INTEGRATING AND PRIORITIZING CANCER PREVENTION IN MEDICAL PRACTICE

预防和早期发现服务经常相互绊倒 因为有多个系统和STS建议 给他们送去。因此，旨在提高对 推荐用于送货。因此，旨在 增加对推荐服务的遵守通常会鼓励过度使用某些服务 一些个人的资源，同时仍留下相当大的群体 服务不足的人。本项目侧重于以下系统的好处： 确定高度优先的癌症预防和早期发现需求， 将它们集成到单一干预中，并提供 采取干预措施，以改善向 服务不足。干预使用激励性访谈和一项 鼓励有选择地交付所需数量的个人模型方法 尽可能多地提供服务。该项目的重点是那些跌入 乳房X光检查纸片涂抹安全网(自上次测试以来间隔过长) 还有抽烟的女人。这三个干预组的方法是 改善向最需要的妇女提供现有服务的情况。 我们还将比较不必要的癌症控制服务在 将这些小组与平时的护理进行比较，并评估 对患者对KP的满意度和系统成本的干预。这个 研究采用2X2析因设计，以系统输出的影响为特征 REACH(邮件-电话)、System In-REACH(此时基于诊所的干预 主要CRE服务)，并将触达和触达相结合。每一位 三种干预措施将与通常的护理进行比较，涉及 在后续时间间隔内满足的高优先级需求的比例， 以及提供不必要服务的比例。

Prevention and early detection services often stumble over one another because there are multiple systems and sts of recommendations for delivering them. Consequently, systems designed to increase adherence to recommended for delivering them. Consequently, systems designed to increase adherence to recommended services often encourage over-use of some resources among some individuals while still leaving a substantial group of underserved persons. This project focuses on the benefit of a system for identifying high priority cancer prevention and early detection needs, integrating them into a single intervention, and delivering that intervention as a means of improving the delivery of services to the underserved. The intervention uses motivational interviewing and a personal models approach to encourage selective delivery of as many needed services as possible. The project focuses on women who fall into the mammography an pap smear safety nets (excessive interval since last tested) and women who smoke. The three intervention groups are methods for improving delivery of existing services to women in greatest need of them. We will also compare the delivery of unnecessary cancer control services in the groups compared to usual care, and assess the impact of the interventions on patient satisfaction with KP and cost to the system. The study has a 2X2 factorial design featuring the effects of a system Out- reach (mail-phone), system In-reach (clinic based intervention at th time of primary cre service), and combined In-reach and Out-reach. Each of the three interventions will be compared to usual care with respect to the proportion of high priority needs that are met during a follow-up interval, and athe proportion of unnecessary services delivered.