240337 Non-physician providers and receipt of Pap test, mammogram, and health behavior counseling

Sunday, October 30, 2011

Deanna Kepka, PhD, MPH , Applied Research Program, National Cancer Institute, Bethesda, MD
K. Robin Yabroff, PhD, MBA , National Cancer Institute, Bethesda, MD
Background/Purpose: Physician recommendation for cancer screening is one of the strongest predictors of patient receipt of screening, yet physicians may not have sufficient time to fully inform patients about cancer screening or cancer risk factor modification. Non-physician providers (NPPs) such as nurse practitioners, certified nurse midwives, and physician assistants may help meet this need.

Methods: Data from the 2005 National Health Interview Survey were analyzed to assess provider type and receipt of cancer screening and behavior counseling among age eligible women (N=17,666) using adjusted logistic regression analyses.

Results: Approximately 18% of women saw a NPP and a physician in the past 12 months, 24% saw a physician only, and 58% did not see a health professional. Compared with women who did not see a health professional, women who saw a NPP and a physician or only a physician were significantly more likely to report receiving a mammogram or Pap test and recommendations for physical activity and smoking cessation. Specifically, they were more likely to be questioned on smoking status if they saw a NPP and physician (OR=2.5; 95% CI: 2.3 2.8) or physician only (OR=1.5; 95% CI: 1.4 1.6). Mammography use was more similar in the two groups (OR=2.7; 95% CI: 2.2 3.3 and OR=2.7; 95% CI: 2.2 3.3, respectively), when compared to women who did not see a health professional.

Conclusions: Seeing a NPP in addition to a physician is associated with increased patient receipt of some cancer prevention and control services.

Learning Areas:
Chronic disease management and prevention
Public health or related nursing

Learning Objectives:
1. Describe female patient utilization of non-physician providers along with a primary care physician and receipt of a Pap test, mammogram, and health behavior counseling. 2. Indentify differences in receipt of a Pap test, mammogram, and health behavior counseling between female patients who saw a non-physician provider and a primary care physician, a primary care physician alone, and those who saw no health professional.

Keywords: Clinical Prevention Services, Preventive Medicine

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a post-doctoral Cancer Prevention Fellow at the National Cancer Institute. I have a PhD in Health Services Research with an emphasis in bio-behavioral cancer prevention.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.