Dissemination of Cervical Cancer Screening to Primary Care Physicians in Underserved Communities
Primary care physicians have an important role to play in the delivery of cancer prevention and detection services to patients. Face-to-face counseling of physicians, called academic detailing, involves a brief and focused intervention, modeled on the practices of pharmaceutical companies. This type of intervention may increase physicians' attention to preventive opportunities and increase their screening behaviors.
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Outcomes Assessor)
Primary Purpose: Screening
|Official Title:||Dissemination of Cervical Cancer Screening to Primary Care Physicians in Underserved Communities|
- Number of asymptomatic female patients age 18-85 who receive or are referred for a recto-pelvic bimanual examination with the collection of the Pap smear (per ACS guidelines); collected via medical chart review [ Time Frame: 12-month followup ] [ Designated as safety issue: No ]
- Physician knowledge, attitudes and beliefs toward cervical cancer prevention, screening, and treatment [ Time Frame: 12-month followup ] [ Designated as safety issue: No ]
|Study Start Date:||January 2004|
|Study Completion Date:||August 2010|
|Primary Completion Date:||August 2006 (Final data collection date for primary outcome measure)|
Experimental: Multi-component Academic Detailing
Multi-component, academic detailing regarding ACS guidelines on cervical cancer screening approaches.
Includes an interactive, digitized CD-ROM, focused on the discussion of risks and benefits, screening options or alternatives, values clarification, and mutual decision-making, alongside patient education materials designed for low literacy patients.
Behavioral: Academic Detailing
It will involve multiple intervention components, some of which are standardized across physicians (i.e., self learning packets, post-tests for CME credit, CD-ROMS, videos, newsletters, culturally sensitive patient education materials, office staff informational sessions, chart and patient reminders, and a general office routine for cervical cancer counseling, including performance feedback, as well as media-ready materials). Academic detailing and the specific office routines will be customized to each physician, although the frequency of the detailing visits will be routinized across all participants, to reduce cost and to maximize its potential for dissemination.
Other Name: Multi-component Academic Detailing
The specific aims of this proposal are:
- To test the hypothesis that an intervention, multi-component academic detailing, will increase the rate of physician cervical cancer screening at 3- and 6-months post-randomization, compared to the rate observed in a service-as-usual control.
- To develop models predicting which physician offices are most and least likely to adopt the intervention, and to generate hypotheses about tailoring the dissemination of cervical cancer screening guidelines to different physician subgroups.
- To conduct a cost-effectiveness analysis comparing the incremental societal costs and effects (in lives saved, life-years saved, and quality-of-life-years saved) of the cervical cancer intervention implemented in physicians' offices.
The long-term goal of this project therefore is to reduce cervical cancer risks among ethnic and racial minorities, by influencing the screening behaviors of their primary care physicians.
|United States, New York|
|New York, New York, United States, 10027|
|Principal Investigator:||Sherri Sheinfeld Gorin, PhD||Columbia University|