Assessing local capacity to expand rural breast cancer screening and patient navigation: An iterative mixed-method tool

Stephen J. Inrig, Robin T. Higashi, Jasmin A. Tiro, Keith E. Argenbright, Simon J Craddock Lee

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Background Despite federal funding for breast cancer screening, fragmented infrastructure and limited organizational capacity hinder access to the full continuum of breast cancer screening and clinical follow-up procedures among rural-residing women. We proposed a regional hub-and-spoke model, partnering with local providers to expand access across North Texas. We describe development and application of an iterative, mixed-method tool to assess county capacity to conduct community outreach and/or patient navigation in a partnership model. Methods Our tool combined publicly-available quantitative data with qualitative assessments during site visits and semi-structured interviews. Results Application of our tool resulted in shifts in capacity designation in 10 of 17 county partners: 8 implemented local outreach with hub navigation; 9 relied on the hub for both outreach and navigation. Key factors influencing capacity: (1) formal linkages between partner organizations; (2) inter-organizational relationships; (3) existing clinical service protocols; (4) underserved populations. Qualitative data elucidate how our tool captured these capacity changes. Conclusions Our capacity assessment tool enabled the hub to establish partnerships with county organizations by tailoring support to local capacity and needs. Absent a vertically integrated provider network for preventive services in these rural counties, our tool facilitated a virtually integrated regional network to extend access to breast cancer screening to underserved women.

Original languageEnglish (US)
Pages (from-to)113-124
Number of pages12
JournalEvaluation and Program Planning
StatePublished - Apr 1 2017


  • Access to care
  • Breast cancer screening
  • Evaluation design and research
  • Service capacity

ASJC Scopus subject areas

  • Business and International Management
  • Social Psychology
  • Geography, Planning and Development
  • Strategy and Management
  • Public Health, Environmental and Occupational Health


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