WISCONSIN BREAST AND CERVICAL CANCER SCREENING PROJECT

这个项目的主要目标是展示一个由 社区卫生和社会服务机构可以共同努力， 实施和评估旨在降低死亡率的战略 因乳腺癌和宫颈癌而增加的女性人数 接受常规乳房X光检查、临床乳房检查和巴氏试验，地址为 建议的间隔。建议的乳房公共卫生方法 宫颈癌筛查的目的是让所有女性在40年内接受筛查 在威斯康星州中北部的四个农村县，年龄更大。因为 她们被诊断为乳房和子宫颈晚期的风险更高。 癌症、低收入妇女和65岁及以上妇女将 专门针对干预措施。还将重点放在 测试旨在引入结构性结构的策略相关策略 医疗保健提供和筹资系统的修改是 有望提高低收入和农村老年人口的筛查率 女人。一项“in Reach”和两项外展的随机对照研究 干预策略将在两个定义明确的低收入人群中实施 人口：1)农村社区卫生中心登记病人， 2)四个农村县的医疗补助受益人。 在第二年，这些研究的结果将是 纳入了一个社区范围的筛查计划。这一计划将 将通过一个区域联盟进行协调，并将涉及公众和 职业意识和教育项目。除了……之外 协调接送和外联活动，区域联合会和 当地工作队将负责提供技术援助和 倡导在与世隔绝的农村推行提醒制度 在干预县的实践。区域财团将 还与当地服务提供商、保险公司和其他相关机构合作 缔约方加强筛选能力并制定筹资机制，以 满足所有地区居民的筛查需求。这件事的影响 全社区的干预措施将通过准试验性的 设计，在干预中使用全人群电话调查 地区和该州的可比地区。对中国的评价 拟议的乳腺癌和宫颈癌筛查项目将评估 综合战略的有效性以及联合战略的有效性 选定的建议干预方法，在克服个人， 环境和系统障碍阻碍筛查利用和 充分的后续行动。

The primary goal of this project is to demonstrate how a consortium of community health and social service agencies can work together to implement and evaluate strategies which are aimed at decreasing mortality due to breast and cervical cancer by increasing the number of women who receive routine mammography, clinical breast exams, and Pap testing at recommended intervals. The proposed public health approaches to breast and cervical cancer screening are designed to reach all women 40 years and older in four rural counties in north central Wisconsin. Because they are at higher risk for late stage diagnosis of breast and cervical cancer, low income women and women aged 65 years and older will be specially targeted for interventions. An emphasis will also be placed on testing policy- relevant strategies designed to introduce structural modifications in the health care delivery and financing systems that are expected to improve rates of screening among low income and elderly rural women. Randomized controlled studies of one "inreach" and two outreach intervention strategies will be conducted in two well-defined, low-income populations: 1) registered patients of a rural community health center, and 2) Medicaid beneficiaries in four rural counties. During the second year, the results from these studies will be incorporated into a community-wide screening program. This program will be coordinated through a Regional Consortium and will involve public and professional awareness and education programs. In addition to coordinating inreach and outreach activities, the Regional Consortium and local task forces will be charged with providing technical assistance and advocating for the implementation of reminder systems in isolated rural practices in the intervention counties. The Regional Consortium will also work with local service providers, insurers and other relevant parties to enhance screening capacity and develop financing mechanisms to meet the screening needs of all area residents. The impact of this community-wide intervention will be assessed by a quasi-experimental design, using population-wide telephone surveys in the intervention region and in a comparable region in the state. The evaluation of the proposed breast and cervical cancer screening project will assess the effectiveness of the combined strategies, as well as the effectiveness of selected proposed intervention methods, in overcoming individual, environmental, and systemic barriers to screening utilization and adequate follow-up.