Addressing high cervical cancer rates in the Rio Grande Valley along the Texas–Mexico border: a community-based initiative focused on education, patient navigation, and medical provider training/telementoring

Salcedo, Mila Pontremoli; Gowen, Rose; Rodrı́guez, Ana M.; Fisher‐Hoch, Susan P.; Daheri, Maria; Guerra, Luca; Toscano, Paul A.; Gasca, María Luisa Rascón; Morales, J.; Reyna-Rodriguez, F. E.; Cavazos, B.; Marín, E.; Perez, C Guisado; Guerra, Maximiliano Ribeiro; Milbourne, Andrea; Varon, Melissa Lopez; Reininger, Belinda M.; Fernández, Marisol; Castle, Philip E.; McCormick, Joseph B.; Baker, Ellen; Hawk, Ernest T.; Schmeler, Kathleen M.

doi:10.1177/1757913921994610

Cited by 13 publications

(13 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Community outreach is necessary to inform uninsured women about the existence of preventative medical screenings and to link them to affordable care. Prior studies have shown that patient navigation can increase screening uptake [42][43][44]. Helping patients move through the complex healthcare system might make the process less daunting.…”

Section: Plos Onementioning

confidence: 99%

Racial and ethnic differences in cervical cancer screening barriers and intentions: The My Body My Test-3 HPV self-collection trial among under-screened, low-income women

Zeno

Brewer²,

Spees³

et al. 2022

PLoS ONE

View full text Add to dashboard Cite

Under-screened women are more likely to be diagnosed with invasive cervical cancer at later stages and have worse survival outcomes. Under- or un-insured women, low-income women, and minoritized groups face barriers to screening. Intention to screen is an indicator of future screening behavior, yet is understudied among low-income, under-screened women. Participants were 710 low-income, uninsured or publicly insured women ages 25–64 years in North Carolina who were not up to date on cervical cancer screening according to national guidelines. Participants were asked about barriers to screening and intention to screen. We estimated reported barriers to cervical cancer screening stratified by race and ethnicity (categorized as White, Black, and Hispanic) and assessed predictors of intention to screen. Sixty-one percent of all participants reported 5 or more barriers to screening. The most commonly reported reasons for not getting screened were lack of insurance (White: 71%, Black: 62%, Hispanic/Latina: 63%) and cost (White: 55%, Black: 44%, Hispanic/Latina: 61%). Women were more likely to have an intention to screen if they reported “it was not hard to get screening” (OR: 1.47 (1.00, 2.15)). Older women reported being less likely to intend to screen. Black women reported being more likely to intend to screen than White women. Lack of health insurance and cost were frequently reported barriers to cervical cancer screening. Increasing knowledge of affordable clinics and expanding access to Medicaid may reduce barriers and increase cervical cancer screening uptake.

show abstract

Section: Plos Onementioning

confidence: 99%

Racial and ethnic differences in cervical cancer screening barriers and intentions: The My Body My Test-3 HPV self-collection trial among under-screened, low-income women

Zeno

Brewer²,

Spees³

et al. 2022

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…For example, MD Anderson Cancer Center has used ECHO's telementoring approach for many years to train and support primary care providers along the Texas/Mexico border in how to screen for cervical cancer, greatly expanding access to screening for underserved Hispanic communities. 49 The ECHO Cancer Network has allowed local providers to triage complex patients to MD Anderson when expert care is required, using the linkages created by this mentorship network to reduce the time to treatment for those who need complex care that only specialists can provide. [50][51][52] Most ECHO oncology partner organizations rely on the generosity of philanthropy or short-term federal grants to operate and expand these networks.…”

Section: Health Policy Implicationsmentioning

confidence: 99%

Leveraging Digital Technology to Reduce Cancer Care Inequities

Arora

Ryals

Rodriguez

et al. 2022

American Society of Clinical Oncology Educational Book

View full text Add to dashboard Cite

The rise of digital technologies such as telehealth, mobile apps, electronic medical records, and telementoring for rural primary care providers could provide opportunities for improving equity in cancer care delivery and outcomes. Benefitting from new technologies requires access to broadband internet, appropriate devices (smartphones, computers, etc.) along with basic digital literacy skills to use the devices. When these requirements are not met, the likelihood of widening existing inequities in access to care increases. This article introduces opportunities for improving cancer care using health informatics systems for engaging patients and flagging bias and existing videoconferencing technology to build workforce capacity. Policy recommendations for expanding evidence-based interventions are also highlighted, with the aim of mitigating the effects of workforce shortages and reducing persistent inequities in access to and quality of care.

show abstract

“…An average of 8.6% of the US population is uninsured, although the rates are much higher in certain states, such as Texas, where 18.4% of the population is uninsured 20,21. Additional barriers to treatment of cervical preinvasive disease include lack of patient awareness and lack of patient knowledge,19,22 lack of adequate system infrastructure to identify and navigate patients in need of treatment, lack of clinical infrastructure to perform diagnostic and treatment procedures, as well as regional lack of trained professionals delivering these services 23–25…”

mentioning

confidence: 99%

“…20,21 Additional barriers to treatment of cervical preinvasive disease include lack of patient awareness and lack of patient knowledge, 19,22 lack of adequate system infrastructure to identify and navigate patients in need of treatment, lack of clinical infrastructure to perform diagnostic and treatment procedures, as well as regional lack of trained professionals delivering these services. [23][24][25] In 2018, Dr Tedros Adhanom Ghebreyesus, Director General of the World Health Organization (WHO), released a call for action to eliminate cervical cancer worldwide, and in 2020 this call for action was adopted as the global strategy for cervical cancer elimination by the World Health Assembly. 26 The aspirational goal of this initiative is to eliminate cervical cancer as a public health problem by 2030 through implementing initiatives to achieve 3 targets: (1) vaccinate 90% of girls with the HPV vaccine; (2) screen 70% of women for cervical cancer using a highperformance test; and (3) treat 90% of women with cervical precancer and cancer.…”

mentioning

confidence: 99%

“…The MD Anderson Program for Reducing Cervical Cancer in Texas (PRCC-Texas) is a multicomponent intervention to address barriers to cervical cancer screening, diagnosis, and treatment. 23 The PRCC-Texas program was initially implemented in 2 Federally Qualified Health Center (FQHC) systems and 1 mobile health clinic in the Rio Grande Valley (RGV) along the Texas-Mexico border. Su Clinica is an FQHC serving uninsured and underinsured patients in 3 locations: Brownsville and Harlingen (both in Cameron County) and Raymondville (Willacy County).…”

mentioning

confidence: 99%

See 1 more Smart Citation

A Comprehensive Program to Improve Treatment of Precancerous Cervical Lesions in the Rio Grande Valley of Texas

Varon,

Salcedo,

Fellman

et al. 2023

Journal of Public Health Management and Practice

Self Cite

View full text Add to dashboard Cite

Objective: To assess the impact of a multicomponent intervention in women with cervical dysplasia who were treated with loop electrosurgical excision procedure (LEEP), as well as the time between colposcopy and treatment. Design: Retrospective cohort study. Intervention: Clinic participation in a multicomponent cervical cancer prevention program that included community outreach, patient in-reach, and navigation, as well as provider capacity building with in-person training and ongoing telementoring through Project ECHO. Main Outcome Measures: Medical records were reviewed to evaluate women with cervical dysplasia undergoing treatment with LEEP within 90 days of colposcopy, as well as time between colposcopy and treatment. Baseline data from year 1 were compared with each subsequent year of implementation. Additional variables examined included patient's age, history of abnormal screening results, and percentage of families living below poverty line based on county of residence, parity, and clinic site. We performed logistic regression and multiple linear regression analyses to assess the programmatic impact in the outcomes of interest by year of program implementation. Results: A total of 290 women were included in the study. The proportion of women undergoing treatment within 90 days of colposcopy increased from 76.2% at baseline to 91.3% in year 3 and 92.9% in year 4 of program implementation. The odds of undergoing treatment within 90 days were 5.11 times higher in year 4 of program implementation than at baseline. The mean time between colposcopy and LEEP decreased from 62 days at baseline to 45 days by year 4 of program implementation. Conclusions: Implementation of our multicomponent cervical cancer prevention program increased the proportion of women undergoing LEEP within 90 days of colposcopy and decreased the time between colposcopy and LEEP. This program has the potential to support cervical cancer prevention efforts and could be implemented in other low-resource settings.

show abstract

Addressing high cervical cancer rates in the Rio Grande Valley along the Texas–Mexico border: a community-based initiative focused on education, patient navigation, and medical provider training/telementoring

Cited by 13 publications

References 16 publications

Racial and ethnic differences in cervical cancer screening barriers and intentions: The My Body My Test-3 HPV self-collection trial among under-screened, low-income women

Racial and ethnic differences in cervical cancer screening barriers and intentions: The My Body My Test-3 HPV self-collection trial among under-screened, low-income women

Leveraging Digital Technology to Reduce Cancer Care Inequities

A Comprehensive Program to Improve Treatment of Precancerous Cervical Lesions in the Rio Grande Valley of Texas

Contact Info

Product

Resources

About