Abstract A055: Enhancing mammography quality in Wisconsin: Barriers and facilitators in developing a shared measurement system
Authors: Hackett Kelly , Pinsoneault Laura , Cawthra Tobi , Brunner Beth , Thompson Tommi , Stolley Melinda , Neuner Joan 
Published: January 2023

Abstract
Breast cancer mortality rates have decreased over several decades although these declines have been unequal. In Wisconsin, some parts of the state experience higher mortality than others, and Black women have the highest breast cancer mortality rate compared to women of other races/ethnicities although mammography screening rates are similar across populations. The Mammographic Quality Initiative (MQI) seeks to examine the role of mammography quality and develop a sustainable statewide model of monitoring and enhancing mammography quality, towards improving equity of early-stage breast cancer diagnoses and survival. Building on a collaborative statewide initiative in Illinois which showed reductions in disparities after documenting and addressing variability in mammographic technical quality and follow-up time, MQI will adapt the Illinois tools for Wisconsin using a transdisciplinary collaborative approach. MQI is a project of the Community and Cancer Science Network (CCSN), a statewide initiative to address cancer disparities. CCSN uses a transdisciplinary model that emphasizes learning and innovation, and full, equitable engagement of non-academic partners. Within MQI, this involves engaging research, community-based organizations, and radiology as initiative leadership and creating learning collaboratives in multiple Wisconsin regions. Learning collaboratives are employed in healthcare to improve patient outcomes through shared learning and practice improvement[CT1] . The learning collaboratives will contribute to the development of a common set of measures to monitor mammography quality and the development of a shared measurement system to monitor and improve outcomes. In its first year, MQI engaged large health systems, and high and low-resourced clinics and stand-alone mammography centers in Southeastern Wisconsin to involve them in the early stages of a learning collaborative. MQI’s leadership documents these engagements as part of the evaluation. Analysis of qualitative data collected identified barriers and facilitators to the development of a shared measurement system. Barriers included: 1) significant variation in how mammogram data reporting occurs that impedes participation, 2) difficulty in tracking follow-up data when a patient is referred for diagnostic services, and 3) multiple strains on system resources including staffing, capacity or payor models. However, a significant facilitator of engagement is a dedicated “champion” who is respected and trusted within the healthcare system. Champions included radiologists, technologists, or other key leaders. The initial analysis supports a front-loaded focus on development of partnerships and collaborative infrastructure. These findings give context and insight into a transdisciplinary approach that has the potential to be adapted and applied to other research programs and collaboratives working to impact population level disparity outcomes.
Citation Format: Kelly Hackett, Laura Pinsoneault, Tobi Cawthra, Beth Brunner, Tommi Thompson, Melinda Stolley, Joan Neuner. Enhancing mammography quality in Wisconsin: Barriers and facilitators in developing a shared measurement system [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A055.