Impact de l'évaluation des besoins de base et du soutien pour améliorer le taux de consultation en colposcopie (BASICS)

Expérimental: Volet 1 : Programme de navigation sur les besoins sociaux

Les participants seront jumelés à un agent de santé communautaire qui fournira un soutien personnalisé pour répondre aux besoins sociaux non satisfaits. Le nombre et la fréquence des appels ne seront limités que par les besoins, l'intérêt et la volonté d'interagir des participants. Le type de contact peut inclure des appels téléphoniques ou des visites à domicile/dans la communauté. L'agent de santé communautaire : (1) identifiera et évaluera les besoins sociaux non satisfaits des patients ; (2) générer conjointement des solutions ; (3) aider à hiérarchiser les besoins multiples ; (4) identifier les ressources communautaires qui pourraient aider à résoudre le(s) problème(s); (5) déterminer l'admissibilité aux services; (6) aider les patients à accéder aux ressources disponibles en fixant des rendez-vous et en fournissant des rappels de rendez-vous ; (7) préparer les patients à interagir avec les agences de services et/ou à agir en tant que défenseur ; (8) fournir un soutien tel que l'organisation du transport ; (9) superviser les actions de suivi de résolution de problèmes ; et (10) examiner les progrès réalisés pour résoudre les besoins sociaux non satisfaits et adapter les solutions.

Comportemental: Programme de navigateur des besoins sociaux

4 mois d'assistance adaptée aux besoins du participant

Comparateur actif: Bras 2 : Soins habituels améliorés

Les participants seront aiguillés verbalement vers une ligne d'assistance gratuite 24 heures sur 24 financée par le gouvernement fédéral, United Way 2-1-1, qui relie les appelants aux services communautaires pour aider à répondre aux besoins sociaux non satisfaits.

Comportemental: Soins habituels améliorés

Renvoi à Centraide 2-1-1

Aucune intervention: Bras 3 : Prestataire de la clinique

4 prestataires de colposcopie de l'EUSM, 4 membres du personnel et 1 agent de santé communautaire seront interrogés pour évaluer le potentiel de diffusion.

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.