Improving female preventive health care delivery through practice change: An every woman matters study

Elisabeth L Backer, Jenenne A Geske, Helen E. McIlvain, Diane M. Dodendorf, William C. Minier

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: The levels of breast and cervical cancer screening in Nebraska primary care remain sub-optimal despite awareness of their importance, and despite implementation of the Every Woman Matters program to assist low-income women. The GAPS model was used to develop a practice-based intervention to identify and reduce barriers to delivery of breast and cervical cancer screening services. Methods: Seven primary care practices actively participated in this multimethod case study. A research nurse collected data and facilitated the intervention process at each site. Qualitative data from field notes, patient encounters, and in-depth interviews of physicians and key informants were collected to describe the process of Papanicolaou and mammogram service delivery, and to identify barriers/facilitators to screening, and potential change areas. Chart reviews provided information regarding the preintervention and postintervention identification/execution of Papanicolaou smears and mammograms. Qualitative and quantitative analyses led to individual practice case studies. Cross case comparisons identified common themes. Results: The individual practice plans for change had many commonalities, ie, developing screening databases and reminder systems. The biggest differences involved practice contexts. Despite use of the GAPS model and a financial incentive to obtain "buy in" from providers and staff, change was difficult for all but 2 of the practices. Conclusion: The complexity of practice context and its effect on change cannot be underestimated. Individual practice providers and staff are often unaware of the potential challenges, and unable/unwilling to overcome them.

Original languageEnglish (US)
Pages (from-to)401-408
Number of pages8
JournalJournal of the American Board of Family Practice
Volume18
Issue number5
StatePublished - Sep 1 2005

Fingerprint

Preventive Health Services
Early Detection of Cancer
Uterine Cervical Neoplasms
Primary Health Care
Reminder Systems
Breast Neoplasms
Delivery of Health Care
Papanicolaou Test
Motivation
Nurses
Databases
Interviews
Physicians
Research

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Improving female preventive health care delivery through practice change : An every woman matters study. / Backer, Elisabeth L; Geske, Jenenne A; McIlvain, Helen E.; Dodendorf, Diane M.; Minier, William C.

In: Journal of the American Board of Family Practice, Vol. 18, No. 5, 01.09.2005, p. 401-408.

Research output: Contribution to journalArticle

@article{d8603e76ab37475f8897919d011d2f95,
title = "Improving female preventive health care delivery through practice change: An every woman matters study",
abstract = "Background: The levels of breast and cervical cancer screening in Nebraska primary care remain sub-optimal despite awareness of their importance, and despite implementation of the Every Woman Matters program to assist low-income women. The GAPS model was used to develop a practice-based intervention to identify and reduce barriers to delivery of breast and cervical cancer screening services. Methods: Seven primary care practices actively participated in this multimethod case study. A research nurse collected data and facilitated the intervention process at each site. Qualitative data from field notes, patient encounters, and in-depth interviews of physicians and key informants were collected to describe the process of Papanicolaou and mammogram service delivery, and to identify barriers/facilitators to screening, and potential change areas. Chart reviews provided information regarding the preintervention and postintervention identification/execution of Papanicolaou smears and mammograms. Qualitative and quantitative analyses led to individual practice case studies. Cross case comparisons identified common themes. Results: The individual practice plans for change had many commonalities, ie, developing screening databases and reminder systems. The biggest differences involved practice contexts. Despite use of the GAPS model and a financial incentive to obtain {"}buy in{"} from providers and staff, change was difficult for all but 2 of the practices. Conclusion: The complexity of practice context and its effect on change cannot be underestimated. Individual practice providers and staff are often unaware of the potential challenges, and unable/unwilling to overcome them.",
author = "Backer, {Elisabeth L} and Geske, {Jenenne A} and McIlvain, {Helen E.} and Dodendorf, {Diane M.} and Minier, {William C.}",
year = "2005",
month = "9",
day = "1",
language = "English (US)",
volume = "18",
pages = "401--408",
journal = "Journal of the American Board of Family Medicine",
issn = "1557-2625",
publisher = "American Board of Family Medicine",
number = "5",

}

TY - JOUR

T1 - Improving female preventive health care delivery through practice change

T2 - An every woman matters study

AU - Backer, Elisabeth L

AU - Geske, Jenenne A

AU - McIlvain, Helen E.

AU - Dodendorf, Diane M.

AU - Minier, William C.

PY - 2005/9/1

Y1 - 2005/9/1

N2 - Background: The levels of breast and cervical cancer screening in Nebraska primary care remain sub-optimal despite awareness of their importance, and despite implementation of the Every Woman Matters program to assist low-income women. The GAPS model was used to develop a practice-based intervention to identify and reduce barriers to delivery of breast and cervical cancer screening services. Methods: Seven primary care practices actively participated in this multimethod case study. A research nurse collected data and facilitated the intervention process at each site. Qualitative data from field notes, patient encounters, and in-depth interviews of physicians and key informants were collected to describe the process of Papanicolaou and mammogram service delivery, and to identify barriers/facilitators to screening, and potential change areas. Chart reviews provided information regarding the preintervention and postintervention identification/execution of Papanicolaou smears and mammograms. Qualitative and quantitative analyses led to individual practice case studies. Cross case comparisons identified common themes. Results: The individual practice plans for change had many commonalities, ie, developing screening databases and reminder systems. The biggest differences involved practice contexts. Despite use of the GAPS model and a financial incentive to obtain "buy in" from providers and staff, change was difficult for all but 2 of the practices. Conclusion: The complexity of practice context and its effect on change cannot be underestimated. Individual practice providers and staff are often unaware of the potential challenges, and unable/unwilling to overcome them.

AB - Background: The levels of breast and cervical cancer screening in Nebraska primary care remain sub-optimal despite awareness of their importance, and despite implementation of the Every Woman Matters program to assist low-income women. The GAPS model was used to develop a practice-based intervention to identify and reduce barriers to delivery of breast and cervical cancer screening services. Methods: Seven primary care practices actively participated in this multimethod case study. A research nurse collected data and facilitated the intervention process at each site. Qualitative data from field notes, patient encounters, and in-depth interviews of physicians and key informants were collected to describe the process of Papanicolaou and mammogram service delivery, and to identify barriers/facilitators to screening, and potential change areas. Chart reviews provided information regarding the preintervention and postintervention identification/execution of Papanicolaou smears and mammograms. Qualitative and quantitative analyses led to individual practice case studies. Cross case comparisons identified common themes. Results: The individual practice plans for change had many commonalities, ie, developing screening databases and reminder systems. The biggest differences involved practice contexts. Despite use of the GAPS model and a financial incentive to obtain "buy in" from providers and staff, change was difficult for all but 2 of the practices. Conclusion: The complexity of practice context and its effect on change cannot be underestimated. Individual practice providers and staff are often unaware of the potential challenges, and unable/unwilling to overcome them.

UR - http://www.scopus.com/inward/record.url?scp=27944464136&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=27944464136&partnerID=8YFLogxK

M3 - Article

C2 - 16148250

AN - SCOPUS:27944464136

VL - 18

SP - 401

EP - 408

JO - Journal of the American Board of Family Medicine

JF - Journal of the American Board of Family Medicine

SN - 1557-2625

IS - 5

ER -