Overview of the Every Woman Matters Program
Congress founded the Every Woman Matters (EWM) program of Nebraska in 1992 in reaction to the enactment of the Breast and Cervical Cancer Mortality Prevention Act. The program targets women aged between 40 to 74 years who have limited or no medical insurance and who earn a meager salary (Backer, Geske, McIlvain, Dodendorf, & Minier, 2005). To qualify for the program, a woman must be between the stipulated age limit and not a member of other health organizations such as Medicare, Health Maintenance Organization, and Medicaid. Once an applicant is registered with the program, she receives a variety of free screening services such as Mammogram screening, clinical breast examination, Pap test, and checks on blood pressure and weight (Backer et al., 2005). In addition, the program covers medical expenses on breast biopsy, breast ultrasound checks, referral for breast lump examination, and Colposcopy. The program also registers health facilities that wish to be providers of the program after paying a predetermined fee and signing a contract of one year. Among the numerous benefits enjoyed by members of the program include free or minimal educational chances about cancer, constant check-up reminders, and quality treatment at low cost (Backer et al., 2005).
The EWM program was ineffective in accomplishing its desired targets and objectives. A major reason why the program failed is due to its lack of continuity, especially after the program enrollment. This is attributed to the fact that once a member is enrolled, subsequent coupon issuance is based on eligibility, an incident that makes most of its members fail to return for subsequent screening. Additionally, the EWM program failed to capture the Hispanic population who are the majority in the state of Nebraska, and enrolls more Native American and African women (Richardson, Tota, & Franco, 2011). The program also lacks adequate mechanisms to recruit and incorporate minority groups of women into the program. Furthermore, the policies of the program discouraged many prospective women from enrolling in it as it failed to give them perpetual insurance cover. The program’s policy stipulates that a woman would only be enrolled when aged 40-74 years thus locking out many needy women below or above the specified age (Backer et al., 2005). Regardless of these limitations, the EWM program has been successful in enlisting low-income earners and less skilled women thereby scaling down inequalities in breast and cancer screening in Nebraska.
Other Successful Cancer screening and Prevention Programs
The Black Corals cancer screening program in South Carolina together with the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) are examples of successful cancer prevention and screening programs (Feresu, Zhang, Puumala, Ullrich, & Anderson, 2008). These two programs have played a critical role in minimizing the imbalanced burden of cancer among low-income earners and unhealthy women. NBCCEDP is indisputably one of the successful and lifesaving cancer prevention programs that advocate for early screening and has received a lot of backing from the Centers for Diseases Control and Prevention (Richardson et al., 2011). The program has some unique features that make it more successful as compared to the EWM program. These features entail the screening of women via a health care delivery system, community consciousness activities that enlighten women of the necessity for screening, education on the dangers of breast and cervical cancer, and the supervision and case management of all women tested to make sure they obtain suitable follow-up for symptomatic care (Feresu et al., 2008).
The Black Corals program was established to increase breast and cervical cancer screenings among African American women who had narrow access to lifesaving cancer screenings. By making the Black Corals appear like a community-based program, it was able to reach a large number of the targeted group and increase the rate of adherence to Pap tests and Mammogram referrals of patients (Cagle et al., 2010). The program became successful by making efforts to empower the community, not giving age limits for admission into the program and securing more funding by applying evidence-oriented interventions (Cagle et al., 2010).
Recommendations to Improve the Effectiveness of the EWM Program
It is evident that the NBCCEDP and the Black Corals cancer screening programs are more effective and successful than the EWM program. As a nurse leader responsible for developing a follow-up to the EWM program, I would recommend several strategies towards enhancing a more efficient prevention program. I would recommend changes in the policy guidelines of the EWM program in order to accommodate all eligible women (Saslow et al., 2012). The program also needs to employ more culturally insightful messages that stress the significance of early screening. The qualification age of 40 years should be reduced to 30 years in order to recruit and retain more needy women in the program. I could also propose that the program formulate a cohort of their members and a record that comprises data gathered by service providers to enhance evaluation and incorporate additional data associated with breast and cervical cancer screening (Feresu et al., 2008).
References
Backer, E. L., Geske, J. A., McIlvain, H. E., Dodendorf, D. M., & Minier, W. C. (2005). Improving female preventive health care delivery through practice change: an Every Woman Matters study. The Journal of the American Board of Family Practice, 18(5), 401-408.
Cagle, A. J., Hu, S. Y., Sellors, J. W., Bao, Y. P., Lim, J. M., Li, S. M., & Qiao, Y. L. (2010). Use of an expanded gold standard to estimate the accuracy of colposcopy and visual inspection with acetic acid. International Journal of Cancer, 126(1), 156-161.
Feresu, S. A., Zhang, W., Puumala, S. E., Ullrich, F., & Anderson, J. R. (2008). Breast and cervical cancer screening among low-income women in Nebraska: findings from the Every Woman Matters program, 1993–2004. Journal of health care for the poor and underserved, 19(3), 797-813.
Richardson, L. A., Tota, J., & Franco, E. L. (2011). Optimizing technology for cervical cancer screening in high-resource settings. Expert Review of Obstetrics & Gynecology, 6(3), 343-353.
Saslow, D., Solomon, D., Lawson, H. W., Killackey, M., Kulasingam, S. L., Cain, J., & Myers, E. R. (2012). American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA: a cancer journal for clinicians, 62(3), 147-172.