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Using Evidence-Based Interventions to Improve Cancer Screening in the National Breast and Cervical Cancer Early Detection Program

DeGroff, Amy PhD, MPH; Carter, Aundrea MS; Kenney, Kristy MPH; Myles, Zachary MPH; Melillo, Stephanie MPH; Royalty, Janet MS; Rice, Ketra PhD, MS; Gressard, Lindsay MEd, MPH; Miller, Jacqueline W. MD

Journal of Public Health Management and Practice: September/October 2016 - Volume 22 - Issue 5 - p 442–449
doi: 10.1097/PHH.0000000000000369
Original Articles
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Context: The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides cancer screening to low-income, un-, and underinsured women through more than 11 000 primary care clinics. The program is well-positioned to work with health systems to implement evidence-based interventions (EBIs) to increase screening among all women.

Objective: To collect baseline data on EBI use, evaluation of EBIs, and related training needs among NBCCEDP grantees.

Design: The Centers for Disease Control and Prevention conducted a Web-based survey in late 2013 among NBCCEDP grantees for the period July 2012 to June 2013. This was the first systematic assessment of EBIs among NBCCEDP grantees.

Setting: The Centers for Disease Control and Prevention's NBCCEDP.

Participants: Primarily program directors/coordinators for all 67 NBCCEDP grantees.

Main Outcome Measures: Data captured were used to assess implementation of 5 EBIs, their evaluation, and related training needs. Frequencies and proportions were determined. Cluster analysis identified grantees with similar patterns of EBI use for NBCCEDP clients and providers.

Results: On average, 4.1 of 5 EBIs were implemented per grantee for NBCCEDP clients and providers. Four clusters were identified including “high overall EBI users,” “high provider EBI users,” “high EBI users with no provider assessment and feedback,” and “high client EBI users.” Only 1.8 EBIs were implemented, on average, with non-NBCCEDP clients and providers. Fewer than half (n = 32, 47.8%) of grantees conducted process or outcome evaluation of 1 or more EBIs. Overall, 47.6% of grantees reported high or medium training needs for client-oriented EBIs and 54.3% for provider-oriented EBIs.

Conclusions: The NBCCEDP grantees are implementing EBIs extensively with clients and providers. Increased EBI use among non-NBCCEDP clients/providers is needed to extend the NBCCEDP's reach and impact. Grantee training and technical assistance is necessary across EBIs. In addition, grantees' use of process and outcome evaluation of EBI implementation must be increased to inform effective program implementation.

This study aims at collecting baseline data on evidence-based intervention use and evaluating evidence-based interventions and related training needs among National Breast and Cervical Cancer Early Detection Program grantees.

National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, Program Services Branch, Centers for Disease Control and Prevention, Atlanta, Georgia (Drs DeGroff, Rice, and Miller, Mss Carter, Melillo, Royalty, and Gressard, Kenney and Messrs Myles).

Correspondence: Amy DeGroff, PhD, MPH, National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, Program Services Branch, Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, MS K-76, Atlanta, GA 30341 (adegroff@cdc.gov).

The authors recognize and thank their colleagues with Information Management Services, Inc., for their outstanding work in developing the Web-based instrument and collecting and validating survey data.

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

There are no conflict of interest disclosures and no resources to report for any author.

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.