caa a22 4500 467934312 CHVBK 20180406152952.0 cr unu---uuuuu 170328e20061201xx s 000 0 eng 10.1007/s10900-006-9027-3 doi (NATIONALLICENCE)springer-10.1007/s10900-006-9027-3 Improving Rescreening In Community Clinics: Does A System Approach Work? [Elektronische Daten] [Regina Otero-Sabogal, Desi Owens, Jesse Canchola, Farzaneh Tabnak] Community clinics provide inadequate breast cancer screening services to low-income, racially- and ethnically-diverse communities. This study develops and evaluates the effectiveness of multifaceted organizational system interventions—operational assessments, tracking systems, reminder calls, tailored education, physician prompts and a tailored counseling call—on mammography rescreening rates within three community clinics. We used the Chronic Care Model and Put Prevention Into Practice framework to redesign breast screening delivery services within the California Cancer Detection Programs: Every Woman Counts(CDP:EWC), community clinic settings. We used a quasi-experimental design with a random selection of 400 patients at pre-intervention. To establish a post-intervention clinic's rescreening rate a new comparable cross-sectional random sample of 347 women was drawn. Measures: A chart abstraction instrument was used to establish clinics' rescreening rates. Subjects: Participants at pre and post-intervention were low-income women 50years of age and older who had received normal mammography results and had not been diagnosed with breast cancer in the last five years. General linear mixed model analysis revealed significant improvements for the organizational system redesign condition [pre-intervention rescreening rate: 32.1 percent v. post-intervention rescreening rate 50.2 percent, (p<.001)]. For the organizational system redesign plus tailored counseling call condition, there was maintenance in the rescreening rate following the intervention [pre-intervention: 44.4 percent v. post-intervention: 45.1 percent, (p>0.05)]. Multilevel interventions directed at redesigning community clinics primary care breast cancer screening services, can improve mammography rescreening rates. Springer Science+Business Media, Inc., 2006 Mammography nationallicence rescreening nationallicence health care delivery nationallicence quality improvement nationallicence community-based intervention nationallicence underserved population nationallicence Otero-Sabogal Regina Institute for Health and Aging, University of California, San Francisco, Laurel Heights Campus, P. O. Box 0646, 94143-0646, San Francisco, CA, USA aut Owens Desi Resource Center on Aging, University of California, Berkeley, 535 University Hall, 94720, Berkeley, CA, USA aut Canchola Jesse Institute for Health and Aging, University of California, San Francisco, Laurel Heights Campus, P. O. Box 0646, 94143-0646, San Francisco, CA, USA aut Tabnak Farzaneh California Department of Health Services, Cancer Detection Section, MS 7203, 1616 Capitol Avenue, Suite 74.421, P.O. Box 997413, 95897-7413, Sacramento, CA, USA aut Journal of Community Health Kluwer Academic Publishers-Plenum Publishers; http://www.springer-ny.com 31/6(2006-12-01), 497-519 0094-5145 31:6<497 2006 31 10900 https://doi.org/10.1007/s10900-006-9027-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10900-006-9027-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Otero-Sabogal Regina Institute for Health and Aging, University of California, San Francisco, Laurel Heights Campus, P. O. Box 0646, 94143-0646, San Francisco, CA, USA aut NATIONALLICENCE 700 1- Owens Desi Resource Center on Aging, University of California, Berkeley, 535 University Hall, 94720, Berkeley, CA, USA aut NATIONALLICENCE 700 1- Canchola Jesse Institute for Health and Aging, University of California, San Francisco, Laurel Heights Campus, P. O. Box 0646, 94143-0646, San Francisco, CA, USA aut NATIONALLICENCE 700 1- Tabnak Farzaneh California Department of Health Services, Cancer Detection Section, MS 7203, 1616 Capitol Avenue, Suite 74.421, P.O. Box 997413, 95897-7413, Sacramento, CA, USA aut NATIONALLICENCE 773 0- Journal of Community Health Kluwer Academic Publishers-Plenum Publishers; http://www.springer-ny.com 31/6(2006-12-01), 497-519 0094-5145 31:6<497 2006 31 10900 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer