Impacto de la evaluación de las necesidades básicas y el apoyo para mejorar la tasa de visualización de la colposcopia (BASICS)

Experimental: Brazo 1: Programa de navegador de necesidades sociales

Los participantes serán emparejados con un trabajador de salud comunitario que brindará apoyo personalizado para abordar las necesidades sociales no satisfechas. El número y la frecuencia de las llamadas estarán limitados únicamente por las necesidades, el interés y la voluntad de interactuar de los participantes. El tipo de contacto podría incluir llamadas telefónicas o visitas al hogar/comunidad. El trabajador de salud comunitario: (1) identificará y evaluará las necesidades sociales insatisfechas de los pacientes; (2) generar soluciones en conjunto; (3) ayudar a priorizar entre múltiples necesidades; (4) identificar los recursos de la comunidad que podrían ayudar a resolver los problemas; (5) determinar la elegibilidad para los servicios; (6) ayudar a los pacientes a acceder a los recursos disponibles programando citas y proporcionando recordatorios de citas; (7) preparar a los pacientes para interactuar con las agencias de servicios y/o actuar como defensores; (8) brindar apoyo, como organizar el transporte; (9) supervisar las acciones de resolución de problemas de seguimiento; y (10) revisar el progreso realizado para resolver las necesidades sociales insatisfechas y adaptar las soluciones.

Conductual: Programa de navegador de necesidades sociales

4 meses de asistencia adaptada a las necesidades del participante

Comparador activo: Brazo 2: atención habitual mejorada

Los participantes recibirán una referencia verbal a una línea directa de asistencia gratuita las 24 horas financiada con fondos federales, United Way 2-1-1, que conecta a las personas que llaman con servicios comunitarios para ayudar a abordar las necesidades sociales no satisfechas.

Conductual: Atención habitual mejorada

Referencia a United Way 2-1-1

Sin intervención: Brazo 3: proveedor de la clínica

Se encuestará a 4 proveedores de colposcopia de WUSM, 4 miembros del personal y 1 trabajador de salud comunitario para evaluar el potencial de difusión.

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.