Cancer Control Research
5P01CA044648-08
Vogt, Thomas M.
TOBACCO REDUCTION AND CANCER CONTROL II
AbstractMedical care systems do a relatively poor job of delivering disease
prevention interventions despite research studies showing that such
interventions are effective. This program project focuses on the
development and delivery of cost-effective smoking cessation programs, the
establishment of a safety net system for breast and cervical cancer
screening, and the testing of effective methods for involving employers in
cancer prevention activities. It addresses the defined population base of
a 375,000 member HMO and the dissemination of those interventions to other
medical car systems. Medical care systems need to integrate effective
cancer control activities into the delivery of care. This goal is
achievable using a community intervention approach in which medical care
systems are treated as communities. In the first four years of TRACC, five
approaches to integrating smoking interventions into the medical care
process were tested in randomized trials. This application takes the next
logical step with two phase IV smoking projects and a phase III-IV
screening project. The interventions are delivered to a defined population
base through activities focused in hospitals, outpatient clinics, and UV
direct mail. TRACC II also takes advantage of other resources inherent in
prepaid group practice settings such as patient tracking systems and the
opportunity for a population based, rather than patient-based, program is
to reduce the prevalence of smoking and raise the incidence of smoking
cessation among HMO members, and to assure that women do not exceed
acceptable maximum intervals for screening for breast and cervical cancers.
This program is generalizable directly to other HMOs, and most elements are
applicable to any large medical organization. An explicit objective is to
extend these interventions to other Kaiser Permanente regions and to
support such extensions with cost effectiveness analyses of the
implementation experiences.
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