Recruitment for research, prevention, and early detection among health disparities populations represents a major challenge in chronic disease control. This effect is magnified for individualsat high risk for conditions such as genetic breast cancer or chronic hepatitis. Costs are typically high, particularly given the common practice of developing a single outreach channel to address a each disease or condition. The goal of this study is to demonstrate the effectiveness of a model that combines efficient statewide public health recruitment of underserved, high-risk women with individuallytailored telephone counseling. Based on results from a recently completed pilot study in which callers to the California toll-free breast/cervical screening phone service (Every Woman Counts -EWC) were successfully recruited to a study on a topic unrelated to cancer screening, we now propose an assessment of the reach, cost, and effectiveness of this channel to identify California women who are at high-risk for breast or ovarian cancer or for chronic Hepatitis B in order to connect them with appropriate research or prevention services.
Our specific aims are: 1. To test the effectiveness of this recruitment channel for chronic disease control research and services by measuring the proportion of eligible EWC callers who consent to take part in a randomized trial of telephone counseling for:a) the next breast cancer prevention trial (Study Component 1) and b) genetic counseling for breast or ovarian cancer (Study Component 2);2. To test the effectiveness of telephone counseling in a prospective randomized trial of consenting EWC callers with two independent main outcomes:a) the proportion of women in the immediate compared with the delayed intervention group who contact a breast cancer prevention trial site for enrollment information;b)the proportion of women in the immediate compared with the delayed intervention group who contact a genetic counseling program;3.To assess the feasibility of the EWC as a recruitment channel for telephone counseling for Hepatitis B counseling (Study Component 3);and 4. For each study component, to explore women's response to the recruitment process, their understanding of the service(s), and their experience participating or not participating in one of the three services using in- depth interviews. At least 144 women (72/year) will be randomized for each of the 2 services in the trial, half to immediate phone counseling and half to counseling 2 months later, upon completion of the follow-up survey. Feasibility of recruitment of Asian immigrants will be assessed through 200 attempts. Qualitative research will explore women's perceptions of recruitment and their understanding of the intervention.
