The theme of the proposed CPRU is to improve the organization and delivery of cancer control services in manage care. The investigators propose a CPRU to extend the previous work, expand the collaboration of CHR and ORI, initiate development of work in two areas new to us that are important to managed care, to add new investigators to our cancer control research team including two young investigators without previous cancer control experience, and to enhance the opportunities for working with a large managed care organization to develop a rational approach to designing, testing, evaluating and implementing cancer control strategies. Project I will test an innovative expert systems model developed at the University of Rhode Island in a medical setting. No adolescent smoking prevention or cessation programs have had a demonstrable long-term impact on teenage smoking. This sophisticated, interactive video provides stage- appropriate smoking prevention/cessation interventions. For adults, we have already shown that the medical encounter is uniquely effective as a vehicle for delivering effective smoking interventions. This project will apply those lessons to adolescent interventions. Project 2 will use the successful outpatient TRACC 1 smoking intervention s a model for delivery of an intervention designed to reduce dietary fat. There are no low- intensity interventions proven to have a long-term impact on dietary fat consumption. We will determine whether an inexpensive, brief dietary counseling approach incorporated into routine primary care can reduce blood lipids and long-term risk of cancer. Project 3 examines the impact of coordinating integrating, and prioritizing the delivery of cancer prevention services ot a population of underserved health plan members. There are multiple, often conflicting, systems and recommendations for delivering cancer control services. This project focuses on women who fall into the mammography and pap smear safety nets and women who smoke. Two developmental projects will initiate new areas of research for us; genetic screening and its implications for cancer control, and quality of life studies among cancer patients. Both developmental projects involve young investigators new to cancer control. The projects will be served by a core that provides data management, quality control, economic analyses, biostatistics, and analysis support.
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