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Ann Fam Med. 2007 Jul-Aug;5(4):320-7.

Translation of an efficacious cancer-screening intervention to women enrolled in a Medicaid managed care organization.

Author information

  • 1Norris Cotton Cancer Center, Dartmouth Medical School, Lebanon, NH 03766, USA. Allen.J.Dietrich@dartmouth.edu

Abstract

PURPOSE:

An earlier randomized controlled trial of prevention care management (PCM) found significant improvement in breast, cervical, and colorectal cancer-screening rates among women attending Community Health Centers but required substantial research support. This study evaluated the impact of a streamlined PCM delivered through a Medicaid managed care organization (MMCO), an infrastructure with the potential to sustain this program for the long term.

METHODS:

This randomized trial was conducted within an MMCO serving New York City between May 2005 and December 2005. A total of 1,316 women aged 40 to 69 years and not up to date for at least 1 targeted cancer-screening test were randomized to either PCM or a comparison group. Women in the PCM group received up to 3 scripted telephone calls to identify barriers and provide support to obtain any needed breast, cervical, and colorectal cancer-screening tests. Women in the comparison group received a modified version of the MMCO's established mammography telephone outreach program, also in up to 3 calls. Women in both groups received a financial incentive on confirmation that they had received a mammogram. Screening status was assessed through MMCO administrative data. Groups were compared using odds ratios.

RESULTS:

In an intent-to-treat comparison adjusted for baseline screening status, PCM women were 1.69 times more likely to be up-to-date for colorectal cancer-screening tests at follow-up than women in the comparison group (95% confidence interval, 1.03-2.77). Follow-up screening rates for cervical and breast cancer did not differ significantly between study groups on an intent-to-treat basis.

CONCLUSIONS:

The abbreviated PCM telephone intervention was feasible to deliver through an MMCO and improved screening for 1 cancer. This approach has the potential to improve cancer-screening rates significantly in settings that can provide telephone support to women known to be overdue.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00376909.

[PubMed - indexed for MEDLINE]
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