Michelle C. Reece

Predictors of new screening for African American men participating in a prostate cancer educational program

Background. African American (AA) men continue to have a greater than twofold risk of dying from prostate cancer compared to Whites. Methods. This community-based intervention study employed a quasi-experimental, delayed-control (cross-over) design with randomization at the church-level (N=345 AA men). Results. Logistic regression analyses revealed that the level of knowledge (b=.61, P<.05, Exp (B)=1.84), the perception of risk (b=2.99, P<.01, Exp (B)=19.95), and having insurance (b=3.20, P<.01, Exp (B)=24.65) significantly increased the odds of participants who needed screening getting screened during study. Discussion. This study demonstrated the need for education, community involvement, and increased access to encourage minority men to obtain needed health screenings.

Using a Participatory Research Process to Address Disproportionate Hispanic Cancer Burden

Community-based participatory research (CBPR) offers great potential for increasing the impact of research on reducing cancer health disparities. This article reports how the Community Outreach Core (COC) of the Meharry–Vanderbilt–Tennessee State University (TSU) Cancer Partnership has collaborated with community partners to develop and implement CBPR. The COC, Progreso Community Center, and Nashville Latino Health Coalition jointly developed and conducted the 2007 Hispanic Health in Nashville Survey as a participatory needs assessment to guide planning for subsequent CBPR projects and community health initiatives. Trained community and student interviewers surveyed 500 Hispanic adults in the Nashville area, using a convenience sampling method. In light of the survey results, NLHC decided to focus in the area of cancer on the primary prevention of cervical cancer. The survey led to a subsequent formative CBPR research project to develop an intervention, then to funding of a CBPR pilot intervention study to test the intervention.

EPSDT Preventive Services in a Low-Income Pediatric Population: Impact of a Nursing Protocol

Medicaid mandates coverage of clinical preventive services for children under the Early and Periodic Screening, Diagnosis, and Treatment program (EPSDT). This article assesses the usefulness of a nursing protocol for delivering comprehensive EPSDT services to pediatric patients during any primary care visit. Secondary data from a recent controlled trial were analyzed. An intervention group received the clinical protocol (n = 514 children in a low-income pediatric clinic), whereas data from a “usual care” comparison group were obtained from medical records (n = 115 children). The nursing protocol included 52 items corresponding to EPSDT services and was administered by a prevention nurse. In the intervention group, 11 605 out of 11 607 (approximately 100.0%) EPSDT service needs were initiated, as compared to 21.2% (572 out of 2695) in the comparison group (P < .001). The study demonstrates the feasibility of using a nursing protocol to integrate EPSDT clinical preventive services into pediatric visits.

Use of Six Sigma for eliminating missed opportunities for prevention services.

Delivery of primary care preventative services can be significantly increased utilizing Six Sigma methods. Missed preventative service opportunities were compared in the study clinic with the community clinic in the same practice. The study clinic had 100% preventative services, compared with only 16.3% in the community clinic. Preventative services can be enhanced to Six Sigma quality when the nurse executive and medical staff agree on a single standard of nursing care executed via standing orders.