Case management was successful at promoting mammography screening uptake, although no change in longitudinal patterns was found. Housing concerns and lacking a regular provider should be addressed to promote mammography uptake. Future research should provide social assessment and address social obstacles in a randomized controlled setting to confirm the efficacy of social determinant approaches to improve mammography use.
Exposure to case management was associated with regular Pap smear screening among women who recently engaged in screening. Future research should focus on systems changes to address social determinants of health, including strategies to facilitate screening for Black women without social support for childcare. To improve follow-up of abnormal results, financial access to care should be addressed.
Primary care sites with EMRs better document mammography use than those with paper records. Patient self-report of mammography screening is more accurate at sites with EMRs. Broader access to EMRs should be implemented to improve quality of documenting mammography use. At a minimum, quality improvement efforts should confirm the accuracy of paper records with supplemental data.
In 2017, the National 4-H professional research, knowledge, and competencies (PRKC) taxonomy was updated reflecting the current needs of 4-H youth development professionals. Knowledge and skill gaps of 4-H professionals need to be identified to optimize resource allocation for professional development on the state and regional level. We developed a web-based self-assessment of the PRKC tool using Qualtrics, that evaluated the core competencies across the 6 PRKC domains: (a) youth development; (b) youth program development; (c) volunteerism; (d) equity, access, and opportunity; (e) partnerships; and (f) organizational systems. The responses from 188 Extension 4-H professionals (approximately a quarter of the 4-H Extension professionals in the Northeast region) were analyzed to (a) identify the knowledge and skills gaps in competencies within 6 domains, and (b) provide suggestions for professional development that would be of value to each state or region, based on the aggregate data. The results show respondents perceived their personal knowledge, skills, and competencies highest in the domains of access, equity, and opportunity and organizational systems. The domains with the lowest perceived personal effectiveness were youth program development and volunteerism. Not surprisingly, the aggregate results indicate that respondents with a greater number of years of experience in Extension reported higher competency in three domains (youth program development, volunteerism, and organizational systems). This tool can be utilized by Extension at any level to better understand the needs of the 4-H professional workforce. Results can aid the design of professional development opportunities to meet the knowledge and skill gaps identified among respondents.
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