Effekten av grundläggande behovsbedömning och stöd för att förbättra visningsfrekvensen för kolposkopi (BASICS)

Experimentell: Arm 1: Navigatorprogram för sociala behov

Deltagarna kommer att paras ihop med en hälso- och sjukvårdspersonal som kommer att ge skräddarsytt stöd för att möta otillfredsställda sociala behov. Antalet och frekvensen av samtal begränsas endast av deltagarnas behov, intresse och vilja att interagera. Typen av kontakt kan inkludera telefonsamtal eller besök i hemmet/samhället. Hälsovårdaren kommer att: (1) identifiera och bedöma patienters otillfredsställda sociala behov; (2) gemensamt generera lösningar; (3) hjälpa till att prioritera bland flera behov; (4) identifiera gemenskapsresurser som kan hjälpa till att lösa problemet/problemen; (5) fastställa berättigande till tjänster; (6) hjälpa patienter att få tillgång till tillgängliga resurser genom att schemalägga möten och tillhandahålla mötespåminnelser; (7) förbereda patienter att interagera med servicebyråer och/eller agera som en advokat; (8) ge stöd som att ordna transport; (9) övervaka uppföljande problemlösningsåtgärder; och (10) granska de framsteg som gjorts för att lösa ouppfyllda sociala behov och anpassa lösningar.

Beteende: Sociala behov navigatorprogram

4 månaders assistans anpassad efter deltagarens behov

Aktiv komparator: Arm 2: Förbättrad vanlig vård

Deltagarna kommer att få muntlig hänvisning till en federalt finansierad, gratis, 24-timmars assistansjourlinje, United Way 2-1-1, som kopplar samman uppringare med samhällstjänster för att hjälpa till att tillgodose sociala behov.

Beteende: Förbättrad vanlig vård

Remiss till United Way 2-1-1

Inget ingripande: Arm 3: Klinikleverantör

4 WUSM-kolposkopileverantörer, 4 anställda och 1 vårdpersonal kommer att undersökas för att bedöma potentialen för spridning.

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.