CLINICAL DIRECTORS NETWORK
DARTMOUTH MEDICAL SCHOOL

NEW YORK PREVENTION CARE MANAGER PROJECT  II (PCM2)

Project Background and Goals:

The recently completed New York Prevention Care Manager (PCM) Intervention (R01 CA087776-04S1) successfully promoted early detection for breast, cervical and colorectal cancer as recommended by the US Preventive Services Task Force (USPSTF), through scripted, telephone-based case management with patients of Community Health Centers in New York City. (1) This new five year, National Cancer Institute (NCI) funded project (R01 CA119014-01) will disseminate the PCM intervention through Medicaid Managed Care Organizations (MMCOs), which can provide sustainable, widely available infrastructures to support breast, cervical and colon cancer screening, especially for low income women who comprise a substantial majority of MMCO enrollees.

Building on the parent project, this project will promote colorectal cancer screening in the context of other indicated screenings for breast and cervical cancer. Primary objectives are to: (1) expand the scope of  the New York Prevention Care Manager Intervention to apply to MMCO-enrolled women who seldom visit primary care (outreach) while continuing to provide in-reach to more frequent attenders; (2) conduct a randomized controlled trial of the expanded PCM intervention to assess its impact on the cancer screening status of 2400 low-income women age 50-64 years in 10 New York Metropolitan Community Health Centers, and describe the process of Prevention Care Management, and (3) explore the relationships between characteristics of the women (demographics), of the Community/Migrant Health Centers that serve them, and of the MMCOs in which they are enrolled, and colorectal, breast, and cervical cancer screening status, as well as the impact of the intervention upon screening rates.

Several unique features of the project should be noted: women who are overdue for screening will be identified through MMCO claims data, which is both practical to sustain and expands the reach of the project to include women who seldom visit primary care; the intervention will be delivered by established MMCO staff trained by CDN and Dartmouth, not externally based researchers who cannot sustain the intervention; MMCO administrative/claims data will be used to evaluate the impact of the intervention, and multiple representative MMCOs in the New York Metropolitan area will be involved. 

Effectiveness of the translation at the patient level will be determined by improvements in up-to-date screening rates for each targeted cancer among participating women assigned to receive PCM compared with usual care.  Up-to-date rates will be derived from administrative data from participating MMCOs.  Costs of the intervention and its relationship to increased screening rates will also be assessed.

• Project Time Frame:  August 1, 2006 – July 31, 2011

• Number of Participating Centers : 10

• 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
PROJECT DIRECTOR - DARTMOUTH: Chirstina M. Robinson, MS Dartmouth Medical School, Dept. of Community & Family Med. 7250 Strasenburgh, Hanover, NH 03755 TEL: (603) 650-1566 FAX: (603) 650-1153 E-MAIL: Christina.M.Robinson@dartmouth.edu www.Dartmouth.edu	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