Evidence Based Dissemination for Mammography Adherence in Safety Net Communities
- Conditions
- Breast Cancer
- Interventions
- Behavioral: Peace of Mind Program
- Registration Number
- NCT02296177
- Brief Summary
Breast cancer is the most common cancer and the second leading cause of cancer related death in American women. Regular screening, early diagnosis, and timely treatment initiation have been shown to reduce breast cancer morbidity and mortality. However, disparities continue to exist across the breast cancer continuum for underserved women, particularly minority women. The reduction of disparities in breast cancer outcomes is a major goal of Healthy People 2020 and the National Cancer Institute. However, the preventable burden of late stage breast cancer will continue until the investigators close the gap between what is known about prevention and what is implemented in the community. Although many sources of information exist about theory and \[theory-\] and evidence-based interventions (EBIs) to promote mammography screening, their adoption and use in the community has been limited and haphazard at best.
- Detailed Description
In order to effectively reach underserved women and reduce breast cancer disparities, D\&I efforts should target the healthcare delivery system where these women receive service - the so called "safety net". Within the safety net, federally qualified health centers (FQHCs), provide comprehensive primary health care services for underserved communities regardless of ability to pay, including mammography screening. Our team has successfully pilot tested a National Cancer Institute research tested intervention program (RTIP) with underserved women and were able to reduce no-show rates from 44% to 19%. In order to accelerate the adoption and implementation of our EBI within the safety net, the investigators will use a two-step approach based on the consolidated framework for implementation research (CFIR), and intervention mapping. The investigators will actively disseminate the EBI through a unique breast health collaborative with a wide membership of FQHCs, support implementation through training and evaluate the adoption, implementation, sustainment and effectiveness of the EBI. The investigators will use a clinic clustered stepped wedge design for implementation in FQHCs.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Female
- Target Recruitment
- 4448
- Underserved as defined by income <=200% of the federal poverty level for a family of four
- Uninsured
- In need of mammography screening; has received clinical breast exam and referral to screening
- Has upcoming screening appointment
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- CROSSOVER
- Arm && Interventions
Group Intervention Description Intervention Peace of Mind Program The intervention group will receive a reminder call about their upcoming appointment that assesses their intent to attend the appointment and counsels them through barriers to attendance. The call is conducted by a trained patient navigator using an adapted NCI RTIP to increase mammography appointment adherence.
- Primary Outcome Measures
Name Time Method Mammography Appointment Adherence 12 months Appointment attendance will be taken from the electronic health record for both control and intervention patients
- Secondary Outcome Measures
Name Time Method Cancellations or rescheduled appointments 12 months Patients who cancelled and rescheduled will be taken from the electronic health record for both control and intervention patients
Trial Locations
- Locations (1)
University of Texas Health Science Center Houston
🇺🇸Houston, Texas, United States