DESCRIPTION (provided by applicant): The long-term objectives of this research are to find effective ways to increase the use and impact of scientifically accurate cancer information delivered through existing resources like the Cancer Information Service (CIS). Using formative and experimental research methodologies, the proposed work investigates how to connect the CIS to low-income urban African-American and Hispanic women with abnormal PAP tests. The research examines the utility of engaging health care providers who treat the underserved in using and referring their patients to the CIS. The study also evaluates the impact of accessing CIS services on patients' abnormal PAP test follow-up as well as on the quality of the provider-patient relationship. Initial formative research with patients and providers from two large community clinics that treat the underserved will examine familiarity with and views about the CIS, as well as barriers and facilitators of telephoning the CIS for information about cancer prevention and screening. Community feedback will also be sought on materials planned for inclusion in a randomized controlled trial (RCT). The RCT will randomize approximately 500 women just scheduled for colposcopy at the two clinics to two conditions involving different letters from the provider. Usual Care participants will receive a generic letter reminding them of their follow-up appointment. Intervention participants will receive a targeted letter reminding them of the follow-up appointment, asking them or someone they designate to call the CIS, and suggesting questions to ask. Specific aims are to examine whether a targeted physician mailing can increase calls to the CIS, enhance appropriate medical follow-up, and improve satisfaction with provider-patient communication at the follow-up medical visit. The study has the potential to identify a feasible, effective, sustainable, and culturally sensitive strategy to increase awareness and use of the CIS among an underserved population. The burden of cancer falls most heavily on low income African Americans and Hispanics, who are the study population. This research activates providers who treat the underserved to connect their patients to well- trained cancer information specialists who are accessible by telephone. The study examines the impact on medical follow-up and provider-patient communication.
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