Grant Number:	5P01CA055112-09 Interpret this number
Primary Investigator:	Pasick, Rena
Organization:	Cancer Prevention Instit Of California
Project Title:	Cancer Screening, Managed Care, and the Underserved
Fiscal Year:	2002

This Program Project, Cancer Screening, Managed Cared, and the Undeserved addresses the major impediments to achievement of the breast and cervical cancer screening goals for the Year 2000: . screening for women who have never been screened; . establishment of maintenance screening behavior; and .improved follow-up of abnormal tests to diagnosis and treatment. Despite notable gains in these areas, low-income and multi-ethnic populations still suffer disproportionately high rates of late-stage disease and mortality due to these cancers. Moreover, advances to data may be jeopardized by the complexity and rapid changes as the delivery of health services evolves into managed care. The proposed research, collectively referred to as the Pathfinders studies, seeks to unravel the impediments to early detection and develop viable, cost-effective solutions. Our investigators are a multi-disciplinary and multi-ethnic team from San Francisco Bay Area research institutions and are members of the Northern California Cancer Center (NCCC) consortium. The team will build on past experiences in studies of under-served populations to tackle critical behavioral and health services research questions. Three projects linked by the Pathfinders them address these issues: 1) Access and Early Cancer Detection for the Under-served 2) A Strategy to Improve Pap Smear Follow-up in a High-risk Under-served Population 3) Race/ethnic Differences in the Evaluation of Abnormal Mammography The first two of these projects are randomized controlled trials that evaluate the effectiveness and cost-effectiveness of innovative interventions. The third study is an exploration of issues interfering with timely and complete resolution of mammographic abnormalities from the women's perspective and the piloting of a responsive intervention. In our core research we will also record and study the changes taking place in cancer screening as a result of the upheaval in health care delivery and methodologic problems in its evaluation. Core components will also provide cohesive services and methodologic, biostatistical, and cost-effectiveness analysis expertise. The proposed research will make a unique contribution to cancer control research and complement other cancer control activities of the NCCC and its consortium in Northern California.




Factors influencing time to diagnosis after abnormal mammography in diverse women.
Authors: Pérez-Stable E.J. , Afable-Munsuz A. , Kaplan C.P. , Pace L. , Samayoa C. , Somkin C. , Nickleach D. , Lee M. , Márquez-Magaña L. , Juarbe T. , et al. .
Source: Journal Of Women's Health (2002), 2013 Feb; 22(2), p. 159-66.
PMID: 23350859
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Behavioral constructs and mammography in five ethnic groups.
Authors: Stewart S.L. , Rakowski W. , Pasick R.J. .
Source: Health Education & Behavior : The Official Publication Of The Society For Public Health Education, 2009 Oct; 36(5 Suppl), p. 36S-54S.
PMID: 19805790
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Ethnic differences in decisional balance and stages of mammography adoption.
Authors: Otero-Sabogal R. , Stewart S. , Shema S.J. , Pasick R.J. .
Source: Health Education & Behavior : The Official Publication Of The Society For Public Health Education, 2007 Apr; 34(2), p. 278-96.
PMID: 16891624
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The costs of an outreach intervention for low-income women with abnormal Pap smears.
Authors: Wagner T.H. , Engelstad L.P. , McPhee S.J. , Pasick R.J. .
Source: Preventing Chronic Disease, 2007 Jan; 4(1), p. A11.
PMID: 17173719
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Depressive symptoms among women with an abnormal mammogram.
Authors: Alderete E. , Juarbe T.C. , Kaplan C.P. , Pasick R. , Pérez-Stable E.J. .
Source: Psycho-oncology, 2006 Jan; 15(1), p. 66-78.
PMID: 15816053
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The effectiveness of a community outreach intervention to improve follow-up among underserved women at highest risk for cervical cancer.
Authors: Engelstad L.P. , Stewart S. , Otero-Sabogal R. , Leung M.S. , Davis P.I. , Pasick R.J. .
Source: Preventive Medicine, 2005 Sep-Oct; 41(3-4), p. 741-8.
PMID: 16125761
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Poor patient comprehension of abnormal mammography results.
Authors: Karliner L.S. , Patricia Kaplan C. , Juarbe T. , Pasick R. , Pérez-Stable E.J. .
Source: Journal Of General Internal Medicine, 2005 May; 20(5), p. 432-7.
PMID: 15963167
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Are risk factors for breast cancer associated with follow-up procedures in diverse women with abnormal mammography?
Authors: Juarbe T.C. , Kaplan C.P. , Somkin C.P. , Pasick R. , Gildengorin G. , Pérez-Stable E.J. .
Source: Cancer Causes & Control : Ccc, 2005 Apr; 16(3), p. 245-53.
PMID: 15947876
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Behavioral interventions and cost-effectiveness analysis.
Authors: Wagner T.H. , Goldstein M.K. .
Source: Preventive Medicine, 2004 Dec; 39(6), p. 1208-14.
PMID: 15539057
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The effect of access and satisfaction on regular mammogram and Papanicolaou test screening in a multiethnic population.
Authors: Somkin C.P. , McPhee S.J. , Nguyen T. , Stewart S. , Shema S.J. , Nguyen B. , Pasick R. .
Source: Medical Care, 2004 Sep; 42(9), p. 914-26.
PMID: 15319618
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Clinical management of chlamydia and gonorrhea infection in a county teaching emergency department--concerns in overtreatment, undertreatment, and follow-up treatment success.
Authors: Levitt M.A. , Johnson S. , Engelstad L. , Montana R. , Stewart S. .
Source: The Journal Of Emergency Medicine, 2003 Jul; 25(1), p. 7-11.
PMID: 12865101
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Access and attitudinal factors related to breast and cervical cancer rescreening: why are Latinas still underscreened?
Authors: Otero-Sabogal R. , Stewart S. , Sabogal F. , Brown B.A. , Pérez-Stable E.J. .
Source: Health Education & Behavior : The Official Publication Of The Society For Public Health Education, 2003 Jun; 30(3), p. 337-59.
PMID: 19731500
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Validation of recall of breast and cervical cancer screening by women in an ethnically diverse population.
Authors: McPhee S.J. , Nguyen T.T. , Shema S.J. , Nguyen B. , Somkin C. , Vo P. , Pasick R. .
Source: Preventive Medicine, 2002 Nov; 35(5), p. 463-73.
PMID: 12431895
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Does willingness to pay vary by race/ethnicity? An analysis using mammography among low-income women.
Authors: Wagner T.H. , Hu T. , Dueñas G.V. , Kaplan C.P. , Nguyen B.H. , Pasick R.J. .
Source: Health Policy (amsterdam, Netherlands), 2001 Dec; 58(3), p. 275-88.
PMID: 11641004
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Abnormal Pap smear follow-up in a high-risk population.
Authors: Engelstad L.P. , Stewart S.L. , Nguyen B.H. , Bedeian K.L. , Rubin M.M. , Pasick R.J. , Hiatt R.A. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2001 Oct; 10(10), p. 1015-20.
PMID: 11588126
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Quality of data in multiethnic health surveys.
Authors: Pasick R.J. , Stewart S.L. , Bird J.A. , D'Onofrio C.N. .
Source: Public Health Reports (washington, D.c. : 1974), 2001; 116 Suppl 1, p. 223-43.
PMID: 11889288
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Willingness to pay for mammography: item development and testing among five ethnic groups.
Authors: Wagner T.H. , Hu T.W. , Dueñas G.V. , Pasick R.J. .
Source: Health Policy (amsterdam, Netherlands), 2000 Sep; 53(2), p. 105-21.
PMID: 11014787
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Cancer screening practices among primary care physicians serving Chinese Americans in San Francisco.
Authors: Lee M.M. , Lee F. , Stewart S. , McPhee S. .
Source: The Western Journal Of Medicine, 1999 Mar; 170(3), p. 148-55.
PMID: 10214101
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Opening pathways to cancer screening for Vietnamese-American women: lay health workers hold a key.
Authors: Bird J.A. , McPhee S.J. , Ha N.T. , Le B. , Davis T. , Jenkins C.N. .
Source: Preventive Medicine, 1998 Nov-Dec; 27(6), p. 821-9.
PMID: 9922064
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Barriers to breast and cervical cancer screening among Vietnamese-American women.
Authors: McPhee S.J. , Bird J.A. , Davis T. , Ha N.T. , Jenkins C.N. , Le B. .
Source: American Journal Of Preventive Medicine, 1997 May-Jun; 13(3), p. 205-13.
PMID: 9181209
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Screening for cancer. Useful despite its limitations.
Authors: McPhee S.J. .
Source: The Western Journal Of Medicine, 1995 Aug; 163(2), p. 169-72.
PMID: 7571574
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