Cancer Control Research
5R01CA057026-04
Simon, Kenneth J.
BREAST/CERVICAL SCREENING--OLDER LOW INCOME RURAL WOMEN
AbstractThe Mary Babb Randolph Cancer Center (West Virginia University) is
collaborating with a regional, multi-county health department and other
public health service providers to demonstrate how a consortium of
community agencies can develop and evaluate strategies to increase the
availability, awareness, and utilization of breast and cervical cancer
screening services. The target population is rural, low income,
unscreened women 40 and over. Emphasis is placed on reaching women 65
years and above.
We have overcome financial barriers by arranging to finance screening
services for uninsured low income women through funds provided by the
West Virginia Bureau of Public Health. We have commitments from the
State Medicaid program and the West Virginia University Health. Sciences
Center to finance necessary follow-up diagnostic and treatment services.
Two counties will serve as test sites for inreach interventions.
Interventions are theoretically grounded in a PROCEED framework and
include: a) a tracking system; b) patient reminders; c) standing orders;
and d) an innovative woman-to-woman effort which will recruit for
screening older women who are mothers of women currently seeing
providers. Providers in one of the two counties will also test outreach
strategies including utilization of interpersonal communication networks
such as church groups and non-health agency providers serving low-income
groups. A third county not subjected to interventions will serve as a
control.
Our consortium includes all public health agencies in the study region,
the Mary Babb Randolph Cancer Center, the West Virginia Bureau of Public
Health, and other relevant groups.
Evaluation occurs within a design that permits us to determine effects of
inreach and effects of inreach combined with outreach. Two primary
sources of data to measure the main effect of increasing screening are a
population based pre- and post-baseline interview survey and a provider
based pre- and post-baseline survey of client screening rates. The
research design will permit a distinction of the effects from statewide
intervention from the effects resulting from our project interventions in
the demonstration region added to the statewide efforts.
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