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Telephone Care Management To Improve Cancer Screening among Low-Income Women: A Randomized, Controlled Trial

Allen J. Dietrich, MD; Jonathan N. Tobin, PhD; Andrea Cassells, MPH; Christina M. Robinson, MS; Mary Ann Greene, MS; Carol Hill Sox, Engr; Michael L. Beach, MD, PhD; Katherine N. DuHamel, PhD; and Richard G. Younge, MD, MPH
[+] Article, Author, and Disclosure Information

From Norris Cotton Cancer Center and Dartmouth Medical School, Hanover, New Hampshire; Albert Einstein College of Medicine of Yeshiva University, Montefiore Medical Group, and Fordham Family Practice, Bronx, New York; and Clinical Directors Network, Mount Sinai School of Medicine, and Beth Israel Medical Center, New York City, New York.

Acknowledgments: The authors thank Joseph P. Addabbo Family Health Center, Bedford Stuyvesant Family Health Center, Betances Health Center, Brownsville Multi-Service Family Health Center, East Harlem/Boriken Community Health Center, Family Physician Health Center, Montefiore Medical Group and Comprehensive Family Care Center, Morris Heights Community Health Center, Park Ridge Health Center, Ryan-NENA Community Health Center, Sunset Park Family Health Center Network, Urban Health Plan, and William F. Ryan Community Health Center.

Grant Support: By the National Cancer Institute (R01 CA-87776).

Potential Conflicts of Interest: None disclosed.

Requests for Single Reprints: Allen J. Dietrich, MD, Department of Community and Family Medicine, Dartmouth Medical School, 7250 Strasenburgh Hall, Hanover, NH 03755; e-mail, Allen.J.Dietrich@dartmouth.edu.

Current Author Addresses: Dr. Dietrich, Ms. Robinson, Ms. Greene, and Ms. Sox: Dartmouth Medical School, 7250 Strasenburgh Hall, Hanover, NH 03755.

Dr. Tobin and Ms. Cassells: Clinical Directors Network, Inc., 5 West 37th Street, 10th Floor, New York, NY 10018.

Dr. Beach: Department of Anesthesiology, Dartmouth Medical School, HB7900, Hanover, NH 03755.

Dr. DuHamel: Mount Sinai School of Medicine, 1 Gustave L. Levy Place, Box 1130, New York, NY 10029.

Dr. Younge: Montefiore Medical Group, 1 Fordham Plaza, Bronx, NY 10458.

Author Contributions: Conception and design: A.J. Dietrich, J.N. Tobin, C.H. Sox, K.N. DuHamel, R.G. Younge.

Analysis and interpretation of the data: A.J. Dietrich, J.N. Tobin, C.M. Robinson, M.A. Greene, M.L. Beach, K.N. DuHamel.

Drafting of the article: A.J. Dietrich, J.N. Tobin, C.M. Robinson, M.A. Greene, M.L. Beach.

Critical revision of the article for important intellectual content: A.J. Dietrich, J.N. Tobin, C.M. Robinson, C.H. Sox, K.N. DuHamel, R.G. Younge.

Final approval of the article: A.J. Dietrich, J.N. Tobin, A. Cassells, C.M. Robinson, M.A. Greene, C.H. Sox, M.L. Beach, K.N. DuHamel, R.G. Younge.

Provision of study materials or patients: A. Cassells.

Statistical expertise: J.N. Tobin, M.L. Beach.

Obtaining of funding: A.J. Dietrich, J.N. Tobin, A. Cassells.

Administrative, technical, or logistic support: A.J. Dietrich, J.N. Tobin, A. Cassells, C.M. Robinson, M.A. Greene, C.H. Sox.

Collection and assembly of data: A. Cassells, M.A. Greene.

Ann Intern Med. 2006;144(8):563-571. doi:10.7326/0003-4819-144-8-200604180-00006
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We found that a telephone-based intervention increased screening rates for all 3 types of cancer in this sample. Rates of colorectal cancer screening showed the largest increase, but changes in all 3 rates were clinically meaningful. The increases in mammography and colorectal cancer screening of 0.10 and 0.24, respectively, represent improvements of 17% and 60% over baseline; the lower boundaries of these confidence intervals for change were 0.05 or more. The rate of Papanicolaou testing increased by only 0.07, but this still represents a 10% improvement over baseline.

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Grahic Jump Location
Flow of study participants through recruitment, eligibility assessment, randomization, intervention, and outcome analysis.

PCM = prevention care management.

Grahic Jump Location




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