INCREASING CANCER SCREENING AMONG UNDERSERVED WOMEN

本研究建议使用两种方法来增加乳房和宫颈 主要是贫困、老年妇女的癌症筛查率 和/或美洲原住民40岁及以上：1）促进癌症 在一家主要的县医院内对因以下原因出现的妇女进行筛查： 癌症筛查以外的其他服务（“inreach”）;以及2）鼓励和 动员社区内低收入妇女 高层建筑进行筛查（“外联”）。基于形成性研究， 在第一年进行的试点研究，以医院为基础的干预 将制定和实施战略，以提高贫困人口的比例， 美洲原住民妇女谁提供，接受，并完成乳房和 子宫颈癌普查。常规筛查的有效性， 一个独立的筛查诊所， “不，不。 研究了1500名来自综合医院的妇女 人口加上250名额外的美国土著妇女将被随机分配到 乳腺癌和宫颈癌筛查干预（基于 形成性研究）或常规护理（对照）。成本效益将是 并会对医院员工进行评估和培训，以帮助维持这项活动。 外联部分将利用社区组织和侦察 向贫困和老年妇女推广乳腺癌筛查的方法， 住在低收入的高楼里42栋高层建筑将在 随机分为治疗组和对照组。治疗 条件，社会工作者和高层领导人将 鼓励他们的客户和邻居在每年的12周内接受筛查 竞选筛查率将通过自我报告进行评估，以待确认 明尼苏达州人类服务部维护的一个数据库， 医疗补助病人的付费程序。美国癌症协会将 在干预的头两年提供协助，并接管运动 在这项研究的外联部分的最后阶段。

This study proposes to use two approaches to increase breast and cervical cancer screening rates among women who are predominantly indigent, elderly and/or Native American 40 years of age and older by: 1)promotion of cancer screening within a major county hospital to women who present for reasons other than cancer screening ("inreach"); and 2) encouragement and mobilization of women from within the community who live in low income high-rises to be screened ("outreach"). Based on formative research and pilot studies conducted in the first year, the hospital-based intervention will develop and implement strategies to improve the proportion of poor and Native American women who are offered, accept, and complete breast and cervical cancer screening. The efficacy of standing orders for screening, a freestanding screening clinic, recruitment from clinics other than primar care, and the offer of immediate (rather than scheduled) screening will be studied. One thousand five hundred women from the general hospital population plus 250 additional Native American women will be randomized to either a breast and cervical cancer screening intervention (based on the formative research) or usual care (control). Cost-effectiveness will be assessed and hospital staff will be trained to help sustain the activity. The outreach component will use a commumity organization and reconnaissance approach to promote breast cancer screening to poor and elderly women who live in low income high-rises. Forty-two high-rise buildings will be randomized to be either treatment or control conditions. In the treatment condition, social workers and peer leaders from the high-rises will encourage their clients and neighbors to be screened during annual 12 week campaigns. Screening rates will be assessed by self-report to be confirmed by a database the Minnesota Department of Human Services maintains for all paid procedures for Medicaid patients. The American Cancer Society will assist during the first two intervention years and take over the campaign during the last phase of the outreach component of this study.