Federally qualified health centers (FQHCs) offer primary and preventive healthcare, including cancer screening, for the nation’s most vulnerable population. The purpose of this study was to explore the relationship between access to FQHCs and cancer mortality-to-incidence ratios (MIRs). One-way analysis of variance was conducted to compare the mean MIRs for breast, cervical, prostate, and colorectal cancers for each U.S. county for 2006–2010 by access to FQHCs (direct access, in-county FQHC; indirect access, adjacent-county FQHC; no access, no FQHC either in the county or in adjacent counties). ArcMap 10.1 software was used to map cancer MIRs and FQHC access levels. The mean MIRs for breast, cervical, and prostate cancer differed significantly across FQHC access levels (p < 0.05). In urban and healthcare professional shortage areas, mean MIRs decreased as FQHC access increased. A trend of lower breast and prostate cancer MIRs in direct access to FQHCs was found for all racial groups, but this trend was significant for whites only. States with a large proportion of rural and medically underserved areas had high mean MIRs, with correspondingly more direct FQHC access. Expanding FQHCs to more underserved areas and concentrations of disparity populations may have an important role in reducing cancer morbidity and mortality, as well as racial-ethnic disparities, in the United States.
Background
Federally qualified health centers (FQHCs) provide a health care safety net for
underserved populations and contribute unique expertise to research that could further
enhance quality of patient care. The purpose of this research was to assess interest in,
readiness to, and capacity for conducting research in FQHCs in South Carolina (SC).
Methods
A web-based survey was administered to 20 FQHCs across SC. Fourteen
representatives of FQHCs completed the 39-item survey that assessed research experience
and interest, partnerships and funding, barriers and benefits to research participation,
training and technical assistance needs, and research capacity.
Results
FQHCs are interested in conducting research. FQHCs reported that health center
leadership, organizational benefit, active engagement of staff, and clear roles for
partners were important factors for successful partnerships. Inequity of budget and
resources were the greatest challenges encountered. Improved patient outcomes,
additional resources for the center, reduction in disparities, and academic partnerships
were considered benefits for participation. FQHCs were interested in training and
technical assistance opportunities for research funding and best practices for the use
of research to inform programs and services.
Conclusions
FQHCs are willing to collaborate on research. For successful research
partnerships, collaborators should understand FQHCs’ challenges and barriers to
participation.
The South Carolina Cancer Prevention and Control Research Network, in partnership with the South Carolina Primary Health Care Association, and Federally Qualified Health Centers (FQHCs), aims to promote evidence-based cancer interventions in community-based primary care settings. Partnership activities include (1) examining FQHCs’ readiness and capacity for conducting research, (2) developing a cancer-focused data sharing network, and (3) integrating a farmers’ market within an FQHC. These activities identify unique opportunities for public health and primary care collaborations.
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