A Natural Alliance Amy DeGroff PhD MPH Division of Cancer Prevention and Control Centers for Disease Control amp Prevention National Association of Deans and Directors School of Social Work Conference ID: 1032827
Download Presentation The PPT/PDF document "Social Work and Public Health:" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
1. Social Work and Public Health: A Natural AllianceAmy DeGroff, PhD, MPHDivision of Cancer Prevention and ControlCenters for Disease Control & Prevention National Association of Deans and Directors School of Social Work Conference October 26, 2011
2. Ida Cannon
3. CDC applies a Public Health Approach to CancerMonitoring and surveillanceApplied Research and EvaluationUnderserved populationsEducation and outreachImproving infrastructureQuality of life for cancer survivors
4. CDC’s Role in Cancer Prevention and ControlProvide national leadership in comprehensive public health approaches to cancer issues, including:Monitoring and surveillancePolicy, systems, environmental change strategiesUnderserved and disparate populationsPublic education and outreachClinical preventive servicesImproving infrastructureImproving quality of life for cancer survivors
5. CDC’s Vital SignsInaugural Issue Focus: Cancer Screening
6. Evidence-Based Clinical Preventive Services for Cancer
7. Aims to educate persons aged 50+ about the importance of regular CRC screening Targeted to Medicare recipients, African Americans, Hispanics and Health ProfessionalsSFL materials adaptable to State and Local needsScreen for Life
8. Inside Knowledge: Get the Facts About Gynecologic CancerCDC conducted formative research, concept and material testingCampaign features ‘real’ women Emphasis on women who have survived or had a personal connection to gynecological cancer
9. Prevention Research Centers ProgramThematic NetworksCancer Prevention and Control Research Network (CPCRN)Mission: Accelerate the adoption of evidence-based cancer prevention and control in communitiesFunded by CDC and National Cancer Institute
10. CPCRN StrengthsAdvancing public health science for implementation and translation researchBuilding strong community partnershipsFocusing on underserved populationsgeographic outreachResearch focus that complements NCI & CDC prioritiesInfrastructure funding provides impetus to focus beyond discovery and be opportunistic
11. PI’sMichelle Kegler, DrPHJennifer Allen, ScD, MPH, RNBetsy Risendahl, PhDRoshan Bastani, PhDCathy Melvin, PhDKurt Ribisl, PhD (Coord Ctr)Maria Fernandez, PhDVicky Taylor, MD, MPHMatthew Kreuter, PhD, MPHMarcia Ory, PhD, MPHJames Hebert, ScD, MSPH
12. CPCRN Map
13. Patient Navigation Study for Colonoscopy Screening
14. Defining Patient Navigation Across Cancer ContinuumPatient-focused intervention intended to eliminate barriers to cancer screening, timely diagnosis, treatment, and survivorshipEmphasis on reducing health disparities through improved health care access and quality for medically underserved populationsPN used in other areas of public health, including other chronic diseases
15. Some Principles of Patient NavigationPatient-centric healthcare service delivery modelCore function to eliminate barriers to timely care across cancer continuumPN serves to integrate a fragmented healthcare system for the individual patientPN often involves navigating patients across disconnected systems of care including primary care, specialty care, and tertiary care sitesFreeman, HP, Rodriguez, RL. History and principles of patient navigation. Cancer. 2011;117(15 suppl):3539-3542
16. Momentum!Harold P. Freeman – Harlem Hospital (1990)2005 Patient Navigation Outreach and Chronic Disease Prevention Act (reauthorized in ACA)2010 Patient Protection and Affordable Care Act (ACA)2011 National Prevention and Health Promotion Strategy (required by ACA)2011 American College of Surgeon’s Commission on Cancer2010 National Patient Navigation Leadership Summit, American Cancer Society
17. CDC Partners Working in Cancer-Related Patient NavigationAmerican Cancer Society (ACS)Centers for Medicare and Medicaid Services (CMS)Health Resource & Service Administration (HRSA)National Cancer Institute (NCI)Academic and non-profit partnersCancer, Supplement to Cancer, National Patient Navigation Leadership Summit, Vol. 117, Issue 15, August 1, 2011
18. Colorectal Cancer ScreeningNational colorectal cancer screening rates low – 65.4% (all screening tests combined)*Extensive barriers to screening documentedColonoscopy is a complex screening procedure*Richardson LC, Tai E, Rim SH, Joseph D, Plescia M. Vital signs: Colorectal cancer screening, incidence, and mortality – United States, 2002-2010. Morbidity and Mortality Weekly Report. 2011;60(26):884-889. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6026a4.htm?s_cid=mm6026a4_w. Accessed 10/20/11.
19. Patient Navigation Models Emerging evidence-base for PN in cancer*PN models varyMulti-disciplinary team developed intervention modelPublic health Oncology social workClinical oncologyEvaluationBehavioral health research*Paskett, et al. 2011. Patient Navigation: An Update on the State of the Science. CA: Cancer J Clin.
20. Patient NavigationResearch Intervention ModelPatient-focused, barrier-focusedTheory-basedSocio-ecological approachIndividual-level behavioral theoriesRemoving cultural, environmental/structural, and health care system barriers will support colorectal cancer screening adherenceTheories suggest that changes in knowledge, attitudes, beliefs, intentions, and self-efficacy precede individual-level behavior change
21.
22. Primary Outcomes of InterestIndividual/Intrapersonal-level outcomesImproved adherence to colonoscopy screeningImproved quality of bowel prepPatient satisfactionSystems-level outcomesIncreased screening rate for referring primary care clinicReduced number of “no-shows” for colonoscopy appointmentsReduced time from screening referral to completionProvider satisfaction
23. Patient Navigation StudyDesign and SettingRCT (825 patients)Treatment group – patient navigationControl – usual careBoston Medical Center (BMC)Teaching hospital for BU Medical SchoolLargest safety net hospital in New EnglandPatients recruited from Internal Medicine (referred for colonoscopy)
24. Opportunities for Evaluators at CDC Evaluation is a multidisciplinary fieldSocial scientists with strong methodological skills (quantitative, qualitative, mixed methods)New CDC fellowship program for PhD-level evaluatorsPracticum or Internships??
25. Social Work and Public Health: A Natural AllianceShared commitment to social justice and reduced disparitiesSocial determinants of health ≈ The person-in-environmentWork within social ecological models Work in community and clinic settingsTheoretical complementarity
26. Contact InformationDivision of Cancer Prevention and ControlNational Center for Chronic Disease Prevention and Health PromotionCDCAmy DeGroff, PhD, MPHadegroff@cdc.gov The findings and conclusions in this presentation are those of the author and do not necessarily represent the official position of CDC or ATSDR
27. Thank You!