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Strengthen the Evidence for Maternal and Child Health Programs

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Displaying records 1 through 13 (13 total).

Nguyen BH, Nguyen K, McPhee SJ, Nguyen AT, Tran DQ, Jenkins CNH. Promoting cancer prevention activities among Vietnamese physicians in California. J Cancer Educ. 2000;15(2):82-5. Access Abstract

NPM: 1: Well-Woman Visit
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, PROVIDER/PRACTICE, Provider Reminder/Recall Systems, Provider Education
Intervention Description: A three‐year intervention targeting Vietnamese physicians in solo practice in California.
Primary Outcomes: Yearly physician Pap test performance rates
Conclusion: The results demonstrate the efficacy of an intervention targeting Vietnamese primary care physicians in promoting smoking cessation counseling, Pap testing, and pelvic examinations, but not other cancer prevention activities.
Study Design: RCT
Significant Findings: Yes
Setting: Private practices with physicians who were members of the Vietnamese Physicians’ Associations in Northern and Southern CA
Target Audience: Physicians in solo practice who had received their medical training in Vietnam
Data Source: Physicians’ medical records
Sample Size: Total (N=48) Analysis (n=20) Intervention (n=9); Control (n=11) N=physicians
Age Range: N/A

Vogt TM, Glass A, Glasgow RE, La Chance PA, Lichtenstein E. The safety net: a cost-effective approach to improving breast and cervical cancer screening. J Womens Health. 2003;12(8):789-98. Access Abstract

NPM: 1: Well-Woman Visit
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Patient Reminder/Invitation, Enabling Services, Designated Clinic/Extended Hours, PROVIDER/PRACTICE
Intervention Description: (1). to assess the cost-effectiveness of three interventions to deliver breast and cervical cancer screening to women unscreened for >or=3 years and (2). to determine the relation of an invasive cervical cancer diagnosis to the interval since the last true screening test.
Primary Outcomes: Percentage of women with a registered Pap smear at 12 weeks after the first intervention contact
Conclusion: Letter reminder, followed by a telephone appointment call, was the most cost-effective approach to screening rarely screened women. Lack of accurate information on prior hysterectomy adds substantial unnecessary costs to a screening reminder program.
Study Design: RCT
Significant Findings: Yes
Setting: Portland, OR metropolitan area
Target Audience: Women who were members of Northwest Kaiser Permanente (NWKP) for at least 3 years, with no history of cervical cancer or hysterectomy, who had not received a Pap smear in the same 3 years they had been members of NWKP
Data Source: Radiology and cytology database
Sample Size: Total (N=1,200) Intervention Group 1 (n=288); Intervention Group 2 (n=308); Intervention Group 3 (n=303); Control (n=301)
Age Range: 18-70

Decker KM, Turner D, Demers AA, Martens PJ, Lambert P, Chateau D. Evaluating the effectiveness of cervical cancer screening invitation letters. J Womens Health. 2013;22(8):687-93. Access Abstract

NPM: 1: Well-Woman Visit
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Patient Reminder/Invitation, Educational Material, PROVIDER/PRACTICE, Designated Clinic/Extended Hours
Intervention Description: Evaluate the effectiveness of an invitation letter on cervical screening participation among unscreened women 30 to 69 years of age.
Primary Outcomes: Odds of receiving a Pap smear in the 6 months following the intervention
Conclusion: Sending invitation letters increased cervical screening participation but because the overall effect was small, additional strategies that remove barriers to screening for unscreened women are also necessary.
Study Design: Cluster RCT
Significant Findings: Yes
Setting: Manitoba
Target Audience: Women who had no Pap smear reported since 2001 and had been registered in the screening registry for at least 5 years (as of June 2010), with no history of gynecological cancer or hysterectomy, and who were covered by provincial health care insurance
Data Source: Cervical cancer screening registry
Sample Size: Total (N=31,452) Intervention (n=17,068); Control (n=14,384)
Age Range: 30-69

Byrnes P, McGoldrick C, Crawford M, Peers M. Cervical screening in general practice - strategies for improving participation. Aust Fam Physician. 2007;36(3):183-4, 192. Access Abstract

NPM: 1: Well-Woman Visit
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Patient Reminder/Invitation, PROVIDER/PRACTICE, Provider Audit/Practice Audit, Nurse/Nurse Practitioner
Intervention Description: To assess the effects on cervical screening rates in one small general practice based on uptake and the benefits of multiple strategies.
Primary Outcomes: Rate of registered Pap smears at the end of the 18-month audit
Conclusion: Strategies are feasible and associated with a considerable increase in screening rates. Patients can choose to have their test performed by a nurse in general practice. This study suggests that each strategy's improvement in uptake is independently additive.
Study Design: QE: pretest-posttest
Significant Findings: Yes
Setting: General practice in Bundaberg, Queensland
Target Audience: Women attending the practice living within Bundaberg
Data Source: Chart review
Sample Size: Baseline (n=1,540) Follow-up (n=1,431)
Age Range: 18-69

Dorrington MS, Herceg A, Douglas K, Tongs J, Bookallil M. Increasing Pap smear rates at an urban Aboriginal Community Controlled Health Service through translational research and continuous quality improvement. Aust J Prim Health. 2015;21(4):417-22. Access Abstract

NPM: 1: Well-Woman Visit
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Patient Reminder/Invitation, Educational Material, PROVIDER/PRACTICE, Provider Reminder/Recall Systems, Quality Improvement/Practice-Wide Intervention, Designated Clinic/Extended Hours, Female Provider, Needs Assessment, PATIENT_CONSUMER, HOSPITAL
Intervention Description: Translational research (TR) and continuous quality improvement (CQI) processes used to identify and address barriers and facilitators to Pap smear screening within an urban Aboriginal Community Controlled Health Service (ACCHS).
Primary Outcomes: Pap smears per year conducted by Aboriginal Community Controlled Health Service
Conclusion: he use of TR with CQI appears to be an effective and acceptable way to affect Pap smear screening. This model is transferrable to other settings and other health issues.
Study Design: QE: pretest-posttest
Significant Findings: Yes
Setting: An urban Aboriginal Community Controlled Health Service (ACCHS)
Target Audience: All women within eligible age range
Data Source: Electronic medical records
Sample Size: Total (N=213)
Age Range: 18-70

Kaczorowski J, Hearps SJ, Lohfield L, et al. Effect of provider and patient reminders, deployment of nurse practitioners, and financial incentives on cervical and breast cancer screening rates. Can Fam Physician. 2013;59(6):e282-9. Access Abstract

NPM: 1: Well-Woman Visit
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Patient Reminder/Invitation, Educational Material, PROVIDER/PRACTICE, Provider Reminder/Recall Systems, Financial Incentives, Nurse/Nurse Practitioner
Intervention Description: Before-and-after comparisons of the time-appropriate delivery rates of cervical and breast cancer screening using the automated and NP-augmented strategies of the P-PROMPT reminder and recall system.
Primary Outcomes: Rate of Pap smear delivery, defined as the number of women in each practice that were up-to-date with screening divided by all eligible women
Conclusion: The use of provider and patient reminders and pay-for-performance incentives resulted in increases in the uptake of Pap tests and mammograms among eligible primary care patients over a 1-year period in family practices in Ontario.
Study Design: Total (N=246) Analysis (n=232) N=physicians
Significant Findings: Yes
Setting: Eight primary care network practices and 16 family health network practices in southwestern Ontario
Target Audience: Practicing physicians from the participating primary care network and family health network groups
Data Source: CytoBase (consortium of main laboratories in Ontario), combined with rosters of eligible patients
Age Range: N/A

Singh MK, Einstadter D, Lawrence R. A structured women's preventive health clinic for residents: a quality improvement project designed to meet training needs and improve cervical cancer screening rates. Qual Saf Health Care. 2010;19(5):e45. Access Abstract

NPM: 1: Well-Woman Visit
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Other Person-to-Person Education, PROVIDER/PRACTICE, Provider Education, Designated Clinic/Extended Hours
Intervention Description: Evaluate the impact of a quality improvement project of implementing a Women's Preventive Health Clinic (WPHC) on addressing gaps identified by needs assessments: residents' comfort and knowledge with female preventive care and cervical cancer screening.
Primary Outcomes: Rate of Pap test orders during two 2.5 year periods (pre-intervention and post-intervention)
Conclusion: The results indicate that a focused resident preventive programme can meet gaps identified by education and needs assessments, and simultaneously have a positive impact on cervical cancer screening rates and thus may serve as a model for other residency programmes.
Study Design: QE: pretest-posttest
Significant Findings: Yes
Setting: MetroHealth Medical Center in Cleveland, OH
Target Audience: All women within eligible age range Second- and third-year internal medicine residents
Data Source: Electronic medical records
Sample Size: Total (=378) N=women Total (N=63) N=resident physicians
Age Range: 18-63

Bastani R, Berman BA, Belin TR, et al. Increasing cervical cancer screening among underserved women in a large urban county health system: can it be done? What does it take? Med Care. 2002;40(10):891-907. Access Abstract

NPM: 1: Well-Woman Visit
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, PROVIDER/PRACTICE, Provider Education, Provider Audit/Practice Audit, Quality Improvement/Practice-Wide Intervention, Designated Clinic/Extended Hours
Intervention Description: Evaluation of a 5-year demonstration project testing a multicomponent (provider, system, and patient) intervention to increase cervical cancer screening among women who receive their health care through the Los Angeles County Department of Health Services, the second largest County Health Department in the nation.
Primary Outcomes: Rate of registered Pap smears during the 9 months following the patient’s first clinic visit and entrance into the study
Conclusion: An intensive multicomponent intervention can increase cervical cancer screening in a large, urban, County health system serving a low-income minority population of under screened women.
Study Design: QE: pretest-posttest non-equivalent control group
Significant Findings: Yes
Setting: Los Angeles County Department of Health Services (LACDHS) facilities: 2 large hospitals, 2 feeder Comprehensive Health Centers, and 6 of the health center’s feeder Public Health Centers
Target Audience: Women attending LACDHS facilities
Data Source: Medical records and computerized databases held by the Los Angeles County Department of Health Services
Sample Size: Total (N=18,642) Intervention (n=9,492); Control (n=9,150) Baseline (n=5,249) Year 2 (n=5,470) Year 3 (n=5,365) First 6 months of Year 4 (n=2,558)
Age Range: ≥18

Gotay CC, Banner RO, Matsunaga DS, et al. Impact of a culturally appropriate intervention on breast and cervical screening among native Hawaiian women. Prev Med. 2000;31(5):529-37. Access Abstract

NPM: 1: Well-Woman Visit
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Enabling Services, Educational Material, Community-Based Group Education, Designated Clinic/Extended Hours, PROVIDER/PRACTICE
Intervention Description: This paper summarizes impacts of a breast and cervical cancer screening intervention spearheaded by a Native Hawaiian community.
Primary Outcomes: Percentage of women who had received annual Pap smears at the 3-year follow-up
Conclusion: Positive changes in screening activities among women aware of the intervention support the importance of information diffusion by community consumers. Diffusion may occur beyond the boundaries of the community as defined.
Study Design: QE: pretest-posttest non-equivalent control group
Significant Findings: Yes
Setting: Oahu, HI
Target Audience: Native Hawaiian women
Data Source: Telephone survey
Sample Size: Total (N=1,260) Analysis (n=678) Intervention (n=318); Control (n=360)
Age Range: ≥18

Nguyen TT, McPhee SJ, Gildengorin G, et al. Papanicolaou testing among Vietnamese Americans: results of a multifaceted intervention. Am J Prev Med. 2006;31(1):1-9. Access Abstract

NPM: 1: Well-Woman Visit
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Community-Based Group Education, Patient Navigation, Enabling Services, PROVIDER/PRACTICE, Provider Reminder/Recall Systems, Provider Education, Designated Clinic/Extended Hours, Female Provider, COMMUNITY, Television Media, Other Media, POPULATION-BASED SYSTEMS
Intervention Description: Development and implementation of a multifaceted intervention using community-based participatory research (CBPR) methodology and evaluated with a quasi-experimental controlled design with cross-sectional pre-intervention (2000) and post-intervention (2004) telephone surveys. Data were analyzed in 2005.
Primary Outcomes: Odds of ever having received a Pap test Odds of having received a Pap test in the past 12 months
Conclusion: A multifaceted community-based participatory research (CBPR) intervention was associated with increased Pap test receipt among Vietnamese-American women in one community.
Study Design: QE: pretest-posttest non-equivalent control group
Significant Findings: Yes
Setting: Santa Clara County, CA and Harris County, TX
Target Audience: Vietnamese women living in either county
Data Source: Computer-assisted telephone interviewing system
Sample Size: Baseline(n=1,566) Intervention (n=798); Control (n=768) Follow-up (n=2,009) Intervention (n=1,004); Control (n=1,005)
Age Range: ≥18

Rosenthal MB, Frank RG, Li Z, Epstein AM. Early experience with pay-for-performance: from concept to practice. JAMA. 2005;294(14):1788-93. Access Abstract

NPM: 1: Well-Woman Visit
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Financial Incentives
Intervention Description: The study evaluated a natural experiment with pay-for-performance using administrative reports of physician group quality from a large health plan for an intervention group (California physician groups) and a contemporaneous comparison group (Pacific Northwest physician groups). Quality improvement reports were included from October 2001 through April 2004 issued to approximately 300 large physician organizations. Main outcome measures: Three process measures of clinical quality: cervical cancer screening, mammography, and hemoglobin A1c testing.
Primary Outcomes: Health care Effectiveness Data and Information Set (HEDIS) cervical cancer measure
Conclusion: Paying clinicians to reach a common, fixed performance target may produce little gain in quality for the money spent and will largely reward those with higher performance at baseline.
Study Design: QE: pretest-posttest non-equivalent control group
Setting: PacifiCare medical groups in California and the Pacific Northwest
Target Audience: Physician groups
Data Source: PacifiCare physician group performance reports
Sample Size: Intervention (n=163); Control (n=42) N=physician groups
Age Range: N/A

Gavagan TF, Du H, Saver BG, et al. Effect of financial incentives on improvement in medical quality indicators for primary care. J Am Board Fam Med. 2010;23(5):622-31. Access Abstract

NPM: 1: Well-Woman Visit
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Financial Incentives
Intervention Description: A retrospective review of administrative data was done to evaluate a natural quasi-experiment in a network of publicly funded primary care clinics. Physicians in 6 of 11 clinics were given a financial incentive twice the size of the current Centers for Medicare and Medicaid Services' incentive for achieving group targets in preventive care that included cervical cancer screening, mammography, and pediatric immunization. They also received productivity incentives. Six years of performance indicators were compared between incentivized and nonincentivized clinics. We also surveyed the incentivized clinicians about their perception of the incentive program.
Primary Outcomes: Proportion of Pap tests performed monthly at each clinic
Conclusion: We found no evidence for a clinically significant effect of financial incentives on performance of preventive care in these community health centers. Based on our findings and others, we believe there is great need for more research with strong research designs to determine the effects, both positive and negative, of financial incentives on clinical quality indicators in primary care.
Study Design: QE: concurrent comparison group
Setting: Eleven safety-net community health centers in Houston/Harris County, TX (Community Health Program [CHP])
Target Audience: Practicing CHP physicians
Data Source: Chart review
Sample Size: Approximate total (N≈110) N=physicians Total (N=12,495) Intervention (n=7,411); Control (n=5,084) N=charts reviewed
Age Range: N/A

Perkins RB, Zisblatt L, Legler A, Trucks E, Hanchate A, Sheinfeld Gorin S. Effectiveness of a provider-focused intervention to improve HPV vaccination rates in boys and girls. Vaccine, 2015;33(9):1223-1229. Access Abstract

NPM: 1: Well-Woman Visit
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Education, Quality Improvement/Practice-Wide Intervention, Provider Incentives (Maintenance of Certification)
Intervention Description: A provider-focused intervention that included repeated contacts, education, individualized feedback, and strong quality improvement incentives to raise HPV vaccination rates at two federally qualified community health centers.
Primary Outcomes: Rates of patient initiation of HPV vaccination at baseline and during 2 follow-up periods: “Active intervention period,” 6-12 months after the start of the intervention “Post-intervention,” the 6-month period after the intervention
Conclusion: Provider-focused interventions including repeated contacts, education, individualized feedback, and strong quality improvement incentives have the potential to produce sustained improvements in HPV vaccination rates.
Study Design: Cluster RCT
Significant Findings: Yes
Setting: 1 outpatient pediatric/adolescent department at a major urban academic medical center and 7 affiliate federally qualified community health centers
Target Audience: Females who received primary care (>1 well visit) in the pediatric/adolescent department at a participating practice during the 2-year study period, excluding females who were pregnant during the study period and patients who received care in both an intervention and control practice5
Data Source: Electronic medical records
Sample Size: Total (n=3,961)6
Age Range: 11/21/2022

   

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.