Effectiveness of Academic Detailing on Breast Cancer Screening among Primary Care Physicians in an Underserved Community

Gorin, Sherri Sheinfeld; Ashford, Alfred R.; Lantigua, Rafael; Hossain, Ashfaque; Desai, Manisha; Troxel, Andrea B.; Gemson, Donald H.

doi:10.3122/jabfm.19.2.110

Cited by 52 publications

(35 citation statements)

References 58 publications

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“…With regard to 83% of the female respondents willing to undergo BSE if the PHC physician advises it, is in accordance with several studies, suggesting that the primary care physicians can significantly alter the behavior of their patients with regard to regular breast examinations. [3132]…”

Section: Discussionmentioning

confidence: 99%

Knowledge, attitude, and behavior among Saudis toward cancer preventive practice

Ravichandran

Al-Hamdan

Mohamed

2011

J Fam Community Med

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Objective:To examine self-reported knowledge, attitude, and preventive practices on cancer among Saudis.Materials and Methods:Data was collected from Saudis aged 15 years or more, who attended one of the randomly selected 20 Primary Health Centers (PHC) or the four major private hospitals located in the Riyadh region, either as patients or their escorts. The association between the variables was evaluated by the Chi square test.Results:The study population consisted of 618 males and 719 females. Among the female respondents 23.1% reported that they practiced breast self-examination (BSE); 14.2 and 8.1%, respectively, had clinical breast examination (CBE) and mammography. However, 10.0 and 16.1% of the females, aged 40 years and older, reported having had mammograms and CBE, respectively. The BSE performers were more educated, knew someone with cancer, and had heard of the cancer warning signal. Both educational level and ‘heard of cancer warning signal’ were significantly related to CBE. Cancer information was received from television / radio by 65.1% and from the physician by 29.4%. Even though 69.4% believed that cancer could be detected early, a vast majority (95.8%) felt early detection of cancer was extremely desirable and 55.1% said their participation was definite in any screening program. A majority of the respondents (92.6%) insisted on the need for physician recommendation to participate and 78.1% expected that any such program should be conducted in the existing hospitals / clinics.Conclusion:Culturally sensitive health education messages should be tailored to fulfill the knowledge gap among all population strata. Saudis will benefit from partnerships between public health educators and media to speed up the dissemination of cancer information.

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Section: Discussionmentioning

confidence: 99%

Knowledge, attitude, and behavior among Saudis toward cancer preventive practice

Ravichandran

Al-Hamdan

Mohamed

2011

J Fam Community Med

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“…A group randomized implementation trial in 32 primary care practices found a 4.9% (adjusted) increase in CRC screening (colonoscopy, FS, and FOBT) and 7.9% increase in CRC screening recommendation due to an AD with audit and feedback intervention. For breast cancer screening, a randomized block study of 168 primary care physicians found that AD intervention increased recommendation for mammography and practical breast examinations in an urban community [23]. Finally, a randomized controlled trial of 16 practices found that AD with chart audit and feedback was associated with a significant increase in recommendation for and receipt of breast cancer screening in Oklahoma [24].…”

Section: Introductionmentioning

confidence: 99%

Academic detailing to increase colorectal cancer screening by primary care practices in Appalachian Pennsylvania

Curry

Lengerich

Kluhsman

et al. 2011

BMC Health Serv Res

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BackgroundIn the United States, colorectal cancer (CRC) is the third most frequently diagnosed cancer and second leading cause of cancer death. Screening is a primary method to prevent CRC, yet screening remains low in the U.S. and particularly in Appalachian Pennsylvania, a largely rural area with high rates of poverty, limited health care access, and increased CRC incidence and mortality rates. Receiving a physician recommendation for CRC screening is a primary predictor for patient adherence with screening guidelines. One strategy to disseminate practice-oriented interventions is academic detailing (AD), a method that transfers knowledge or methods to physicians, nurses or office staff through the visit(s) of a trained educator. The objective of this study was to determine acceptability and feasibility of AD among primary care practices in rural Appalachian Pennsylvania to increase CRC screening.MethodsA multi-site, practice-based, intervention study with pre- and 6-month post-intervention review of randomly selected medical records, pre- and post-intervention surveys, as well as a post-intervention key informant interview was conducted. The primary outcome was the proportion of patients current with CRC screening recommendations and having received a CRC screening within the past year. Four practices received three separate AD visits to review four different learning modules.ResultsWe reviewed 323 records pre-intervention and 301 post-intervention. The prevalence of being current with screening recommendation was 56% in the pre-intervention, and 60% in the post-intervention (p = 0. 29), while the prevalence of having been screened in the past year increased from 17% to 35% (p < 0.001). Colonoscopies were the most frequently performed screening test. Provider knowledge was improved and AD was reported to be an acceptable intervention for CRC performance improvement by the practices.ConclusionsAD appears to be acceptable and feasible for primary care providers in rural Appalachia. A ceiling effect for CRC screening may have been a factor in no change in overall screening rates. While the study was not designed to test the efficacy of AD on CRC screening rates, our evidence suggests that AD is acceptable and may be efficacious in increasing recent CRC screening rates in Appalachian practices which could be tested through a randomized controlled study.

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“…The fact that the intervention was effective in a population with severe cancer health disparities underscores its importance and potential to greatly effect change. The intervention was delivered using academic detailing, and while there is evidence that academic detailing can be used to increase cancer screening in urban environments (Sheinfield-Gorin et al, 2006), to our knowledge there are no reports of its effectiveness with rural populations, thus indicating the importance of the results of this current study.…”

Section: Discussionmentioning

confidence: 98%

“…Academic detailing is a highly adaptable method of education where physicians are instructed through personal contact with an individual or group focused on a specific topic (Soumerai and Avorn, 1990; Albert et al, 2004; Gorin et al, 2006). This method was selected because of the rural locations of the primary health care providers and their limited time for continuing education.…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of a primary care practice intervention for increasing colorectal cancer screening in Appalachian Kentucky

Dignan

Shelton

Slone

et al. 2014

Preventive Medicine

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Objective This report describes findings from a randomized controlled trial of an intervention to increase colorectal cancer (CRC) screening in primary care practices in Appalachian Kentucky. Methods Sixty-six primary care practices were randomized to early or delayed intervention groups. The intervention was provided at practices using academic detailing, a method of education where providers receive information on a specific topic through personal contact. Data were collected in cross-sectional surveys of medical records at baseline and six months post-intervention. Results A total of 3844 medical records were reviewed at baseline and 3751 at the six-month follow-up. At baselines, colonoscopy was recommended more frequently (43.4%) than any other screening modality, followed by fecal occult blood testing (18.0%), flexible sigmoidoscopy (0.4%), and double-contrast barium enema (0.3%). Rates of documented screening results were higher for all practices at the six-month follow-up for colonoscopy (31.8% vs 29.6%) and fecal occult blood testing (12.2% vs 11.2%). For early intervention practices that recommended screening, colonoscopy rates increased by 15.7% at six months compared to an increase of 2.4% in the delayed intervention practices (p=.01). Conclusions Using academic detailing to reach rural primary care providers with a CRC screening intervention was associated with an increase in colonoscopy.

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Effectiveness of Academic Detailing on Breast Cancer Screening among Primary Care Physicians in an Underserved Community

Cited by 52 publications

References 58 publications

Knowledge, attitude, and behavior among Saudis toward cancer preventive practice

Knowledge, attitude, and behavior among Saudis toward cancer preventive practice

Academic detailing to increase colorectal cancer screening by primary care practices in Appalachian Pennsylvania

Effectiveness of a primary care practice intervention for increasing colorectal cancer screening in Appalachian Kentucky

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