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Cancer early-detection services in community health centers for the underserved. A randomized controlled trial
A J Dietrich1, J N Tobin, C H Sox
1Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH, USA. allen.dietrich@dartmouth.edu
Archives of Family Medicine
|July 31, 1998
Summary
Implementing a preventive services office system in community health centers improved cancer early-detection services overall. However, the intervention
Area of Science:
- Public Health
- Preventive Medicine
- Health Services Research
Background:
- Cancer early detection remains a significant challenge, particularly for underserved populations including low-income and minority groups.
- Community health centers play a crucial role in providing healthcare access to these vulnerable populations.
Purpose of the Study:
- To evaluate the impact of a preventive services office system intervention on cancer early-detection rates in community health centers serving underserved populations.
- To identify factors influencing the successful implementation and effectiveness of cancer screening services.
Main Methods:
- A randomized trial was conducted across 62 community health centers in New York, New Jersey, and western Connecticut.
- An intervention involving workshops, materials, and advice was implemented to establish a system for identifying patients needing preventive services.
- Medical record reviews were used to assess the proportion of patients up-to-date with indicated cancer early-detection services at baseline and follow-up.
Main Results:
- Seven of eight target cancer early-detection services showed significant improvement across all 62 centers.
- The intervention demonstrated a small overall impact on cancer early-detection services, as measured by record review.
- A significant association was found between the stability of the medical director position and improvements in service delivery; centers with consistent leadership showed better outcomes.
Conclusions:
- While cancer early-detection services are improving in community health centers, the tested intervention had a limited impact.
- The effectiveness of the intervention was contingent on maintaining consistent leadership, specifically the medical director.
- Further research is needed to understand the complex interplay between practice environment changes and the delivery of preventive health services.