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Grant Details

Grant Number: 5R01CA087776-04 Interpret this number
Primary Investigator: Dietrich, Allen
Organization: Dartmouth College
Project Title: NY Prevention Care Manager Project
Fiscal Year: 2003


This project will test the impact and measure the costs of a prevention case manager (PCM) to improve cancer early detection provided to ethnically diverse women age 50-69 years seen in community health centers in the New York City area. Patients of four community health centers will be randomly assigned to usual care or the PCM intervention. The conceptual framework for the project is provided by the PRECEDE model. Evidence-based statements of the National Cancer Institute's CancerNet identify appropriate intervals for mammography, Pap and fecal occult blood testing, and sigmoidoscopy. Project Aims are: 1. To learn of barriers faced by this population in obtaining indicated services; 2. To assess at baseline the office environment and work processes in each participating center; 3. To develop and implement the PCM intervention to help patients overcome barriers; 4. To evaluate the impact and costs of the PCM in a randomized controlled efficacy trial. Phase I of the project involving Aims 1 and 2 will provide a baseline assessment of patient barriers and center environments. Aim 1 will be achieved through interviewing up to 50 systematically selected women in each center to learn about barriers to preventive care. Aim 2 will be addressed through questionnaires and guided discussions with clinical support staff in each center. Phase II concerns Aim 3, to refine the intervention informed by results of Phase I. The Intervention includes identification of patients who are overdue for services, culturally appropriate patient advice, assistance in overcoming barriers to care and follow-up monitoring to assist in resolution of abnormal test results. Phase III concerns Aim 4 conducting the efficacy trial. Outcome evaluation based on record review will compare the preventive status of patient cohorts between baseline and follow- up across the two study groups taking into account the work-up status of any abnormal test results with an evaluation cohort of 1400 women age 50-69 years. Process evaluation will allow accurate assessment of intervention costs, as well as observations of the practice environments and the process of providing preventive care. As a result of this project, a new model of enhancing preventive care for special populations will be tested and its efficacy and costs determined.


Barriers to colorectal cancer screening among publicly insured urban women: no knowledge of tests and no clinician recommendation.
Authors: Robinson C.M. , Cassells A.N. , Greene M.A. , Beach M.L. , Tobin J.N. , Dietrich A.J. .
Source: Journal of the National Medical Association, 2011 Aug; 103(8), p. 746-53.
PMID: 22046852
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Staffing time required to increase cancer-screening rates through telephone support.
Authors: Robinson C.M. , Beach M.L. , Greene M.A. , Cassells A. , Tobin J.N. , Dietrich A.J. .
Source: The Journal of ambulatory care management, 2010 Apr-Jun; 33(2), p. 143-54.
PMID: 20228638
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Can language-concordant prevention care managers improve cancer screening rates?
Authors: Beach M.L. , Flood A.B. , Robinson C.M. , Cassells A.N. , Tobin J.N. , Greene M.A. , Dietrich A.J. .
Source: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2007 Oct; 16(10), p. 2058-64.
PMID: 17932353
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Translation of an efficacious cancer-screening intervention to women enrolled in a Medicaid managed care organization.
Authors: Dietrich A.J. , Tobin J.N. , Cassells A. , Robinson C.M. , Reh M. , Romero K.A. , Flood A.B. , Beach M.L. .
Source: Annals of family medicine, 2007 Jul-Aug; 5(4), p. 320-7.
PMID: 17664498
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Telephone care management to improve cancer screening among low-income women: a randomized, controlled trial.
Authors: Dietrich A.J. , Tobin J.N. , Cassells A. , Robinson C.M. , Greene M.A. , Sox C.H. , Beach M.L. , DuHamel K.N. , Younge R.G. .
Source: Annals of internal medicine, 2006-04-18; 144(8), p. 563-71.
PMID: 16618953
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Perceptions of barriers and facilitators of cancer early detection among low-income minority women in community health centers.
Authors: Ogedegbe G. , Cassells A.N. , Robinson C.M. , DuHamel K. , Tobin J.N. , Sox C.H. , Dietrich A.J. .
Source: Journal of the National Medical Association, 2005 Feb; 97(2), p. 162-70.
PMID: 15712779
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