Quality improvement initiatives improve mammography access in underserved populations, highlighting health disparities.
Purpose: Recent modeling studies suggest that increasing mammography screening utilization reduces breast cancer disparities, however screening utilization remains limited in underserved patient populations. Quality improvement collaboratives bring together diverse healthcare organizations to accelerate practice change through data benchmarking and shared learning. Integrating implementation science and quality improvement provides health service researchers with reproducible methods to accelerate the implementation of mammography screening in underserved patient populations. Our purpose was to describe the integration of implementation science frameworks within an operational quality improvement collaborative, the ACR Learning Network, to increase mammography screening percentages among underserved populations. Methods/Materials: The ACR Learning Network Quality Improvement Collaborative utilizes QI tools to identify problems, develop solutions, and document progress. To integrate implementation science and QI frameworks, the Healthcare Institute for Innovations in Quality at UMKC’s QIPI A3 template was integrated within the ACR A3 template. Collaborative participants were recruited from existing Learning Network and Radiology Health Equity Coalition participants. Teams were asked to identify patient populations that experience health disparities within their catchment areas using NIMHD definitions (low income, disabled, rural, racial and ethnic minority groups). IRB approval was not required for QI initiatives. Results: 68 participants (26 states) expressed interest in Collaborative participation, focused on Black(20), Hispanic(12), Low-income(15), Rural(4), Elderly(1), Disabilities(2), Asian(2), AI/AN(3) women. Adapted A3 template included equity focused SMART goals(Figure 1). Adapted current state includes evaluation of screening utilization percentages over time. A fishbone diagram was modified using CFIR implementation science determinants framework to identify cancer screening barriers within domains and levels of influence characterized using the NIMHD Minority Health and Health Disparities Research Framework. Identified barriers will be mapped to implementation strategies using the CFIR–ERIC mapping tool, specified using the Expert Recommendations for Implementing Change (ERIC) nomenclature to foster generalizability. Tested strategies will be evaluated using RE-AIM implementation outcomes framework with effectiveness (change in mammography screening percentage over time) representing our primary outcome. Program sustainability will be assessed using Program Sustainability Assessment Tool(PSAT). Conclusions By providing a shared platform for improvement training and dissemination of evidence-based interventions, the Mammography Health Equity Improvement Collaborative provides an opportunity for health care systems to reduce breast cancer disparities. Citation Format: Lewis A. Jordan, Stacy Farr, Esra Alagoz, Carla Brathwaite, Judy Burleson, Mythreyi Chatfield, Kay Zacharias-Andrews, Kandice Garcia, Anand Narayan. Development of the Mammography Health Equity Quality Improvement Learning Collaborative [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr C099.
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