Cancer Control Research
5R01CA057014-04
Anderson, Henry A.
WISCONSIN BREAST AND CERVICAL CANCER SCREENING PROJECT
AbstractThe primary goal of this project is to demonstrate how a consortium of
community health and social service agencies can work together to
implement and evaluate strategies which are aimed at decreasing mortality
due to breast and cervical cancer by increasing the number of women who
receive routine mammography, clinical breast exams, and Pap testing at
recommended intervals. The proposed public health approaches to breast
and cervical cancer screening are designed to reach all women 40 years
and older in four rural counties in north central Wisconsin. Because
they are at higher risk for late stage diagnosis of breast and cervical
cancer, low income women and women aged 65 years and older will be
specially targeted for interventions. An emphasis will also be placed on
testing policy- relevant strategies designed to introduce structural
modifications in the health care delivery and financing systems that are
expected to improve rates of screening among low income and elderly rural
women. Randomized controlled studies of one "inreach" and two outreach
intervention strategies will be conducted in two well-defined, low-income
populations: 1) registered patients of a rural community health center,
and 2) Medicaid beneficiaries in four rural counties.
During the second year, the results from these studies will be
incorporated into a community-wide screening program. This program will
be coordinated through a Regional Consortium and will involve public and
professional awareness and education programs. In addition to
coordinating inreach and outreach activities, the Regional Consortium and
local task forces will be charged with providing technical assistance and
advocating for the implementation of reminder systems in isolated rural
practices in the intervention counties. The Regional Consortium will
also work with local service providers, insurers and other relevant
parties to enhance screening capacity and develop financing mechanisms to
meet the screening needs of all area residents. The impact of this
community-wide intervention will be assessed by a quasi-experimental
design, using population-wide telephone surveys in the intervention
region and in a comparable region in the state. The evaluation of the
proposed breast and cervical cancer screening project will assess the
effectiveness of the combined strategies, as well as the effectiveness of
selected proposed intervention methods, in overcoming individual,
environmental, and systemic barriers to screening utilization and
adequate follow-up.
|