Improving Mammography Screening Percentages in Overdue Women: A Tribal Medical Track Quality Improvement Project

Background: In Cherokee County, mammography screening percentages are below the overall state and national averages. This is problematic, as adequate and timely mammograms can detect breast cancer at an earlier stage. This quality improvement (QI) project, conducted during a four-week clinical rotation, aimed to increase screening among overdue patients at a Cherokee Nation family medicine clinic and to assess the feasibility of conducting QI studies during short rotations.

Methods: During scheduled in-clinic appointments with eligible patients, the medical student (and first author) assigned to the patient’s physician used motivational interviewing (MI) to encourage women to schedule mammograms. Patients’ electronic health records were followed until a completed mammogram appointment was viewed or until December 21, 2023, whichever came first.

Results: Only two patients seen during the project timeframe were overdue for screening and one completed screening by the project cutoff date. The other patient indicated she preferred a more “natural” approach and thus never planned to get screened.

Conclusions: Targeted motivational interviewing during scheduled in-clinic appointments may increase the likelihood of women obtaining mammogram screening. The project demonstrated the feasibility of conducting QI projects during short rotations, but also identified challenges of reaching targeted patients who may or may not visit the clinic during the rotation.