In 2011, the CSSS du Coeur-de-l’Île initiated an information and awareness-raising project to reach out to women of lower socioeconomic status as this particular group were underusing the services offered by the Programme québécois de dépistage du cancer du sein (PQDCS). Thus, the “À la santé de vos seins!” [For your breast health!] project was born. Since the traditional methods of breast cancer screening did not appear to be reaching this particularly vulnerable group of women, the “À la santé de vos seins!” project focused on personalized and individualized contact to raise awareness amongst women, support them in their decision making process, and facilitate access to a designated screening centre.

Developed in partnership with two community organizations and the Agence de la santé et des services sociaux de Montréal, the project included both a population-based component and a clinical component. The population-based component aimed to raise awareness in women aged 50 to 69 years about the importance of early screening and informing them about the PQDCS’s purpose and the benefits and limitations of screening mammograms.

Community groups in the CSSS’s area whose clients are generally socio-economically disadvantaged were used strategically to raise awareness amongst this group of women. The action plan adopted consisted of workshops co-facilitated by a CSSS nurse and a worker from one of the community organizations.

The objective of the clinical component was to encourage health care clinic referrals of eligible women to the screening centres. Clinicians were informed about the PQDCS’s added value and clinicians were asked to encourage their eligible clients to use the appropriate services.

The innovative elements of the project are as follows:

• The coordination committee’s collegial way of operating which facilitates expression of all points of view and promotes decision making in a consensual manner;

• Presence of a CSSS nurse, multiplying agents and community workers in settings where the women targeted by the “À la santé de vos seins!” campaign are found;

• Holding of “health” seminars in community organizations jointly facilitated by a CSSS nurse and a community worker; these become a place for exchanging ideas and providing education during which each participant is encouraged to relay the information to a friend, sister or a neighbour to increase the number of women reached by the campaign;

• Visits to pharmacies and medical clinics to identify potential professionals to relay information on the PQDCS; and

• Adaptation of the documentation to the profile of the women targeted by neighbourhood organizations specialized in literacy; the messages are clear, the images are meaningful, and the resources available to them clearly identified.
The project’s implementation was formally assessed, and the final report submitted to the CSSS in November 2013 identified several positive outcomes. The information and messages conveyed to the women appear to have enabled most of them to make an informed decision on their participation in the PQDCS. The majority of the respondents expressed their intention to have a screening mammogram, regardless of their immigration status or whether or not they have a family physician. Participation in the workshops by women aged 40 to 49 years old was a significant benefit of the project because these women will be eligible for the PQDCS in the near future.

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