Open Gates, a nurse-managed, community-based primary care clinic providing care to underserved women in inner city Baltimore, is increasing access to care through an innovative program aimed at preventing cervical cancer. Two clinic studies confirmed a higher than average proportion of abnormal Pap smears, and a notable lack of adherence to follow-up. Economic, cultural and knowledge barriers were found to negatively impact screening and follow-up. The three-pronged cervical cancer prevention program consists of 1)educating women on the need for Pap screening and on the financial assistance available through a sliding fee scale, 2)providing colposcopy services on site with the clinic’s own nurse- midwife, and 3)introducing additional testing such as the Thin Prep Pap system and Human Papilloma Virus (HPV) typing, which can influence the type and cost of follow-up treatment for abnormal Pap smears. The program evaluation will examine: the clinic’s efforts to break down the barriers of inadequate knowledge and fear in order to increase the levels of Pap screening; the use of mid-level providers in a nurse-managed setting to increase access to women’s health care in an underserved population by decreasing cultural and economic barriers; the effectiveness of utilizing colposcopy on-site at the primary care clinic in order to increase access to this specialized care; the effectiveness of additional laboratory testing, such as the Thin Prep Pap and HPV typing, for accurate risk stratification, impact on treatment, and utilization of scarce financial resources.
Learning Objectives: At the conclusion of the session, the participant will be able to: 1)Describe the steps for development and implementation of a three-pronged cervical cancer prevention program modeled on the Open Gates program. 2)Discuss methods for increasing access to cervical cancer screening by eliminating economic, cultural and knowledge barriers based on the Open Gates model. 3)Assess the effectiveness of using mid-level providers in primary care settings for focused cervical cancer prevention interventions aimed at reducing cultural and economic barriers to care
Keywords: Access to Care, Cancer Prevention
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employment by University of Maryland School of Nursing, sponsor of Open Gates Health Center