St. James-Santee Family Health Center is a community health center which provides primary and preventive health care services to medically underserved residents of three counties in South Carolina. St. James-Santee used the Community Guide to provide us with select empirically-based interventions for an effective program without wasting time and resources on strategies that would not produce desired outcomes for the target population. In September 2008 we applied for and received Legacy grant funding through the Southeastern U.S. Collaborative Center in the Elimination of Health Disparities to implement a breast and cervical cancer screening promotion project in African American communities. The project was implemented by the outreach department of our health center. The department consists of a registered nurse case manager, patient navigator, and three community health workers.

 

We selected a combination of client-oriented, provider-oriented, and community-wide interventions for the project: client reminders, client incentives, group education, provider prompts, and social marketing strategies. At the conclusion of the 2-year project, Pap smear and mammogram rates at the health center increased by 10% and women in local churches continue to maintain screening behaviors. The interventions were so effective that St. James-Santee began utilizing the same strategies to address the missed appointment rates at four locations of our health center. We demonstrated a 30% decrease in missed appointment in 6 months by using client reminders and incentives. Compliance with regular follow-up appointments translates into better management of chronic diseases in vulnerable populations.

 

We have conducted numerous cancer education workshops at community-based organizations since the inception of Black Corals in 2008. As a result of our model, two new community projects are underway and using the same user-friendly interventions from the Community Guide. One of our partners for Black Corals, a local African Methodist Episcopal church, applied for grant funds to implement their own cancer screening promotion project using reminders, incentives, social marketing, and group education. A grassroots group of African American women formed the Oatland Community Outreach Group which conducted their first breast cancer survivors’ charity walk and cookout in October 2010. The founder of the group attended a Black Corals workshop before starting her own project. These community-wide events expand the reach of Black Corals to improve health and prevent diseases in African American communities.

 

Since we discovered the Community Guide the health center has adopted two new policies for our primary care program: nurse visits and case management services. To shorten wait times for patients with chronic diseases, the medical providers have chosen to have patients scheduled for “quick visits” with the nursing staff. These visits are free of charge and serve as an incentive for patients with diabetes and/or hypertension to adhere to medical regimens and thereby prevent complications of their diseases. The other new component to our health center services is the addition of a nurse case manager to not only assist women with mammograms and Pap smears but also self-management of chronic diseases. The nurse case manager is currently implementing a communitygarden with staff, patients, and community residents to promote consumption of fresh fruits and vegetables, physical activity, and wellness in the community.