Telephone Care Management To Improve Cancer Screening among Low-Income Women: A Randomized, Controlled Trial
Publication: Annals of Internal Medicine
Volume 144, Number 8
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Abstract
Background:
Minority and low-income women receive fewer cancer screenings than other women.
Objective:
To evaluate the effect of a telephone support intervention to increase rates of breast, cervical, and colorectal cancer screening among minority and low-income women.
Design:
Randomized, controlled trial conducted between November 2001 and April 2004.
Setting:
11 community and migrant health centers in New York City.
Patients:
1413 women who were overdue for cancer screening.
Intervention:
Over 18 months, women assigned to the intervention group received an average of 4 calls from prevention care managers and women assigned to the control group received usual care. Follow-up data were available for 99% of women, and 91% of the intervention group received at least 1 call.
Measurements:
Medical record documentation of mammography, Papanicolaou testing, and colorectal cancer screening according to U.S. Preventive Services Task Force recommendations.
Results:
The proportion of women who had mammography increased from 0.58 to 0.68 with the intervention and decreased from 0.60 to 0.58 with usual care; the proportion who had Papanicolaou testing increased from 0.71 to 0.78 with the intervention and was unchanged with usual care; and the proportion who had colorectal screening increased from 0.39 to 0.63 with the intervention and from 0.39 to 0.50 with usual care. The difference in the change in screening rates between groups was 0.12 for mammography (95% CI, 0.06 to 0.19), 0.07 for Papanicolaou testing (CI, 0.01 to 0.12), and 0.13 for colorectal screening (CI, 0.07 to 0.19). The proportion of women who were up to date for 3 tests increased from 0.21 to 0.43 with the intervention.
Limitations:
Participants were from 1 city and had access to a regular source of care. Medical records may not have captured all cancer screenings.
Conclusions:
Telephone support can improve cancer screening rates among women who visit community and migrant health centers. The intervention seems to be well suited to health plans, large medical groups, and other organizations that seek to increase cancer screening rates and to address disparities in care.
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References
1.
Elmore JG, Armstrong K, Lehman CD, Fletcher SW. Screening for breast cancer. JAMA. 2005;293:1245-56. [PMID: 15755947]
2.
Levin B, Smith RA, Feldman GE, Colditz GA, Fletcher RH, Nadel M, et al. Promoting early detection tests for colorectal carcinoma and adenomatous polyps: a framework for action: the strategic plan of the National Colorectal Cancer Roundtable. Cancer. 2002;95:1618-28. [PMID: 12365008]
3.
Schiffman MH, Brinton LA, Devesa SS. Cervical cancer. In: Schottenfeld D, Fraumeni JF, eds. Cancer Epidemiology and Prevention. 2nd ed. New York: Oxford Univ Pr; 1996:1090-116.
4.
Jemal A, Murray T, Ward E, Samuels A, Tiwari RC, Ghafoor A, et al. Cancer statistics, 2005. CA Cancer J Clin. 2005;55:10-30. [PMID: 15661684]
5.
Agency for Healthcare Research and Quality. National Healthcare Disparities Report. Rockville, MD: U.S. Department of Health and Human Services; 2003.
6.
Cooper GS, Koroukian SM. Racial disparities in the use of and indications for colorectal procedures in Medicare beneficiaries. Cancer. 2004;100:418-24. [PMID: 14716780]
7.
National Academies Press. Unequal treatment: confronting racial and ethnic disparities in health care. Accessed at www.nap.edu/books/030908265X/html/ on 16 May 2004.
8.
U.S. Department of Health and Human Services. Healthy People 2010. Accessed at www.healthypeople.gov/Document/HTML/Volume1/03Cancer.htm#_ednref28 on 2 April 2005.
9.
National Cancer Institute. Cancer Health Disparities Fact Sheet. 2003. Accessed at www.nci.nih.gov/cancertopics/factsheet/cancerhealthdisparities on 13 May 2005.
10.
Dietrich AJ, O'Connor GT, Keller A, Carney PA, Levy D, Whaley FS. Cancer: improving early detection and prevention. A community practice randomised trial. BMJ. 1992;304:687-91. [PMID: 1571644]
11.
Dietrich AJ, Tobin JN, Sox CH, Cassels AN, Negron F, Younge RG, et al. Cancer early-detection services in community health centers for the underserved. A randomized, controlled trial. Arch Fam Med. 1998;7:320-7; discussion 328. [ 9682685]
12.
Roetzheim RG, Christman LK, Jacobsen PB, Cantor AB, Schroeder J, Abdulla R, et al. A randomized, controlled trial to increase cancer screening among attendees of community health centers. Ann Fam Med. 2004;2:294-300. [PMID: 15335126]
13.
Roetzheim RG, Christman LK, Jacobsen PB, Schroeder J, Abdulla R, Hunter S. Long-term results from a randomized, controlled trial to increase cancer screening among attendees of community health centers. Ann Fam Med. 2005;3:109-14. [PMID: 15798035]
14.
Vernon SW. Participation in colorectal cancer screening: a review. J Natl Cancer Inst. 1997;89:1406-22. [PMID: 9326910]
15.
Barr JK, Franks AL, Lee NC, Antonucci DM, Rifkind S, Schachter M. A randomized intervention to improve ongoing participation in mammography. Am J Manag Care. 2001;7:887-94. [PMID: 11570022]
16.
Champion V, Maraj M, Hui S, Perkins AJ, Tierney W, Menon U, et al. Comparison of tailored interventions to increase mammography screening in nonadherent older women. Prev Med. 2003;36:150-8. [PMID: 12590989]
17.
Crane LA, Leakey TA, Ehrsam G, Rimer BK, Warnecke RB. Effectiveness and cost-effectiveness of multiple outcalls to promote mammography among low-income women. Cancer Epidemiol Biomarkers Prev. 2000;9:923-31. [PMID: 11008910]
18.
Saywell RM Jr, Champion VL, Skinner CS, Menon U, Daggy J. A cost-effectiveness comparison of three tailored interventions to increase mammography screening. J Womens Health (Larchmt). 2004;13:909-18. [PMID: 15671706]
19.
Wood D, Halfon N, Donald-Sherbourne C, Mazel RM, Schuster M, Hamlin JS, et al. Increasing immunization rates among inner-city, African American children. A randomized trial of case management. JAMA. 1998;279:29-34. [PMID: 9424040]
20.
Friedrich MJ. Enhancing diabetes care in a low-income, high-risk population. JAMA. 2000;283:467-8. [PMID: 10659861]
21.
Taylor CB, Miller NH, Reilly KR, Greenwald G, Cunning D, Deeter A, et al. Evaluation of a nurse-care management system to improve outcomes in patients with complicated diabetes. Diabetes Care. 2003;26:1058-63. [PMID: 12663573]
22.
Simon GE, VonKorff M, Rutter C, Wagner E. Randomised trial of monitoring, feedback, and management of care by telephone to improve treatment of depression in primary care. BMJ. 2000;320:550-4. [PMID: 10688563]
23.
Riegel B, Carlson B, Kopp Z, LePetri B, Glaser D, Unger A. Effect of a standardized nurse case-management telephone intervention on resource use in patients with chronic heart failure. Arch Intern Med. 2002;162:705-12. [PMID: 11911726]
24.
Yarnall KS, Pollak KI, Ostbye T, Krause KM, Michener JL. Primary care: is there enough time for prevention? Am J Public Health. 2003;93:635-41. [PMID: 12660210]
25.
Health Resources and Service Administration. Section 330 Grantees Uniform Data System: Calendar Year 2003 Data. Bethesda, MD: Bureau of Primary Health Care; 2003.
26.
Agency for Healthcare Research and Quality. Put Prevention into Practice. Washington, DC: U.S. Department of Health and Human Services; 1997.
27.
National Cancer Institute. Patient Navigator Research Program. Accessed at crchd.nci.nih.gov/Navigator/index.htm on 13 October 2005.
28.
Humphrey LL, Helfand M, Chan BK, Woolf SH. Breast cancer screening: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2002;137:347-60. [PMID: 12204020]
29.
Agency for Healthcare Research and Quality. Screening for Cervical Cancer: Recommendations and Rationale. 2003. Accessed at www.ahrq.gov/clinic/uspstf/uspscerv.htm on 23 May 2005.
30.
U.S. Preventive Services Task Force. Screening for colorectal cancer: recommendation and rationale. Ann Intern Med. 2002;137:129-31. [PMID: 12118971]
31.
Prochaska J, DiClementa C. Toward a comprehensive model of change. In: Miller W, Healther N, eds. Treating Addictive Behaviours: Process of Change. New York: Plenum Pr; 1986:3-27.
32.
Ogedegbe G, Cassells AN, Robinson CM, DuHamel K, Tobin JN, Sox CH, et al. Perceptions of barriers and facilitators of cancer early detection among low-income minority women in community health centers. J Natl Med Assoc. 2005;97:162-70. [PMID: 15712779]
33.
Winker MA. Measuring race and ethnicity: why and how? [Editorial]. JAMA. 2004;292:1612-4. [PMID: 15467065]
34.
Geronimus A, Bound J, Neidert L. On the Validity of Using Census Geocode Characteristics To Proxy Economic Status. PSC Research Report. Ann Arbor, MI: Population Studies Center; 1993:269.
35.
McCullagh P, Nelder J. Generalized Linear Models, 2nd ed. London: Chapman and Hall; 1989.
36.
New York City Health and Hospitals Corporation. Colonoscopies at City Hospitals Double in 2004; Blacks in NYC Still Have Lowest Screening Rates and Highest Colon Cancer Death Rates. Accessed at www.nyc.gov/html/hhc/html/pressroom/press-release-20050314.shtml on 22 March 2005.
37.
Woolf SH, Johnson RE, Fryer GE Jr, Rust G, Satcher D. The health impact of resolving racial disparities: an analysis of US mortality data. Am J Public Health. 2004;94:2078-81. [PMID: 15569956]
38.
National Committee for Quality Assurance. HEDIS 2005 Summary Table of Measures and Product Lines. Accessed at www.ncqa.org/Programs/HEDIS/HEDIS%202005%20Summary.pdf on 21 February 2005.
39.
West DS, Greene P, Pulley L, Kratt P, Gore S, Weiss H, et al. Stepped-care, community clinic interventions to promote mammography use among low-income rural African American women. Health Educ Behav. 2004;31:29S-44S. [PMID: 15296690]
40.
Duan N, Fox SA, Derose KP, Carson S. Maintaining mammography adherence through telephone counseling in a church-based trial. Am J Public Health. 2000;90:1468-71. [PMID: 10983211]
41.
Rimer BK, Conaway M, Lyna P, Glassman B, Yarnall KS, Lipkus I, et al. The impact of tailored interventions on a community health center population. Patient Educ Couns. 1999;37:125-40. [PMID: 14528540]
42.
Lantz PM, Stencil D, Lippert MT, Beversdorf S, Jaros L, Remington PL. Breast and cervical cancer screening in a low-income managed care sample: the efficacy of physician letters and phone calls. Am J Public Health. 1995;85:834-6. [PMID: 7646664]
43.
Tunis SR, Stryer DB, Clancy CM. Practical clinical trials: increasing the value of clinical research for decision making in clinical and health policy. JAMA. 2003;290:1624-32. [PMID: 14506122]
44.
Glasgow RE, Magid DJ, Beck A, Ritzwoller D, Estabrooks PA. Practical clinical trials for translating research to practice: design and measurement recommendations. Med Care. 2005;43:551-7. [PMID: 15908849]
Information & Authors
Information
Published In
Annals of Internal Medicine
Volume 144 • Number 8 • 18 April 2006
Pages: 563 - 571
History
Published online: 18 April 2006
Published in issue: 18 April 2006
Keywords
Copyright
© 2006 American College of Physicians.
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Telephone Care Management To Improve Cancer Screening among Low-Income Women: A Randomized, Controlled Trial. Ann Intern Med.2006;144:563-571. [Epub 18 April 2006]. doi:10.7326/0003-4819-144-8-200604180-00006
Telephone Care Management To Improve Cancer Screening among Low-Income Women: A Randomized, Controlled Trial. Ann Intern Med.2006;144:563-571. [Epub 18 April 2006]. doi:10.7326/0003-4819-144-8-200604180-00006
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