The indigent, multi-ethnic populations who use the emergency rooms of urban hospitals in our country as their sole source of medical care are seldom exposed to opportunities for preventive medical services including early cancer detection. Paradoxically, low- income populations are at highest risk of many cancers, including cervical cancer. The social, cultural, economic and political factors associated with inadequacies in their medical and preventive care are numerous and insurmountable in the short term. In the case of cervical cancer, however, we have shown in an NCI- funded pilot study, that it is feasible to bypass the underlying lack of a preventive orientation in this population by providing Pap smear screening as part of routine acute care in the Emergency Department (ED) of Highland General Hospital (HGH), Oakland. The current proposal is based on this innovation and will take the next step along the pathway to an effective program of cervical cancer screening. In two randomized, controlled substudies we will: (1) develop, implement, and evaluate the effectiveness of a specialized Cancer Awareness, Referral, and Education (CARE) Clinic compared to routine Gynecology Clinic follow-up for women with abnormal ED Pap smears; and (2) develop, implement, and evaluate a program designed to encourage women with normal ED Pap smears to return for periodic screening at recommended intervals. These interventions reflect innovations in procedural and organizational aspects of health care delivery within the county health care system.
| Pérez-Stable, Eliseo J; Afable-Munsuz, Aimee; Kaplan, Celia Patricia et al. (2013) Factors influencing time to diagnosis after abnormal mammography in diverse women. J Womens Health (Larchmt) 22:159-66 |
| Stewart, Susan L; Rakowski, William; Pasick, Rena J (2009) Behavioral constructs and mammography in five ethnic groups. Health Educ Behav 36:36S-54S |
| Otero-Sabogal, Regina; Stewart, Susan; Shema, Sarah J et al. (2007) Ethnic differences in decisional balance and stages of mammography adoption. Health Educ Behav 34:278-96 |
| Wagner, Todd H; Engelstad, Linda P; McPhee, Stephen J et al. (2007) The costs of an outreach intervention for low-income women with abnormal Pap smears. Prev Chronic Dis 4:A11 |
| Alderete, Ethel; Juarbe, Teresa C; Kaplan, Celia Patricia et al. (2006) Depressive symptoms among women with an abnormal mammogram. Psychooncology 15:66-78 |
| Juarbe, Teresa C; Kaplan, Celia Patricia; Somkin, Carol P et al. (2005) Are risk factors for breast cancer associated with follow-up procedures in diverse women with abnormal mammography? Cancer Causes Control 16:245-53 |
| Karliner, Leah S; Patricia Kaplan, Celia; Juarbe, Teresa et al. (2005) Poor patient comprehension of abnormal mammography results. J Gen Intern Med 20:432-7 |
| Engelstad, Linda P; Stewart, Susan; Otero-Sabogal, Regina et al. (2005) The effectiveness of a community outreach intervention to improve follow-up among underserved women at highest risk for cervical cancer. Prev Med 41:741-8 |
| Wagner, Todd H; Goldstein, Mary K (2004) Behavioral interventions and cost-effectiveness analysis. Prev Med 39:1208-14 |
| Somkin, Carol P; McPhee, Stephen J; Nguyen, Tung et al. (2004) The effect of access and satisfaction on regular mammogram and Papanicolaou test screening in a multiethnic population. Med Care 42:914-26 |
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