Expanding Outcomes in Cancer Screening Safety Net Programs: Promoting Sustainability and Policy Reform.

Area of Science:

• Public Health
• Health Services Research
• Cancer Prevention and Control

Background:

• Community-engaged patient navigation safety net programs are evidence-based for cancer prevention and early detection.
• Barriers to program expansion and sustainability persist, with limited research on their impact on community buy-in and policy change.

Purpose of the Study:

• To describe the use of the Capacity for Sustainability Framework to guide program sustainability and multi-level change.
• To demonstrate the impact of a breast cancer screening and patient navigation safety net program on community, institutional, and policy levels.

Main Methods:

• Utilized the nine domains of the Capacity for Sustainability Framework to develop logic models.
• Informed program implementation, quality improvement, and multi-level stakeholder engagement.
• Guided outreach and dissemination of outcomes.

Main Results:

• The program achieved sustained annual funding from city and state public health departments for seven years.
• Secured additional 5-year renewable funding and expanded institutional support for breast cancer patients.
• Facilitated legislative efforts for patient navigator and community health worker training certification and reimbursement.

Conclusions:

• Community-engaged patient navigation safety net programs can be sustained long-term.
• These programs influence outcomes beyond individual and interpersonal levels, impacting organizational and policy change.
• The Capacity for Sustainability Framework effectively guided sustainability and multi-level change efforts.