260603 Systematic Screening: Applying lessons learned from an international best practice to a rural U.S. setting

Tuesday, October 30, 2012 : 10:30 AM - 10:45 AM

Felicia Batts, MPH , Research Program Manager, Golden Valley Health Center, Merced, CA
Kimberly Aumack-Yee, BA , Institute for Reproductive Health, Georgetown University, Washington, DC
Miranda Beckman, MPH , Georgetown University, The Institute for Reproductive Health, Washington, DC
Irit Sinai, PhD , Institute for Reproductive Health, Georgetown University, Washington, DC
Rebecka Lundgren, MPH , Institute for Reproductive Health, Georgetown University, Washington, DC
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.

Learning Areas:
Administer health education strategies, interventions and programs
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related research

Learning Objectives:
1. Design participatory research to allow communities and clinicians to target underutilized services. 2. Design strategies to assess the impact of clinic-wide interventions. 3. Evaluate the effectiveness of Systematic Screening in a U.S. setting.

Keywords: Diabetes, Family Planning

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Research Program Manager at Golden Valley Health Centers where this study and several other research projects are being conducted. I oversee all study operations in conjunction with the project manager - Rosa Camacho. I work directly for the co-principal investigator on this project - Christine Noguera.
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.