OBJECTIVES:
* Determine whether telephone support for patients, provided through a Prevention Care Manager (PCM), can increase breast, cervical, and colorectal cancer screening rates among minority and low-income women.
* Measure the amount of PCM time required to improve early cancer detection provided to age-eligible ethnically diverse women seen in community health centers in the New York City area.
* Learn barriers faced by this population in obtaining indicated services (mammograms, Pap tests, fecal occult blood testing, and sigmoidoscopy).
* Assess at baseline and follow-up the office environment and work processes in each participating center (in PCM randomized controlled study only).
* Develop and implement the PCM intervention to help patients overcome barriers.
* Evaluate the impact and costs of the PCM in a randomized controlled efficacy trial.
OUTLINE: This is a randomized, controlled, single-blind, multicenter study. Patients are randomized according to participating center.
* Part 1: Some patients undergo a series of structured interviews about the obstacles to early cancer detection. Participating sites are assessed for study eligibility.
* Part 2: Pilot testing, training, and competency testing of the Prevention Care Managers (PCM) are conducted.
* Part 3: Patients are randomized to 1 of 2 intervention arms.
* Arm I: Patients are offered health education and follow-up services by telephone with a PCM.
* Arm II: Patients receive usual care.
PROJECTED ACCRUAL: A total of 2,729 (1,413 for PCM randomized controlled study and 1,316 for pilot study) patients will be accrued for this study.
