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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
John A Capitman, PhD, Schneider Institute for Health Policy, Brandies University, MS 035, 415 South Street, Brandeis University, Waltham, MA 02454, 781 736 3932, capitman@brandeis.edu, Sarita Malik Bhalotra, MD, PhD, Schneider Institute for Health Policy, Heller School, Brandeis University, 415 South Street, MS 035, Waltham, MA 02454, and Vanessa Calderon-Rosado, PhD, National Center on Women and Aging, Brandeis University, MS 035, Waltham, MA 02454.
This paper describes findings and conclusions from literature syntheses and case studies with respect to two types of interventions that Medicare might explore in an effort to reduce racial/ethnic disparities in cancer: (1) Increasing participation of ethinc and racial minority elders in primary prevention./health promotion activities, such as smoking, exercise, and weight loss through linkage between primary care providers and community-based, culturally-tailored programs; and (2) increasing participation of ethnic and racial minorities in breast, cervical, and colon screening and diagnostic testing for related and other cancers through lay health worker/promotora models, and other community-based and public health oriented models in the United States. Neither set of intervention approaches has been the subject of multiple, well-designed intervention trials targeted to this population, so evidence for their potential is drawn from community program experience and more formal analyses of interventions with other populations. Several critical factors were identified: basing programs in both traditional primary care and other health care settings, follow-up by primary care clinicians to reinforce referral and support behavior change over time, careful training and reasonable reimbursement for lay health workers, and focusing on reducing practical barriers to behavior change or screening as well as attitudinal barriers. International primary health care models were explored briefly for assessment of relevance to this context, for example, the need to make health care accessible to this population by means acceptable to them and through their participation.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.