Cancer is the second leading cause of death for American Indian/Alaska Natives, even though cancer incidence is often lower for this group. Five-year survival rates are significantly lower for racial and ethnic minority populations, in part because of the late stage at diagnosis and problems with access to follow-up care. With support from Avon and the Susan G. Komen Foundation, the South Puget Intertribal Planning Agency's Native Women's Wellness Program hired outreach workers in 2000 in the five tribal communities in Washington State. The program has five American Indian outreach workers and five tribal health care providers (one for each tribe) to encourage women to use available health services. Because they are highly respected and well known in their communities, the American Indian outreach workers have built a level of trust with the women in their communities. This rapport has enabled outreach workers to better educate and encourage the women to take advantage of the health services that are offered to them. They also have increased turnout rates by providing incentives, holding special events such as mother and daughter teas, and offering transportation and day care to make it easier for the women to be screened.

The goal of this program is to encourage screening and early detection of cancer among American Indian women.

In 2000, only 136 women were newly enrolled. In 2001, after hiring American Indian outreach workers, the number of newly enrolled women almost doubled to 251. In 2001, the program delivered the highest number of services in its history: 1,218 Pap tests, mammograms, and clinical breast exams combined. Since its inception, the South Puget Intertribal Agency's Native Women's Wellness Program has provided 1,600 mammograms, 2,330 clinical breast exams, and 2,473 Pap tests.