Impacto da Avaliação de Necessidades Básicas e Apoio para Melhorar a Taxa de Colposcopia (BASICS)

Experimental: Braço 1: Programa navegador de necessidades sociais

Os participantes serão emparelhados com um agente comunitário de saúde que fornecerá suporte personalizado para atender às necessidades sociais não atendidas. O número e a frequência das chamadas serão limitados apenas pelas necessidades, interesse e vontade de interagir dos participantes. O tipo de contato pode incluir telefonemas ou visitas domiciliares/comunitárias. O agente comunitário de saúde irá: (1) identificar e avaliar as necessidades sociais não atendidas dos pacientes; (2) gerar soluções em conjunto; (3) ajudar a priorizar entre múltiplas necessidades; (4) identificar recursos comunitários que possam ajudar a resolver o(s) problema(s); (5) determinar a elegibilidade para serviços; (6) ajudar os pacientes a acessar os recursos disponíveis agendando consultas e fornecendo lembretes de consultas; (7) preparar os pacientes para interagir com agências de serviços e/ou atuar como defensores; (8) fornecer suporte, como providenciar transporte; (9) supervisionar ações de resolução de problemas de acompanhamento; e (10) revisar o progresso feito para resolver as necessidades sociais não atendidas e adaptar as soluções.

Comportamental: Programa navegador de necessidades sociais

4 meses de assistência adaptada às necessidades do participante

Comparador Ativo: Braço 2: Cuidados habituais aprimorados

Os participantes receberão encaminhamento verbal para uma linha direta de assistência 24 horas gratuita financiada pelo governo federal, United Way 2-1-1, que conecta os chamadores com serviços comunitários para ajudar a atender às necessidades sociais não atendidas.

Comportamental: Cuidados habituais aprimorados

Encaminhamento para United Way 2-1-1

Sem intervenção: Braço 3: provedor de clínica

4 provedores de colposcopia WUSM, 4 membros da equipe e 1 agente comunitário de saúde serão entrevistados para avaliar o potencial de disseminação.

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.