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Brady LA, Tumiel-Berhalter LM, Schad LA, Bentham A, Vitale K, Norton A, Noronha G, Swanger C, Morley CP. Increasing Breast, Cervical, and Colorectal Cancer Screenings: A Qualitative Assessment of Barriers and Promoters in Safety-Net Practices. J Patient Cent Res Rev 2021; 8:323-330. [PMID: 34722800 PMCID: PMC8530240 DOI: 10.17294/2330-0698.1857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
PURPOSE Breast, cervical, and colorectal cancer screening rates are suboptimal in underserved populations. A 7-year quality improvement (QI) project implemented academic detailing and practice facilitation in safety-net primary care practices to increase cancer screening rates. This manuscript assesses barriers and promoters. METHODS Primary care practices providing care to underserved patients were recruited in New York cities Buffalo, Rochester, and Syracuse. Enrollment totaled 31 practices, with 12 practices participating throughout. Annually, each practice received 6 months of practice facilitation support for development and implementation of evidence-based interventions to increase screening rates for the three cancer types. At the end of each practice facilitation period, focus groups and key informant interviews were conducted with participating personnel. Content analysis was performed annually to identify barriers and promoters. A comprehensive final analysis was performed at project end. RESULTS Barriers included system-level (inconsistent communication with specialists, electronic health record system transitions, ownership changes) and practice-level challenges (staff turnover, inconsistent data entry, QI fatigue) that compound patient-level challenges of transportation, cost, and health literacy. Cyclical barriers like staff turnover returned despite attempts to resolve them, while successful implementation was promoted by reducing patients' structural barriers, adapting interventions to existing practice priorities, and enacting officewide policies. During the QI project, practices became aware of the impact of social determinants of health on patients' screening decisions. CONCLUSIONS The project's longitudinal design enabled identification of key barriers that reduced accuracy of practices' screening rates and increased risk of patients falling through the cracks. Identified promoters can help sustain interventions to increase screenings.
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Affiliation(s)
- Laura A. Brady
- Department of Family Medicine, State University of New York (SUNY) University at Buffalo, Buffalo, NY
| | - Laurene M. Tumiel-Berhalter
- Department of Family Medicine, State University of New York (SUNY) University at Buffalo, Buffalo, NY
- University at Buffalo Clinical and Translational Science Institute, Buffalo, NY
| | - Laura A. Schad
- Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY
| | - Alexandrea Bentham
- Department of Family Medicine, State University of New York (SUNY) University at Buffalo, Buffalo, NY
| | - Karen Vitale
- University of Rochester Clinical and Translational Science Institute, Rochester NY
| | - Amanda Norton
- A. Mandatory, Inc. (consulting for SUNY Upstate Medical University), Groton, NY
| | - Gary Noronha
- Center for Primary Care, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Carlos Swanger
- Center for Primary Care, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY
- Health Reach for the Homeless, Rochester Regional Health, Rochester, NY
| | - Christopher P. Morley
- Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY
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Swanson M, Wong ST, Martin‐Misener R, Browne AJ. The role of registered nurses in primary care and public health collaboration: A scoping review. Nurs Open 2020; 7:1197-1207. [PMID: 32587740 PMCID: PMC7308712 DOI: 10.1002/nop2.496] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 02/06/2020] [Accepted: 03/17/2020] [Indexed: 11/12/2022] Open
Abstract
Aim The purpose of this work was to examine the roles of Registered Nurses (RNs) in primary care (PC) and public health (PH) collaboration. Additionally, we aimed to explore whether the current scope of practice for RNs is adequate to support their roles in PC/PH collaboration. Design A scoping review of current literature relating to the RN's role in PC/PH collaboration was conducted using the PRISMA 2009 checklist. Methods The review used key terms: primary care, public health, collaboration, nursing and nurse role across six electronic databases; 23 articles that were included in the final review were published over a 7-year span. Results Four key RN roles relating to PC/PH collaboration were identified: relationship builder, outreach professional, programme facilitator and care coordinator. RNs supported transitions in chronic disease, communicable disease care and maternity care at various healthcare system levels including systemic, organizational, intrapersonal and interpersonal levels.
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Affiliation(s)
- Monica Swanson
- School of NursingUniversity of British ColumbiaVancouverBCCanada
- Present address:
North Island CollegeCourtenayBCCanada
| | - Sabrina T. Wong
- School of Nursing and Centre for Health Services and Policy ResearchUniversity of British ColumbiaVancouverBCCanada
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Atti del 52° Congresso Nazionale: Società Italiana di Igiene, Medicina Preventiva e Sanità Pubblica (SItI). JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2019; 60:E1-E384. [PMID: 31777763 PMCID: PMC6865078 DOI: 10.15167/2421-4248/jpmh2019.60.3s1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Allgood SD, Leeman J, Rosemond CA, Ammerman AS, Samuel-Hodge C, Cykert S. Reducing cardiovascular disease in a rural community. Public Health Nurs 2019; 36:676-682. [PMID: 31396991 DOI: 10.1111/phn.12649] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 07/09/2019] [Accepted: 07/11/2019] [Indexed: 11/29/2022]
Abstract
In this case report, we describe the one-year formative phase of a five-year study to develop, implement, and test a community health worker (CHW)-delivered cardiovascular disease (CVD) prevention intervention. The purpose of the formative phase was to engage community partners in the adaptation of an existing evidence-based CVD prevention intervention to fit the needs and preferences of a rural, predominantly African-American community. The formative work was guided by a framework for adapting evidence-based interventions and involved engaging stakeholders in assessing the intervention's fit with the local context and then applying assessment findings to iteratively adapt the intervention's contents, materials, and delivery methods. Findings from the formative work were then applied to develop CHW position descriptions, workflow diagrams, and a training plan. Findings also were applied to adapt intervention materials and protocols to fit the needs of the community. This case report illustrates how community-engaged formative work can be applied to adapt an evidence-based intervention to fit community needs and resources.
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Affiliation(s)
- Sallie D Allgood
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jennifer Leeman
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Cherie A Rosemond
- Partnerships in Aging Program, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Alice S Ammerman
- Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Carmen Samuel-Hodge
- Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Samuel Cykert
- Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Division of General Medicine and Clinical Epidemiology, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Shahzad M, Upshur R, Donnelly P, Bharmal A, Wei X, Feng P, Brown AD. A population-based approach to integrated healthcare delivery: a scoping review of clinical care and public health collaboration. BMC Public Health 2019; 19:708. [PMID: 31174501 PMCID: PMC6556001 DOI: 10.1186/s12889-019-7002-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 05/17/2019] [Indexed: 12/14/2022] Open
Abstract
Background A population-based approach to healthcare goes beyond the traditional biomedical model and addresses the importance of cross-sectoral collaboration in promoting health of communities. By establishing partnerships across primary care (PC) and public health (PH) sectors in particular, healthcare organizations can address local health needs of populations and improve health outcomes. The purpose of this study was to map a series of interventions from the empirical literature that facilitate PC-PH collaboration and develop a resource for healthcare organizations to self-evaluate their clinical practices and identify opportunities for collaboration with PH. Methods A scoping review was designed and studies from relevant peer-reviewed literature and reports between 1990 and 2017 were included if they met the following criteria: empirical study methodology (quantitative, qualitative, or mixed methods), based in US, Canada, Western Europe, Australia or New Zealand, describing an intervention involving PC-PH collaboration, and reporting on structures, processes, outcomes or markers of a PC-PH collaboration intervention. Results Out of 2962 reviewed articles, 45 studies with interventions leading to collaboration were classified into the following four synergy groups developed by Lasker’s Committee on Medicine and Public Health: Coordinating healthcare services (n = 13); Applying a population perspective to clinical practice (n = 21); Identifying and addressing community health problems (n = 19), and Strengthening health promotion and health protection (n = 21). Furthermore, select empirical examples of interventions and their key features were highlighted to illustrate various approaches to implementing collaboration interventions in the field. Conclusions The findings of our review can be utilized by a range of organizations in healthcare settings across the included countries. Furthermore, we developed a self-evaluation tool that can serve as a resource for clinical practices to identify opportunities for cross-sectoral collaboration and develop a range of interventions to address unmet health needs in communities; however, the generalizability of the findings depends on the evaluations conducted in individual studies in our review. From a health equity perspective, our findings also highlight interventions from the empirical literature that address inequities in care by targeting underserved, high-risk populations groups. Further research is needed to develop outcome measures for successful collaboration and determine which interventions are sustainable in the long term. Electronic supplementary material The online version of this article (10.1186/s12889-019-7002-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mohammad Shahzad
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. .,Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - Ross Upshur
- Division of Clinical Public Health, Dalla Lana School of Public Health, Toronto, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, Canada.,Bridgepoint Collaboratory, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada
| | - Peter Donnelly
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Public Health Ontario, Toronto, Canada
| | - Aamir Bharmal
- Division of Clinical Public Health, Dalla Lana School of Public Health, Toronto, Canada.,Fraser Health Authority, Surrey, British Columbia, Canada
| | - Xiaolin Wei
- Division of Clinical Public Health, Dalla Lana School of Public Health, Toronto, Canada
| | - Patrick Feng
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Adalsteinn D Brown
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, Toronto, Canada
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Liang H, Beydoun MA. Modifiable health risk factors, related counselling, and treatment among patients in health centres. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:693-705. [PMID: 30525260 PMCID: PMC6626663 DOI: 10.1111/hsc.12686] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 10/29/2018] [Accepted: 11/01/2018] [Indexed: 06/09/2023]
Abstract
Chronic disease burden and its related health risk factors are especially concentrated among the poor. Community health centres reach the nation's most vulnerable population. This study explored the prevalence, racial/ethnic, and gender disparities of five modifiable health risk factors and the receipt of related counselling and treatment among patients in U.S. federally qualified health centres. The 2014 Health Center Patient Survey was used for this study. We performed a cross-sectional study. Measures included tobacco use, excessive alcohol consumption, obese/overweight, high blood pressure, high blood cholesterol, and five related counselling/treatment measures. Logistic regression models were conducted to examine the multivariable-adjusted putative associations of several sociodemographic and health-related factors with modifiable health risk and counselling/treatment measures. Preliminary findings revealed differences in modifiable health risk factors across different racial/ethnic groups, while few racial/ethnic differences existed in related counselling/treatment measures. In the multivariable-adjusted logistic regression models, these differences in health risk factors were still apparent, while associations between race/ethnicity status and counselling/treatment measures were not detected. Gender was also a predictor for four types of health risk measures and two types of counselling/treatment measures. Health centre patients had high rates of modifiable health risk factors. The rates were different across race/ethnicity groups, and the differences found did not always favour non-Hispanic Whites. However, the findings reveal equitable access to related counselling/treatment service among patients across race/ethnicity groups.
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Affiliation(s)
- Hailun Liang
- School of Public Administration and Policy, Renmin University of China, Beijing, China
| | - May A. Beydoun
- National Institute on Aging Intramural Research Program, Baltimore, Maryland
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McVicar KL, Ivanitskaya LV, Bradley DW, Montero JT. Primary Care and Public Health Collaboration Reports: A Qualitative Review of Integration Aims, Participants, and Success Determinants. Popul Health Manag 2018; 22:422-432. [PMID: 30562144 DOI: 10.1089/pop.2018.0160] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This qualitative review of 57 published case reports aimed to analyze primary care and public health integration efforts in 45 states to summarize collaboration aims, participants, and systemic, organizational, and interactional success determinants. Chronic disease management, maternal and child health, and wellness and health promotion were the most commonly reported aims of collaboration between primary care and public health entities in the United States. Typical participants were government public health structures, health delivery systems, communities, academia, state professional medical associations, and employers and businesses. Systemic, organizational, and interactional determinants included adequate funding, multiple stakeholder engagement, leadership, data and information sharing, capitalization on collaborator resources, community engagement, steering committees, effective communication, regular meetings, shared mission, vision, and goals, previous positive relationships, collaborations, and partnerships. The present study contributes to the body of knowledge of when, where, and under what contextual circumstances collaboration and integration have been perceived as effective. Future research could extrapolate which determinants are more essential than others and focus on how systemic, organizational, and interactional factors are interrelated. To advance the practice of successful integration between primary care and public health entities, longitudinal research is needed to examine the degree of integration and sustainability.
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Affiliation(s)
- Kimberly L McVicar
- College of Health Professions, Ferris State University, Big Rapids, Michigan
| | - Lana V Ivanitskaya
- School of Health Sciences, Central Michigan University, Mount Pleasant, Michigan
| | - Don W Bradley
- Duke University School of Medicine, Durham, North Carolina
| | - Jose T Montero
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Management of sexually transmitted infections in New York State health care organizations: who is thinking about the quality of STI care? Sex Transm Dis 2015; 41:519-24. [PMID: 25118963 DOI: 10.1097/olq.0000000000000171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Rising rates of sexually transmitted infections (STIs) warrant a renewed focus on the management of STIs in health care organizations. The extent to which hospitals and community health centers (CHCs) have established processes and allocated staff for the management of STIs within their organizations remains poorly understood. METHODS A New York State Department of Health survey was distributed electronically through a closed state communication network to targeted administrators at New York State hospitals and CHCs. The survey asked if STI management in their facilities included the following: the ability to measure and report rates of STIs, a process to assess the quality of STI care and treatment outcomes, and a centralized person/unit to coordinate its work throughout the facility. Multivariate analysis was performed to identify whether organizational characteristics were associated with survey findings. RESULTS Ninety-five percent (243/256) of hospitals and CHCs responded to the survey. Fifty percent of respondents had a person or unit to report rates of STIs; 30% reported an organization-wide process for monitoring the quality of STI care, which, according to the multivariate analysis, was associated with CHCs; only 23% reported having a centralized person or unit for coordinating STI management. CONCLUSIONS Most facilities report STI cases to comply with public health surveillance requirements but do not measure infection rates, assess the quality of STI care, or coordinate its work throughout the facility. The development of this organizational capacity would likely decrease STI rates, improve treatment outcomes, and address local public health goals.
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Heintzman J, Marino M, Hoopes M, Bailey SR, Gold R, O'Malley J, Angier H, Nelson C, Cottrell E, Devoe J. Supporting health insurance expansion: do electronic health records have valid insurance verification and enrollment data? J Am Med Inform Assoc 2015; 22:909-13. [PMID: 25888586 DOI: 10.1093/jamia/ocv033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Accepted: 03/15/2015] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To validate electronic health record (EHR) insurance information for low-income pediatric patients at Oregon community health centers (CHCs), compared to reimbursement data and Medicaid coverage data. MATERIALS AND METHODS Subjects Children visiting any of 96 CHCs (N = 69 189) from 2011 to 2012. Analysis The authors measured correspondence (whether or not the visit was covered by Medicaid) between EHR coverage data and (i) reimbursement data and (ii) coverage data from Medicaid. RESULTS Compared to reimbursement data and Medicaid coverage data, EHR coverage data had high agreement (87% and 95%, respectively), sensitivity (0.97 and 0.96), positive predictive value (0.88 and 0.98), but lower kappa statistics (0.32 and 0.49), specificity (0.27 and 0.60), and negative predictive value (0.66 and 0.45). These varied among clinics. DISCUSSION/CONCLUSIONS EHR coverage data for children had a high overall correspondence with Medicaid data and reimbursement data, suggesting that in some systems EHR data could be utilized to promote insurance stability in their patients. Future work should attempt to replicate these analyses in other settings.
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Affiliation(s)
- John Heintzman
- Oregon Health and Science University, Department of Family Medicine, Portland, OR 97239, USA
| | - Miguel Marino
- Oregon Health and Science University, Department of Family Medicine, Portland, OR 97239, USA
| | | | - Steffani R Bailey
- Oregon Health and Science University, Department of Family Medicine, Portland, OR 97239, USA
| | - Rachel Gold
- Kaiser Center For Health Research Northwest, Portland, OR, USA
| | - Jean O'Malley
- Oregon Health and Science University, Department of Family Medicine, Portland, OR 97239, USA
| | - Heather Angier
- Oregon Health and Science University, Department of Family Medicine, Portland, OR 97239, USA
| | | | | | - Jennifer Devoe
- Oregon Health and Science University, Department of Family Medicine, Portland, OR 97239, USA
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Akhtar-Danesh N, Valaitis R, O'Mara L, Austin P, Munroe V. Viewpoints about collaboration between primary care and public health in Canada. BMC Health Serv Res 2013; 13:311. [PMID: 23945461 PMCID: PMC3765372 DOI: 10.1186/1472-6963-13-311] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Accepted: 08/13/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although there is a global movement toward health system integration and collaboration, little is known about values, beliefs, and attitudes towards collaboration between stakeholders in public health (i.e. promotion, protection, and prevention with vulnerable groups and/or at the population level) and primary care (i.e., family practices, nurse-led clinics). The purpose of this study was to explore viewpoints of key stakeholders regarding primary care (PC) and public health (PH) collaboration in Canada. METHODS We used Q-methodology to identify common viewpoints held by participants who attended a national meeting in Canada in 2010 to discuss PC and PH collaboration. The study was conducted in two phases. In Phase 1 a Q-sample, a Q-sort table, and a short demographic questionnaire were developed which were used in Phase 2 for data collection. The Q-sorts then were analysed to identify the salient factors and consensus statements. RESULTS In total, 25 multidisciplinary individuals including researchers, policy-makers, directors, managers, and practitioners (e.g., nurses, family physicians, dietitians) participated. Using a by-person factor analysis, three factors (salient viewpoints) emerged. Factors were named based on their distinguishing statements as follows: a) System Driven Collaborators, b) Cautious Collaborators, and c) Competent Isolationists. System Driven Collaborators strongly believed that a clear mandate from the top is needed to enable PH, PC and the rest of the health system to effectively work together and that people in different branches in the Ministry/ Ministries have to strongly believe in collaboration, actively support it, and develop directed policies to foster organizations work together. Cautious Collaborators strongly supported the idea of having better consciousness-raising about what collaborations might be possible and beneficial, and also reflecting on the collaborations already in place. The Competent Isolationists strongly believed that it is necessary for PC and PH sectors to spend time to ensure that both parties clearly understand the differences between their roles. They believe that physicians, nurses, and social workers will not see the value in collaboration because they lack inter-professional educational programs. CONCLUSIONS Different viewpoints are held by stakeholders around PC and PH collaboration which have the potential to influence the success of collaborations. Understanding and managing these differences is important to assist change management processes required to build and maintain strong PC and PH collaborations.
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Potter MB. Strategies and resources to address colorectal cancer screening rates and disparities in the United States and globally. Annu Rev Public Health 2013; 34:413-29. [PMID: 23297661 DOI: 10.1146/annurev-publhealth-031912-114436] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Colorectal cancer is a significant cause of mortality in the United States and globally. In the United States, increased access to screening and effective treatment has contributed to a reduction in colorectal cancer incidence and mortality for the general population, though significant disparities persist. Worldwide, the disparities are even more pronounced, with vastly different colorectal cancer mortality rates and trends among nations. Newly organized colorectal cancer screening programs in economically developed countries with a high burden of colorectal cancer may provide pathways to reduce these disparities over time. This article provides an overview of colorectal cancer incidence, mortality, screening, and disparities in the United States and other world populations. Promising strategies and resources are identified to address colorectal cancer screening rates and disparities in the United States and worldwide.
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Affiliation(s)
- Michael B Potter
- Department of Family and Community Medicine, University of California, San Francisco, California 94143, USA.
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Koo D, Felix K, Dankwa-Mullan I, Miller T, Waalen J. A call for action on primary care and public health integration. Am J Public Health 2012; 102 Suppl 3:S307-9. [PMID: 22690962 PMCID: PMC3478083 DOI: 10.2105/ajph.2012.300824] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2012] [Indexed: 11/04/2022]
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