 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Sarita Malik Bhalotra, MD, PhD, Schneider Institute for Health Policy, Heller School, Brandeis University, 415 South Street, MS 035, Waltham, MA 02454, 781 736 3960, bhalotra@brandeis.edu, John A Capitman, PhD, Schneider Institute for Health Policy, Brandeis University, MS 035, 415 South Street, Brandeis University, Waltham, MA 02454, and Vanessa Calderon-Rosado, PhD, National Center on Women and Aging, Brandeis University, MS 035, Waltham, MA 02454.
The "Cancer Prevention and Treatment Demonstration for Ethnic and Racial Minorities" evidence report offered recommendations for combining community health workers (CHWs) and new operational supports to improve the delivery of primary and secondary cancer prevention and treatment services to racial/ethnic group Medicare beneficiaries. This paper describes a major task of the Demonstration Design stage which specifies the clinical components of the intervention in order to develop comparable and evaluable services based on the report's recommended interventions: health risk management (HRM), screening adherence and detection facilitation (SADF) services, and treatment and follow-up facilitation (TAFF). First, we conducted a detailed exploration of existing relevant approaches, including assessment tools, motivational interviewing, group versus individual programs, and means of coordinating and communication among CHWs and the health care delivery system. We searched explicit protocols that have been tested with elders or that show promise in being adapted to elders that may be featured in the demonstration. Since many services affect multiple disease conditions, we extended our search to other chronic conditions beyond cancer, such as cardiac disease and diabetes. Our search for protocols and services mapped each item of service provided by CHWs to the three intervention components with a major emphasis on HRM and SADF. Based on this evidence, a model of clinical services was built with proposed implementation steps, and evaluation of the clinical treatment protocol designed with the collaboration of community health professionals, educators, and direct service providers and delivered by CHWs.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.