of the poverty line
� Unsure
� Other, please list: __________________________________________________
19) Do you know of other organizations in your community that offer financial assistance
to uninsured or under-insured women for breast health services?
� No (skip to question 20)
� Yes
19 a) Please list them _______________________________________________
______________________________________________________________________
__
My final questions today are about partnerships that some organizations are able to
form to address breast health needs in the community.
20) Do you presently partner with any other local organizations in providing breast
health services to women in your community?
� No (skip to closing)
� Yes
� Unsure (skip to closing)
20a) Please list partnering organizations and describe the partnerships
Organization Type of partnership
______________________________________________________________________
_____
______________________________________________________________________
_____
______________________________________________________________________
_____
Closing: Thank you for your time and valuable feedback. We greatly appreciate your
participation.
37
Appendix G:
Survey Scripts
The survey introduction serves several purposes:




Helps establish the nature of the relationship between the interviewer and the
respondent.
Establishes a context for the questions and the respondent’s answers.
Establishes credibility.
Provides an incentive for the respondent. The incentive is often the feeling the
respondent has in cooperating and knowing that their contribution will help lead
to a better community.
The introduction should include:






An introduction to interviewer and organization behind project
A statement of purpose
A thank you statement
An explanation of the importance of respondent’s input
A confidentiality statement and
An overview of how data will be used
Sample Phone Script
Hello, I'm ______ calling on behalf of Susan G Komen for the Cure. We are doing a
survey and are asking questions about breast cancer services and your community.
The information provided will be used to help Susan G Komen for the Cure’s local office
to create a community profile report which will then inform the work we do in the
community. Your name and number was obtained (describe how person/organization
was chosen). Because you are a community leader and involved in breast cancer we
feel your input is valuable and should be included in our report.
Your responses are completely confidential and will only be viewed by the community
profile team that is helping us create the community profile report. You don't have to
answer any question you don't want to, and you can end the interview at any time. The
interview takes about (estimate time). Please feel free to ask any questions you have
as we go through the survey and if there is something that I can’t answer today, I will
provide you the phone number and email address of the contact person at Susan G
Komen for the Cure.
Begin Scripted Survey Questions
Sample In-Person Script
Hello, I'm ______ working with Susan G Komen for the Cure on the community profile
project. Thank you for meeting with me today to complete this survey on breast cancer
38
in our community. The information you provide will be used to help Susan G Komen for
the Cure’s local office create a community profile report which will then inform the work
we do in the community. Your input will help us determine our community’s priorities as
they relate to breast cancer and help us determine how our money is best granted, what
outreach and advocacy we should be focusing on and in general what areas of focus
we need to be aware and involved in. Your name and number was obtained (describe
how person/organization was chosen). Because you are a community leader and
involved in breast health we feel your input is valuable and should be included in our
report.
Your responses are completely confidential and will only be viewed by the community
profile team that is helping us analyze the data and put together the community profile
report. You don't have to answer any question you don't want to, and you can end the
interview at any time. The interview should take about (estimate time). Please feel free
to ask any questions you have as we go through the survey and if there is something
that I can’t answer today, I will provide you the phone number and email address of the
contact person at Susan G Komen for the Cure.
Begin Scripted Survey Questions
39
Appendix H:
National and Texas Breast Health, Program, and Service Providers
County
Provider
Address
Town
Phone #
Armstrong
Coalition of Health
Services Inc.
201 S. Park
Claude, TX
79019
806-226-5611
Childress
Coalition of Health
Services, Inc., Fox
Rural Clinic
Highway 83
North
Childress, TX
79201
940-937-9654
Childress Regional
Medical Center
PO Box 1030
Childress, TX
79201
940-937-6371
Gray
Pampa Regional
Medical Center
1 Medical Plaza
Pampa, TX
79065
806-663-5509
Hutchinson
Golden Plains
Community Hospital
200 South
McGee
Borger, TX
79007
806-273-1220
Moore
Moore County
Hospital District
224 East 2nd St
Dumas, TX
79029
806-935-7171
Ochiltree
Perryton Health
Center/ Ochiltree
General Hospital
3101 Garrett Dr.
Perryton, TX
79070
806-435-7224
Potter/Randall
Texas Panhandle
Family Planning
Health Clinic
1501 S. Taylor
Amarillo, TX
79101
806-372-8746
The Don and Sybil
Harrington Cancer
Center
1500 Wallace
Blvd
Amarillo, TX
79106
806-356-1905
1301 S. Coulter,
suite 300
Amarillo, TX
79106
806-355-6330
1310 Wallace
Blvd.
Amarillo, TX
79106
806-356-1905
Texas Diagnostic
Imagine Center
1000 Coulter
Amarillo Tx
79106
806-358-1010
Northwest Texas
Hospital
Coulter Imaging,
LLC
Amarillo Family
Physicians Clinic,
PA
Amarillo Diagnostic
Center
1501 South
Coulter Rd
1900 S. Coulter,
Suite N
suite 100 South
1215 South
Coulter
6700 West
Ninth
Website
Screening
Women's Healthcare
Associates
Comprehensive
Breast Center of the
Harrington Cancer
Center
Northwest Women
and Children Clinic
Sherman
Stratford Clinic
814 Martin Rd.
1220 Purnell
PO Box
Amarillo, TX
79106
Amarillo, TX
79106
Amarillo, TX
79106
Amarillo, TX
79106
Amarillo, TX
79107
Stratford, TX
79084
signaturehospital.com
Harringtoncc.org
secure.harringtoncc.org
806-354-1703
806-358-7149
806-354-1703
806-358-0228
806-342-4789
806-396-2852
Treatment
40
Comprehensive
Breast Center
1310 Wallace
Blvd.
Amarillo, TX
79106
806-356-1905
Texas Diagnostic
Imagine Center
1000 Coulter
Amarillo Tx
79106
806-358-1010
Susan G Komen for
the Cure Greater
Amarillo Affiliate
PO Box 50610
Amarillo TX
79159
806-354-9706
1500 Wallace
Blvd
Amarillo, TX
79106
806-356-1905
1310 Wallace
Blvd.
Amarillo, TX
79106
806-356-1905
Amarillo Area Breast
Health Coalition
301 S. Polk St.,
Suite 740
Amarillo, TX
806-331-4710
aabhc.org/
American Cancer
Society
3915 Bell St
Amarillo, TX
79109
806-353-4306
cancer.org
800-622-2839
natlbcc.org
312-644-6610
wcn.org
212-916-7667
youngsurvival.org
Education
The Don and Sybil
Harrington Cancer
Center
Comprehensive
Breast Center of the
Harrington Cancer
Center
Harringtoncc.org
National Education
National Breast
Cancer Coalition
Women's Cancer
Network
Young Survival
Coalition
M.D. Anderson
Cancer Center
800-345-6324
American Cancer
Society
800-227-2345
cancer.org
Susan G. Komen for
the Cure
877-465-6636
komen.org
National Cancer
Institute
800-4Cancer
Cancer.gov
Project Aware
project-aware.org
Cancer Treatment
Centers of America
800-268-0768
Cancer Care
800-813-4673
U.S. Department of
Health & Human
Services
hhs.gov
Breast Cancer
Network of Strength
Medicine World
Texas Education
Texas Cancer Data
Center
txcancer.org
41
Texas Department
of State Health
Services
dshs.state.tx.us
Texas Cancer
Information
texascancer.info
Texas Department
of Health
888-963-7111
tdh.state.tx.us
Texas Oncology
Mobile
Mammograms
Hemphill County
Hospital
1020 South
Fourth
Clarendon Church of
Christ
Coon Memorial
Hospital
Medical Center of
Dimmitt
Canadian TX
806-323-6422
301 Carhart
1411 Denver
Avenue
Clarendon, TX
806-874-2495
Dalhart, TX
806-246-4571
300 W. Halsell
Dimmitt, TX
806-647-2194
310 West
Halsell Box 278
Dimmitt, TX
806-647-2191 ext. 14
1307 Cleveland
Friona, TX
806-250-2754
110 N. 25 Mile
Ave. Suite A
Hereford, TX
806-364-7688
707 S. Roland
Spearman, TX
806-659-2535
Tulia, TX
806-995-3581
Wheeler, TX
806-826-5581
3915 Bell St
Amarillo, TX
79109
877-227-1618
1309 W. 8th
Amarillo, TX
79120
806-372-2531
Jan Werner Transit
3108 S Fillmore
Amarillo, TX
79110
806-374-5516
Ronald McDonald
House of Amarillo
1501 Streit
Amarillo, TX
806-358-8177
3915 Bell St
Amarillo, TX
79109
806- 353-4306
Plains Memorial
Hospital
Parmer County
Hospital
Hereford South
Plains Health
Provider
Hansford County
Hospital
Swisher Memorial
Hospital
Parkview Hospital
539 Southeast
Second
901 Sweetwater
Street
www.pcchtx.com
Support
Transportation
American Cancer
Society/ Road to
Recovery
Panhandle
Community
Services- Panhandle
Transit
Medicaid
Transportation
www.cancer.org
877-633-8747
Housing
Circle of Friends
Apartments
American Cancer
Society
www.cancer.org
Support Groups
42
The Don and Sybil
Harrington Cancer
Center
Pathways
1500 Wallace
Blvd
Amarillo, TX
79106
806-356-1905
Journeys
2nd Monday of
each month
5:30-7:00 PM
Amphitheater,
2nd floor
Women in Touch
3rd Monday of
each month
5:30-7:00 PM
Amphitheater,
2nd floor
Dialogue
Thursdays
noon-1:00 PM
Amphitheater,
2nd floor
Radiation Therapy
Class
Tuesdays
9:00-11:30 AM
Pampa Area Cancer
Support Group
100 W 30th Ave
Pampa, TX
79065
4th Tuesday
Hereford Regional
Medical Center
www.Harringtoncc.org
On-going support group
6:00 PM
806- 663-5566
www.prmctx.com
Pampa Regional
Medical Center
Cafeteria
801 E. 3rd St
Hereford, TX
79045
806-364-2141
2nd Monday of
each month
6:30-7:30
806-364-2121 ext
3370
Breast Cancer
Support
www.Bcsupport.org
Network of Strength
2BME
www.2bme.org
Anderson Network
800-345-6324
www.mdanderson.org
Medicine World
Texas Oncology
Susan G. Komen
www.komen.org
Mastectomy
Products
Advanced Limb and
Brace
The Woman's
Personal Health
Resource Inc.
1900 S Coulter
St # E
Amarillo, TX
79106
806-351-1775
877-463-1343
Breast Forms
Nearly You
Mastectomy
Products
800-734-1886
www.Breastform.com
866-722-6168
www.nearlyyou.com
Tender Loving Care
800-850-9445
www.tlcdirect.org
Me Again Breast
Prosthesis Boutique
Amarillo, TX
806-358-7851
Wigs
Feke Wigs
www.fekewings.com
Best Wig Outlet
Hairpieces for
Women
www.bestoutlet.com
Affordable Wigs
Evilene's Wigs &
Accessories
G-Bob's Wigs
www.headcovers.com
1201 Buchanan
Street
Amarillo TX
79107
3701 Plains
Blvd
3801 Olsen
Blvd
Amarillo TX
79102
Amarillo TX
79109
806-372-3541
806-331-4247
806-352-1601
43
Merle Norman
Cosmetics
3440 Bell St.
Amarillo, TX
79109
806-352-1022
American Cancer
Society
3915 Bell St
Amarillo, TX
79109
877-227-1618
Hair Club for Men &
Women
6900 West
Interstate 40
Amarillo, TX
79106
806-353-4247
www.cancer.org
Financial
Assistance
AVONCares
Program for
Medically
Underserved
Women
800-813-4673
National Cancer
Institute
Coverage for AllHealthcare
Coverage
800-234-1317
University Medical
Center
806-775-9045
Medicaid Hotline
800-422-6237
Medicare Hotline
800-633-4227
Patient's Advocate
Foundation's CoPay Relief Program
Health Well
Foundation Financial
Assistance
Partnership for
Prescription
Assistance
www.cancercare.org
www.cancer.gov
www.coverageforall.org
www.cms.hhs.gov
866-512-3861
800-675-8416
888-477-2669
www.pparx.org
800-444-4106
www.abbott.com
800-292-6363
www.astrazeneca.com
888-477-2669
www.sanofi-aventis.us
800-998-9180
www.bayer.com
Prescription
Assistance for Drug
Companies
Abbott Laboratories
Prescription
Assistance
Astra Zeneca
Prescription
Assistance
Aventis SanofiAventis Prescription
Assistance
Bayer Prescription
Assistance
Biogen Idec
Prescription
Assistance
Boehringer
Ingelheim
Prescription
Assistance
Bristol-Meyers
Squibb Prescription
Assistance
Forest Laboratories
Prescription
Assistance
800-456-2255
800-556-8317
212-546-4000
www.bms.com
800-951-0758
www.frx.com
44
Glaxo Smith
Prescription
Assistance
866-475-3678
www.gsk.com
888-825-5249
www.gsk.com
866-734-7366
www.kingfarm.com
Lilly Prescription
Assistance
800-545-6962
www.lilly.com
Merck Prescription
Assistance
800-727-5400
www.merck.com
862-778-8300
www.novartis.com
888-477-2669
www.pparx.com
212-733-2323
www.pfizer.com
877-757-6243
www.roche.com
908-981-5000
www.sanofi-aventis.us
Glaxo Smith Kline
King
Pharmaceuticals
Prescription
Assistance
Novartis Prescription
Assistance
Partnership for
Prescription
Assistance
Pfizer Prescription
Assistance
Roche Prescription
Assistance
Sanofi-Aventis
Prescription
Assistance
Schering Plough
Prescription
Assistance
Solvoy
Pharmaceuticals
Teva
Pharmaceuticals
Prescription
Assistance
800-521-7157
800-256-8918
877-254-1039
www.rx-med.net
Watson Prescription
Assistance
800-964-4766
www.nextag.com
Wyeth Prescription
Assistance
800-568-9938
www.wyeth.com
www.bsahs.org
Hospitals
Potter
Baptist St. Anthony's
1600 Wallace
Blvd
Amarillo, TX
79106
806-212-2000
Potter
Northwest Texas
Healthcare System
1501 South
Coulter Rd
Amarillo, TX
79106
806-354-1703
Hutchinson
Golden Plains
Community Hospital
200 South
McGee
Borger, TX
79007
806-273-1220
www.goldenplains.org
Hemphill
Hemphill County
Hospital
1020 S. 4th St.
806-323-6422
www.hch.dst.us.us
Randall
Palo Duro Hospital
2 Hospital Dr.
Canadian, Tx
79014
Canyon, TX
79015
Childress Regional
Medical Center
Coon Memorial
Hospital
PO Box 1030
1411 Denver
Ave.
Childress, TX
79201
Dalhart, TX
79022
Childress
Dallam
Castro
Moore
Castro County
Healthcare Plains
Memorial Hospital
Moore County
Hospital
310 W. Halsell
St.
224 E. 2nd St.
Dimmitt, TX
79027
Dumas, TX
79029
806-655-7751
940-937-6371
806-249-4571
806-647-2191
806-935-7171
45
Parmer
Parmer County
Community Hospital
1307 Cleveland
Ave
Friona, TX
806-250-2754
Deaf Smith
Hereford Regional
Medical Hospital
801 E. 3rd St.
Hereford TX
79045
806-364-2141
Gray
Pampa Regional
Medical Center
1 Medical Pl
Pampa, TX
79065
806-665-3721
Ochiltree
Ochiltree General
Hospital
3101 Garret Dr.
Perryton, TX
79070
806-435-3606
Hansford
Hansford County
Hospital
707 Roland St.
Spearman, TX
79081
806-659-2535
Collingsworth
Collingsworth
General Hospital
Wheeler
Parkview Hospital
1014 15th St.
1000
Sweetwater St
Wellington, TX
79095
Wheeler, TX
79096
www.pcchtx.com
www.prmctx.com
www.hchd.net
806-447-2521
806-826-3201
www.parkviewhosp.org
46