Breast screening in Canada, 2023-24

Strategies to engage equity-denied populations

Methods to identify equity-denied populations or communities include leveraging geospatial mapping, developing specialized roles for community engagement, and community engagement surveys, as well as mobile and remote screening. Engagement strategies include developing targeted educational materials, increasing availability of mobile and remote screening, and collaborating with community champions.

On this page:


Community engagement strategies used with equity-denied populations or communities

P/T Specific community engagement strategies each jurisdiction has used with equity-denied populations or communities
YT
NT Targeted awareness: development of new resources (pamphlets, posters, and FAQs on guidelines, and “What to Expect When Getting a Mammogram”). In addition, the “What to Expect” document was translated into the 11 official languages of the NT.
NU
BC Targeted education/awareness campaigns (e.g., social media): The health promotions team is working in collaboration with First Nations Health Authority and BC Cancer — Indigenous Cancer Control portfolio to create strategies to serve Indigenous communities.
AB Screen Test program conducts specific projects to engage with Indigenous communities. Strategies include community champions, surveys, and use of targeted education/awareness campaigns. Screening programs do regular media campaigns to increase awareness about cancer screening.
SK Building relationships with community champions and attending community events with presentations targeted to meet community needs. Developing new resources with inclusive images. Patient and family advisors are members of continuing program development and initiatives.
MB
  • Cancer screening education module created with and for educators with students with low literacy.
  • Coordinating interpreter services with appointment times.
  • Translation document included in all public-facing letters.
  • Scheduling longer appointments for those individuals who require longer appointment times for physical or emotional reasons.
  • Accessibility barriers addressed with two mobile clinics and four fixed locations.
ON
  • Advisors with lived experience from the community participated in an advisory panel where they provided feedback on proposed guidance for screening Two-Spirit, trans and nonbinary people in the OBSP.
  • At the regional level, mobile coaches target people who live in rural and remote areas who are unable to reach screening sites. Many regions have also done work to train community ambassadors and provide education to areas in regions that have low screening rates. Some regions are working with primary care providers in their regions to improve breast screening rates in priority neighbourhoods and work on multi-lingual delivery.
QC
NB
  • First Nations community health clinics: building relationships with community champions, and targeted education (presentation or information booths) upon invitation.
  • Gender-diverse population: program staff completing online training, and content of breast program materials and guidelines being updated to better reflect gender inclusivity.
NS
  • African Nova Scotian Community of Cherry Brook: The Nova Scotia Breast Screening Program (NSBSP) was invited to attend a health fair that had a booth to book screening appointments.
  • African Nova Scotia Community in Kentville (health fair): NSBSP provided breast screening brochures when requested at the health fair.
PE
NL

-YT, NU, QC, PE, NL: No information was provided at the time data were collected.


Strategies to improve screening participation through understanding and addressing barriers

P/T Strategies used with equity-denied populations or communities to identify and reduce barriers to screening participation
YT
NT
  • Development of the RN role of Territorial Specialist — Breast Cancer Screening helps healthcare providers navigate the process of cancer screening.
  • Toll-free number also provides access to the Territorial Specialist.
NU
BC Mobile screening program serves the following:

  • Those who experience difficulty accessing the healthcare system
  • Those with travel barriers
  • Client Services team books appointments with the help of translation services, which supports clients with language barriers
AB
  • Committees and focus groups are used to identify barriers to screening on a regular basis.
  • Strategies to reduce barriers are issue-dependent (e.g., animated video series in different languages to promote and educate about cancer screening).
  • Access to healthcare providers continues to be an issue, not just for equity-deserving populations, but also for cancer screening as a whole due to human resource constraints.
SK Strategies include:

  • Mobile mammography services
  • Targeted education
  • Navigation
MB Strategies include:

  • Comprehensive letter campaigns that included an insert translated into 17 languages.
  • Interpreter services, including information on available interpreter services and translated documents on most public-facing communications.
  • Cancer screening education module created for new international healthcare providers.
  • Curriculum designed for educators to use with adults with low literacy (curriculum found on screening website).
  • Translated resources.
  • Focus testing with primary care advisory groups and community groups.
ON Strategies include:

  • Developed a guidance document and changed eligibility criteria to improve access to the Ontario Breast Screening Program for Two-spirit, trans and nonbinary people.
  • Removed breast implants from program exclusion criteria.
  • Updated provincial correspondence campaigns so that Two-spirit, trans and nonbinary people receive result and recall letters from the OBSP.
  • Unattached participants who receive abnormal screening results or have actionable incidental findings are supported by a primary care provider designate who can follow the participant through any necessary follow-up, including diagnosis, if applicable.
  • Development of breast screening materials (e.g., posters, postcards) in over 20 different languages to support regional outreach activities related to breast screening
  • Mobile coaches in two Regional Cancer Programs, North West and Hamilton Niagara Haldimand Brant, provide screening services to people who do not have a primary care provider or face barriers accessing existing screening services (due to transportation or other barriers).The Screening Activity Report (SAR) is an online report, which provides screening data to help family doctors improve their cancer screening rates and appropriate follow-up. The report allows family doctors to quickly find specific cancer screening information for each patient, including those who are overdue or have never been screened
QC
NB
  • Lack of regular healthcare provider: Individuals that meet the breast cancer screening program eligibility can self-refer for mammography screening. Those at higher-than-average risk or not eligible due to age can only be screened with a PCP referral. In these cases, a process is in place for participants to register with NB Health Link.
  • Lack of screening recommendation from healthcare provider: The breast program has CPGs. The program regularly communicates with healthcare providers on program updates to activities and recommendations.
  • Difficulty accessing the healthcare system: NB Cancer Screening Line receives and handles calls from individuals with inquiries regarding access to screening services. A process is in place for participants when they have no access to a PCP for a referral (register with NB Health Link) or to escalate their concerns with the RHAs.
  • Low health literacy: NB Cancer Screening Line is available to respond to calls from individuals, including those with low literacy.
  • Language barriers: The program has on-the-phone interpreter services available for those who call the NB Cancer Screening Line. Staff is fluent in French and English.
  • Recent immigrants and refugees: Individuals with federally issued health cards are invited to participate in program.
  • Gender-diverse: Program staff completing online training and screening program content is being updated. Program materials and guidelines will better reflect gender inclusivity.
NS
PE
  • Health fairs to support community engagement.
NL

-YT, NU, QC, NS, NL: No information was provided at the time data were collected.