Virkningen af ​​grundlæggende behovsvurdering og støtte til at forbedre visningsfrekvensen for kolposkopi (BASICS)

Eksperimentel: Arm 1: Sociale behovs navigatorprogram

Deltagerne vil blive parret med en lokal sundhedsarbejder, som vil give skræddersyet støtte til at imødekomme udækkede sociale behov. Antallet og hyppigheden af ​​opkald vil kun være begrænset af deltagernes behov, interesse og vilje til at interagere. Typen af ​​kontakt kan omfatte telefonopkald eller besøg i hjemmet/samfundet. Den lokale sundhedsarbejder vil: (1) identificere og vurdere patienters udækkede sociale behov; (2) i fællesskab skabe løsninger; (3) hjælpe med at prioritere blandt flere behov; (4) identificere samfundsressourcer, der kan hjælpe med at løse problemet/problemerne; (5) bestemme berettigelse til tjenester; (6) hjælpe patienter med at få adgang til tilgængelige ressourcer ved at planlægge aftaler og give påmindelser om aftaler; (7) forberede patienter til at interagere med servicebureauer og/eller fungere som advokat; (8) yde støtte såsom at arrangere transport; (9) overvåge opfølgende problemløsningshandlinger; og (10) gennemgå de fremskridt, der er gjort i retning af at løse udækkede sociale behov og tilpasse løsninger.

Adfærdsmæssigt: Sociale behov navigator program

4 måneders assistance skræddersyet til deltagerens behov

Aktiv komparator: Arm 2: Forbedret sædvanlig pleje

Deltagerne vil modtage mundtlig henvisning til en føderalt finansieret, gratis 24-timers assistancehotline, United Way 2-1-1, som forbinder opkaldere med samfundstjenester for at hjælpe med at imødekomme udækkede sociale behov.

Adfærdsmæssigt: Forbedret sædvanlig pleje

Henvisning til United Way 2-1-1

Ingen indgriben: Arm 3: Klinikudbyder

4 WUSM-kolposkopiudbydere, 4 medarbejdere og 1 sundhedsarbejder i lokalsamfundet vil blive undersøgt for at vurdere potentialet for formidling.

Adherence to Colposcopy Visit as Measured as Number of Participants Who Complete Colposcopy Visit Within 6 Weeks After Enrollment

Total Number of Unmet Basic Needs

-Unmet basic needs include food security, housing, personal safety, neighborhood safety, sufficient money for necessities, childcare (if applicable), and transportation. A questionnaire will be given to participants to identify the number of unmet basic needs the participant has.

Change in General Distress Score as Measured by the NCCN Distress Thermometer and Problem List

Participants will be asked to rate the amount of distress (scale of 0 to 10, 10=extreme distress) that they have experienced in the past week and the amount of distress (scale of 0 to 10) that they attribute to their abnormal cervical cancer screen. The NCCN distress problem list is a 40-item list categorized into five themes-practical, family, emotional, spiritual, and physical problems¬-and leaves room for patients to describe "other". A higher score indicates the greater the amount of distress.

Intent to Use Intervention Over Time

-Providers are asked after completion of enrollment to indicate on a scale of 1=not committed to 10=fully committed of how committed they are to use the intervention in their clinic.

Patients' Satisfaction With Intervention

-The interview guide has two questions that relate to patient satisfaction related to the intervention. 1) Was the [community health worker or 2-1-1 operator] helpful to you? 2) Would you recommend [the community healthworker/2-1-1] to a family member or friend?

Providers' Satisfaction With Intervention

-Providers are asked after completion of enrollment to indicate their satisfaction with the intervention. They are given 12 statements about the satisfaction of the intervention and are asked to circle responses of 1=completely disagree, 2=disagree, 3=neither agree nor disagree, 4=agree, or 5=completely agree. The higher the score the more satisfied the provider is with the intervention.

Resources Needed to Sustain Intervention

-Validated questionnaire that will be administered to providers, staff, and community health workers: Self-administered 15-minute online survey that will be completed at the end of the study enrollment period. The survey will ask about specific implementation outcomes using the Acceptability Intervention Measure, the Intervention Appropriateness Measure, and the Feasibility of Intervention Measure.

Likelihood That Intervention Will Become Built Into Usual Care

-Providers are asked after completion of enrollment to indicate the likelihood that the intervention can be built into usual care in their clinic. The responses are either likely, very likely, neutral, unlikely, very unlikely, or unsure.