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.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project (R01)
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Special Emphasis Panel (HSDG)
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Wake Forest University Health Sciences
Family Medicine
Schools of Medicine
United States
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Michielutte, R; Dignan, M B; Sharp, P C et al. (1996) Skin cancer prevention and early detection practices in a sample of rural women. Prev Med 25:673-83