Systematic Screening: Applying lessons learned from an international best practice to a rural U.S. setting

Golden Valley Health Centers (GVHC) and the Institute for Reproductive Health collaborated to test whether Systematic Screening, a best practice in developing countries, is an effective method of improving health outcomes by increasing utilization of preventive services, encouraging earlier testing and treatment for reproductive health needs, sexually transmitted infections (STI) and diabetes/pre-diabetes. Systematic Screening consists of asking patients several simple yes/no questions to identify needs for services. GVHC serves a predominantly Latino population in central California, including many migrant workers, and is experiencing increased rates of obesity and diabetes.

Participatory formative research, which enabled clinics and patients to select underutilized services and design the screening tool, resulted in improved adherence to the screening procedure. Baseline and endline measures included anonymous patient surveys, chart reviews, and provider interviews. Simulated client visits assessed intervention fidelity. Service statistics were used to monitor services provided per visit. Screening was acceptable to patients, and easily integrated into the intake process by providers.

Baseline results show 48% of patients desired additional services, 24% received them and 9% were unaware they could request more than one service in a visit. Initial results show increased service utilization, suggesting systematic screening is an effective intervention.

This is the first time Systematic Screening has been tested in the U.S., providing a unique opportunity for South-to-North diffusion with significant potential to address health disparities. Identifying effective, feasible and replicable interventions for scale-up could aid reducing unintended pregnancies, ensuring healthier pregnancies, reducing STI transmission, and preventing and managing diabetes.