The purpose of this study is to document barriers and test strategies with a replicable model to improve the appropriate identification, diagnosis, and treatment of DES-associated medical conditions.
The specific aims of this study are: l) to identify potentially DES-exposed women and offspring in addition to those already registered in the DESAD project; 2) to reach health providers and the DES-exposed population in a cost effective strategy to disseminate the most current information about DES exposure sequelae and treatment; and, 3) to provide clinical and educational consultation to physicians, nurses and DES-exposed women and their children through an expansion of previous efforts with the establishment of the Southwest Regional DES Clinical Center. A behavioral model by Prochaska & DiClemente is utilized in this study which presumes that all persons are not at the same point of adopting a specific health-related practice, such as surveillance and treatment of DES exposure. This theoretical model will facilitate the interpretation of the effect of a health communication intervention with two population targets: health providers and DES-exposed women in the state of Texas. Several methods will be used including specific sampling techniques to identify the exposed population; education with multi-media and other schema; measurement of health practices in the exposed population and readiness to act on germane DES information; and, identification and education of health providers. These methods are cost effective and efficient, utilizing existing professional organizations and print/television media to promulgate specific health information to improve identification of potential DES-exposed women and their offspring and health providers.
