Abstract

Very little research has been conducted on how to disseminate effective cancer screening interventions in health care settings. We propose to implement, through the Veterans Affairs (VA) health system, a targeted mammography intervention (Project HOME) aimed at women veterans age 40 and over who are currently non-compliant with breast cancer screening guidelines. This theory-based intervention was tested by a 5year prospective randomized trial in a national population-based sample of women veterans, including users and non-users of the VA health system. Preliminary results show that the intervention was effective overall, and particularly effective in motivating VA users to adhere to guidelines (RO1 CA76330-05, 1999-2004). The Department of Veterans Affairs (VA) has sought to improve health care services for women veterans by creating the Women Veterans Health Program and assigning Women Veterans Program Managers (WVPMs) to all VA Regional Offices. Women veterans are at increased lifetime risk of cancer relative to the general adult female population and the VA is committed to preventive health measures that prevent or lead to the early detection of cancer. The VA has set an 85% compliance standard for women veterans to have had a mammogram in the past 2 years and WVPMs are very interested in educational efforts to promote compliance. We plan to build on the VA's existing infrastructure by partnering with WVPMs to understand adopter and setting characteristics, customizing the Project HOME intervention for use in 6 VA clinics, implementing a theory-based strategy to maximize program adoption, implementation, and maintenance, and evaluating the effectiveness of the dissemination strategy and potential for institutionalization among all VA clinics. We will conduct a cost-effectiveness analysis of implementing Project HOME in the VA clinics. Theories of diffusion and dissemination will guide plans for program adoption, implementation, and maintenance. Quantitative and qualitative tools will be created to conduct a process evaluation of the dissemination plan. Outcomes will include interest in adopting Project HOME, quality of implementation, number of women veterans reached, and mammography compliance. If successful, we will extend this dissemination project to all VA clinics, thus potentially reaching an estimated 166,000 women veterans over 40 years of age who are currently using VA outpatient health services.

  Funding Agency

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
3R01CA076330-05S2
Application #
6801725
Study Section
Community Prevention and Control Study Section (CPC)
Program Officer
Breslau, Erica S
Project Start
1999-06-17
Project End
2006-03-31
Budget Start
2003-04-01
Budget End
2006-03-31
Support Year
5
Fiscal Year
2003
Total Cost
$184,655
Indirect Cost

  Institution

Name
University of Texas Health Science Center Houston
Department
Psychology
Type
Schools of Public Health
DUNS #
800771594
City
Houston
State
TX
Country
United States
Zip Code
77225

  Publications

Murphy, Caitlin C; Vernon, Sally W; Diamond, Pamela M et al. (2014) Competitive testing of health behavior theories: how do benefits, barriers, subjective norm, and intention influence mammography behavior? Ann Behav Med 47:120-9
Lairson, David R; Chan, Wen; Chang, Yu-Chia et al. (2011) Cost-effectiveness of targeted versus tailored interventions to promote mammography screening among women military veterans in the United States. Eval Program Plann 34:97-104
Vernon, Sally W; McQueen, Amy; Tiro, Jasmin A et al. (2010) Interventions to promote repeat breast cancer screening with mammography: a systematic review and meta-analysis. J Natl Cancer Inst 102:1023-39
Pruitt, Sandi L; McQueen, Amy; Tiro, Jasmin A et al. (2010) Construct validity of a mammography processes of change scale and invariance by stage of change. J Health Psychol 15:64-74
Mhoon, Kendra Brown; Chan, Wenyaw; Del Junco, Deborah J et al. (2010) A CONTINUOUS-TIME MARKOV CHAIN APPROACH ANALYZING THE STAGES OF CHANGE CONSTRUCT FROM A HEALTH PROMOTION INTERVENTION. JP J Biostat 4:213-226
Savas, Lara S; del Junco, Deborah J; Bastian, Lori A et al. (2009) Mortality ascertainment of women veterans: a comparison of sources of vital status information, 1979-2002. Med Care 47:125-8
Fisher, Deborah A; Voils, Corrine I; Coffman, Cynthia J et al. (2009) Validation of a questionnaire to assess self-reported colorectal cancer screening status using face-to-face administration. Dig Dis Sci 54:1297-306
Fernández, María E; Gonzales, Alicia; Tortolero-Luna, Guillermo et al. (2009) Effectiveness of Cultivando la Salud: a breast and cervical cancer screening promotion program for low-income Hispanic women. Am J Public Health 99:936-43
del Junco, Deborah J; Vernon, Sally W; Coan, Sharon P et al. (2008) Promoting regular mammography screening I. A systematic assessment of validity in a randomized trial. J Natl Cancer Inst 100:333-46
McQueen, Amy; Swank, Paul R; Bastian, Lori A et al. (2008) Predictors of perceived susceptibility of breast cancer and changes over time: a mixed modeling approach. Health Psychol 27:68-77

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