Table 3 Needs assessment recommendations

1. Development of a comprehensive referral tracking system that systematically documents the referral process from the clinic-level referral for screening through follow up to determine screening outcomes.

2. Development of a coherent application process that supports patient access to mammogram screening.

3. Development of guidelines to determine when all county clinics will make referrals for screening mammograms.

4. Ensure cultural and linguistic barriers to breast cancer prevention are addressed at time of mammogram referral.

5. Electronic Medical Record (CHL Care) implementation and training to support coordination of breast cancer screening care at the clinic level.

6. Ensure that the clinic environment is culturally and linguistically competent to provide effective, sensitive breast and cervical cancer health care prevention and treatment services for patients.

7. Evaluate the educational program and timing of the delivery of the breast health educational initiatives at each clinic and develop a protocol for best practices across clinics.