CANCER CONTROL IN PUBLIC HEALTH DEPARTMENTS

拟议项目的总体目标是制定、实施、 并评估增加教育和支持服务的干预措施 预防和早期发现乳腺癌和宫颈癌， 在农村公共卫生部门接受护理的妇女。 这项研究将 测试在公众中建立预防保健计划的有效性 卫生部门将其服务与现有诊所相结合， 以及增加高风险人群获得预防保健服务的机会， 通过外展教育，在社区中对妇女进行风险教育。 一个预防 公共卫生部门的计划将旨在增加 妇女对乳腺癌和宫颈癌的认识，鼓励积极 对癌症预防和早期发现的态度，并增加 接受巴氏涂片检查、临床乳房检查和 定期做乳房X光检查 该计划将涉及整合 将教育和支助活动纳入公共卫生结构 部门，并将旨在确定，提供信息， 筛选或安排筛选预约的妇女谁来到 部门出于其他原因。 该方案将（a）提供关于 乳腺癌和宫颈癌的危险因素、预防方法和 早期检测和治疗方法，（B）安排筛查 （c）协助需要跟进和治疗的妇女。 设计 为拟议的项目将是一个准实验设计涉及六个 北卡罗来纳州西部的乡村县。 设计将涉及两个 （a）第一阶段，三个县被分配到 一个程序组和三个程序组被指定为控制，以及（B）第二阶段 所有的县都将接受干预。 基线数据将 在项目开始时收集所有结果指标，以及 将进行两次测试后数据收集，以评估 两组国家的成果计量。 成果计量， 关于乳腺和宫颈癌的知识、态度和行为 癌症将通过与公众客户的访谈获得 卫生部门和图表审查进行的公共卫生 部门 拟议的项目解决了提供 癌症预防和早期发现服务， 特别是高风险，公共卫生部门的客户， 两种最可预防的女性癌症死亡原因。 的 研究结果有望开发出具体的方法， 在美国，高风险女性占很大比例。

The general objective of the proposed project is to develop, implement, and evaluate an intervention to increase education and support services for the prevention and early detection of breast and cervical cancer among women receiving care in rural public health departments. The study will test the efficacy of establishing a preventive care program in the public health departments that will integrate its services with existing clinics, as well as increasing accessibility of preventive care services to high- risk women in the community through outreach education. A prevention program based in public health departments will be designed to increase womens knowledge of breast and cervical cancer, encourage positive attitudes toward cancer prevention and early detection, and increase the percentage of women who obtain Pap smears, clinical breast exams, and mammograms on a regular basis. The program will involve integration of educational and support activities into the structure of the public health department, and will be designed to identify, provide information, and screen or arrange screening appointments for women who come into the department for other reasons. The program will (a) provide information on risk factors for breast and cervical cancer, methods of prevention and early detection, and methods of treatment, (b) arrange for screening tests, and (c) assist women who need follow-up and treatment. The design for the proposed project will be a quasi-experimental design involving six rural counties in western North Carolina. The design will involve two stages, (a) an initial stage in which three counties are assigned to the program group and three are assigned as controls, and (b) a second stage in which all counties will receive the intervention. Baseline data will be collected for all outcome measures at the beginning of the project, and two posttest data collections will be conducted to evaluate changes in the outcome measures for the two groups of counties. Outcome measures dealing with knowledge, attitudes, and behavior regarding breast and cervical cancer will be obtained through interviews with clients of the public health departments and chart reviews conducted in the public health departments. The proposed project addresses the problem of providing cancer prevention and early detection services to a population at especially high risk, clientele of public health departments, and focuses on two of the most preventable causes of cancer deaths among women. The results hold promise of developing specific approaches that could reach a large proportion of high-risk women in the United States.