Education Development Center, Inc. (EDC), in collaboration with Dana- Farber Cancer Institute, Harvard Community Health Plan (HCHP), and the Dartmouth School of Medicine, proposes a study of the effectiveness of a multilevel communication campaign to improve identification, treatment, and support for women and men who are at risk of the health consequences associated with exposure to diethylstilbestrol (DES). We will compare the impact of low-intensity and high-intensity interventions in ensuring DES services for all potentially exposed individuals in Massachusetts, which has one of the highest prevalence of DES exposure in the nation. Over 36 months, we will: 1. Design and implement a low-intensity public education intervention to increase knowledge about the DES risk factors and the health consequences of DES exposure to identify individuals currently unaware of their exposure, increasing DES screening, and increasing referral of those with identified DES-related health problems to treatment and support services. 2. Design and implement a low-intensity provider education intervention to increase DES-related knowledge and compliance with NCI-recommended screening and treatment protocols among physicians, nurses, and ancillary medical personnel. 3. Design video- and audiotape-based CME/CEU programs which are tailored to meet the informational needs and practice demands of physicians and nurses who should provide DES-related screening, treatment, and support services. 4. Conduct a randomized clinical trial in 14 HCHP sites comparing two levels of DES public and provider education: (a) low-intensity public and provider education interventions and (b) high-intensity combined CME/CEU, office management, and patient education interventions. 5. Assess the effectiveness of low-intensity and high-intensity interventions in terms of impact on improved public, provider, and patient knowledge about the health risks and consequences of DES; increases in the proportion of women and men in target groups who have been screened for DES; increases in the number of DES-exposed individuals identified in the medical record; and increased adherence to NCI- recommended DES screening, follow-up, and treatment procedures. 6. Disseminate CME/CEU programs to providers in office, group, and hospital practices throughout our region and continue public education outreach. Working with DES Action, the DES Cancer Network, and the DES Sons, as well as the massachusetts Medical Society, nursing associations, and local chapters of specialty practice groups, we will design and evaluate educational interventions that reach the public, providers, and patients.
| Jackson, R; O'Donnell, L; Johnson, C et al. (2000) Office systems intervention to improve diethylstilbestrol screening in managed care. Obstet Gynecol 96:380-4 |
