Hannah Perry, MD (second from left) and colleagues welcome Nepali women to the breast screening clinic at the UVM Medical Center.
When the UVM Cancer Center’s Hannah Perry, M.D., made a routine grand rounds presentation at Community Health Centers (CHC) in January 2023, she never anticipated the extent of the impact this connection would bring.
As part of her outreach role, Dr. Perry, Division Chief and Medical Director of Breast Imaging at the University of Vermont Medical Center, was presenting information to CHC clinicians and staff on breast cancer screening guidelines. After this talk, staff at CHC, who serve 35,000 patients in Chittenden and southern Grand Isle counties, invited her to stay and learn about their own outreach project.
CHC’s Mammogram Task Force was eager to address a pressing health inequity in its patient population: the low rate of breast cancer screening for non-English speakers, with its largest group being patients whose primary language is Nepali.
CHC identified a range of barriers holding these patients back — from the lack of knowledge of preventative procedures to distrust of the medical system — that they were prepared to address. But they needed a breast cancer diagnostics expert and a screening facility to make the program work.
Would Dr. Perry like to be involved?
“Dr. Perry reached out almost immediately after that meeting and said, let's work together,” said Kerry Goulette, PA-C, MHP, CHC’s director of quality risk and compliance. “It was a real game changer for us.”
Her enthusiasm wasn’t surprising; Dr. Perry has had a long interest in providing imaging care to underserved groups — she’d published on the topic and made presentations at professional conferences — and was keen to continue this work on a local level.
“This was an opportunity to apply what I’d been thinking about for a long time to patients in need right here in the greater Burlington area,” she said.
Reaching out
CHC lost no time in connecting with Nepali women in the community, using a community health worker funded through You First, a Vermont Department of Health program.
Dr. Perry, Ms. Goulette, and their colleagues prioritized making the screening experience a positive one for Nepali women. They scheduled the clinic for a Saturday — May 20, 2023 — a more convenient day of the week when family members could help provide transportation to the UVM Medical Center. On the day of the event, there were welcoming signs and directive signs in Nepali so that patients could navigate the hospital and find the clinic. Three Nepali interpreters, supplied by the Association of Africans Living in Vermont (AALV), a non-profit that helps immigrants and refugees gain independence in their new community, were on hand, and a screenshow in Nepali rolled on several monitors showing patients what to expect during their appointment.
The event was a huge success. Twenty-six Nepali patients were screened.
“That was a big impact on the number of Nepali women cared for by CHC who needed screening,” Dr. Perry said.
Building on that initial success, an additional screening session with Nepali women followed, along with one each for Maay-Maay speakers from Somalia, and French speakers from several West African countries.
The partnership will hold screening clinics for two additional underserved populations this fall. In September, a clinic will be held for patients who are transgender and in need of breast cancer screening. This patient population has historically experienced discrimination in receiving gender affirming care, so this clinic aims to create a safe and welcoming environment for all who attend.
On September 8 at the Vermont Pride festival and parade in Burlington, the Breast Imaging team, with support from the UVM Cancer Center, will staff a booth to help spread information on breast cancer screening for all patients.
The task force will also focus on the unhoused population in the Burlington area beginning in November, aiming to mitigate challenges such as scheduling and transportation.
Ms. Goulette is grateful for the partnerships developed through this innovative and thoughtful project, and the impact it has had in reducing health disparities.
“We are always looking for ways to grow our community connections,” she said. “This project has shown the power of collaboration.”