Enhancing breast health in rural populations: clinical nurse specialist as the key.

Four clinical nurse specialists (CNSs) were funded for a project to increase breast cancer (BC) screening practices and the knowledge of BC risk factors for women in 4 medically underserved rural counties. The goal was to implement a program to increase knowledge of breast health practices, increase access to mammography, establish linkages among CNSs and community organizations, and increase resources for breast health education and screening. Phase I: A training program (focusing on breast health, breast cancer, and screening) was presented to public health nurses from each of the 4 counties. Phase II: Project and public health nurses teamed to provide an education and screening program for rural area women. The program involved making mammograms available at no cost through a mobile mammography unit that was brought to each county. Mammograms and educational programs were provided to 141 women. The project team was clearly able to function as both clinical experts and clinical leaders. The spheres of influence for these 4 CNSs included patient/client (rural women), nursing personnel (county health department nurses), and organization/network (state health department and governmental bodies). This project, based on the Logic Model, can serve as a framework for delivering care in underserved, rural populations.