Parkland-UT Southwestern PROSPR Center Colon Cancer Screening in a Safety net

描述(由申请者提供)：扩建后的Parkland-UT西南PROSPR中心的总体目标是在我们的综合安全网系统中优化宫颈癌和结肠癌筛查。我们贡献的人群是PROSPR网络中最多样化和最弱势的群体，代表了大型研究网络中罕见的患者。帕克兰市符合宫颈癌筛查条件的成年女性超过7.8万人，其中西班牙裔占6.1%，非裔美国人占24%，非西班牙裔白人占8%。所有人都是低收入者，很少有私人保险，这导致他们依赖公共保险或慈善护理。因此，我们的患者代表了经历宫颈癌差异的“传统上服务不足”的群体--更高的发病率和死亡率，以及更低的筛查和HPV疫苗接种。Parkland通过一个由11个社区初级保健诊所、11个妇女健康中心和专科诊所(异型增生、妇科和肿瘤科)组成的集成系统，提供完整的宫颈癌筛查过程(风险评估、早期发现、诊断评估和治疗)。所有诊所都共享一个全面的电子病历(EMR)，通过该病历可以电子方式确定是否有资格进行测试、测试排序、结果、转诊和治疗。我们的中心将扩大，增加一个宫颈筛查过程文件股(SPDU)和一个宫颈研究核心。宫颈SPDU将：1)利用Parkland的EMR在多个层面收集宫颈癌筛查过程的准确数据，包括患者、提供者、诊所、系统和医疗政策，以及2)安全传输 将未查明的数据提交给统计协调中心，调查员#年 颈椎研究核心将通过确定优先顺序、概念化和实施协作项目来为PROSPR网络提供智力领导，这些合作项目利用网络在患者群体、卫生系统和背景方面的异质性。帕克兰-德克萨斯大学西南PROSPR中心向该网络提供的数据将使分析能够检验最近指南的变化以及新可用的筛查和疫苗技术如何影响宫颈癌方面长期存在的差异。这项研究将提高有效宫颈癌筛查的科学性和可操作性。

DESCRIPTION (provided by applicant): The overall goal of the expanded Parkland-UT Southwestern PROSPR Center is to optimize cervical and colon cancer screening in our integrated safety-net system. The population we contribute is the most diverse and disadvantaged in the PROSPR network, representing patients infrequently included in large scale research networks. Parkland's cervical cancer screen-eligible population of more than 78,000 adult women is 6 1% Hispanic, 24% African American, and 8% Non-Hispanic White. All are low-income and few have private insurance leading them to rely on public insurance or charity care. Thus, our patients represent the "traditionally underserved" groups experiencing cervical cancer disparities - higher incidence and mortality, and lower screening and HPV vaccination. Parkland delivers the full cervical cancer screening process (risk assessment, early detection, diagnostic evaluation, and treatment) through an integrated system of 11 neighborhood-based primary care clinics, 11 women's health centers, and specialty clinics (dysplasia, gynecology and oncology). All clinics share a comprehensive electronic medical record (EMR) through which eligibility for a test, test ordering, results, referrals, and treatmentis ascertainable electronically. Our Center will expand by adding a Cervical Screening Process Documentation Unit (SPDU) and a Cervical Research Core. The Cervical SPDU will: 1) harness Parkland's EMR to collect accurate data on the cervical cancer screening process at multiple levels including the patient, provider, clinic, system, and health policy, and 2) securely transfer de-identified data to the Statistical Coordinating Center, investigators in the Cervical Research Core will provide intellectual leadership to the PROSPR network by prioritizing, conceptualizing, and conducting collaborative projects that capitalize on the heterogeneity of the network with respect to patient population, health system, and context. Data contributed by the Parkland-UT Southwestern PROSPR Center to the Network will enable analyses that examine how recent changes in guidelines and newly available screening and vaccine technologies impact long-standing disparities in cervical cancer. This research will improve both the science and delivery of effective cervical cancer screening.