Project Background and Goals:

This four year project, funded by the National Cancer Institute (NCI), is measuring the impact and costs of a prevention care manager (PCM) to improve cancer early detection services provided to ethnically diverse women age 50-69 years seen in four community health centers in the metropolitan New York City area.  A total of 1400 female patients from four Community/Migrant Health Centers (C/MHCs) are being randomly assigned to either the PCM intervention (Experimental group) or Usual Care (Control group). Evidence-based statements of the National Cancer Institute's CancerNet will be used to identify appropriate intervals and patients needing mammography, Pap, fecal occult blood testing, and sigmoidoscopy.

1. Learn of barriers faced by this population in obtaining indicated preventive services
2. Assess at baseline the office environment and work processes in each participating center
3. Develop and implement the PCM intervention to help patients overcome barriers
4. Evaluate the impact and costs of the PCM in a randomized controlled efficacy trial

Initially, the project conducted a baseline assessment of patient barriers and health center environments by interviewing 50 systematically selected women in each center to learn about their barriers to preventive care. Results from interviews, (along with guided discussions and questionnaires) were used to refine the intervention. Subsequently, the intervention will include the identification of patients who are overdue for services, providing culturally appropriate patient advice and assistance in overcoming barriers to care and follow-up monitoring, and to assist in resolution of abnormal test results. Finally, the intervention will be tested in a randomized controlled efficacy trial with an evaluation cohort of 1400 women age 50-69 years.

Outcome evaluation based on record reviews will compare the preventive status of patient cohorts between baseline and follow-up across the two study groups taking into account the work-up status of any abnormal test results. Process evaluation will allow accurate assessment of intervention costs, as well as observations of the practice environments and the process of providing preventive care. As a result of this project, a new model of enhancing preventive care for special populations will be tested in four C/MHCs serving low income and minority women, and the efficacy and costs will be determined.

CDN's latest research publication on this study "Phone Calls Boost Cancer Screening" click here >

• Project Time Frame: September 1, 2000 – August 31, 2004

• Number of Participating Sites: 6 (4 intervention sites and 2 pilot sites)

• Funding Sources: National Cancer Institute (NCI)

• Contact Persons:

PRINCIPAL INVESTIGATOR Allen Dietrich, MD Dartmouth Medical School (DMS) Dept. of Community & Family Med. 7250 Strasenburgh, Hanover , NH 03755 Phone: 603-650-1772 Fax:603-650-1153 E-MAIL: Allen.J.Dietrich@Dartmouth.edu www.Dartmouth.edu	CO- PRINCIPAL INVESTIGATOR: Jonathan N. Tobin, Ph.D. Clinical Directors Network, Inc. (CDN) 5 West 37 th Street , 10 th Floor New York , NY 10018 TEL: (212) 382-0699, ext. 234 FAX: (212) 382-0669 E-MAIL: jntobin@CDNetwork.org www.CDNetwork.org
MEDICAL DIRECTOR Richard G. Younge, MD, MPH Clinical Directors Network, Inc. (CDN) 5 West 37 th Street , 10 th Floor New York , NY 10018 TEL: (212) 382-0699 FAX: (212) 382-0669 E-MAIL: ryounge@msn.com www.CDNetwork.org	PROJECT DIRECTOR-CDN Andrea Cassells, MPH Clinical Directors Network, Inc. (CDN) 5 West 37 th Street , 10 th Floor New York , NY 10018 TEL: (212) 382-0699, ext. 227 FAX: (212) 382-0669 E-MAIL:acass@cdnetwork.org www.CDNetwork.org