Proactive Screening for Health Needs in United Way's 2-1-1 Information and Referral Service

Abstract

Cancer disproportionately affects the underserved. United Way 2-1-1 is an information and referral system that links underserved populations to community services. This study explores the feasibility of integrating proactive screening and referral to health services into 2-1-1. A cancer risk assessment was administered to callers (n=297), measuring their need for six cancer control services. A subset of respondents was randomized to receive generic or tailored referrals to needed services. Nearly all participants (85%) needed at least one of the services. Those who received tailored referrals were more likely to make appointments. Future research will explore approaches to address and eliminate health disparities through 2-1-1.

Cancer Control Needs of 2-1-1 Callers in Missouri, North Carolina, Texas, and Washington

“…14 Delivering such interventions through partnerships with social service agencies that reach low-income Americans is a promising strategy. 15 The Federal Collaboration on Health Disparities Research recommends partnering with service agencies in dissemination efforts. 16 One potential partner is 2-1-1 , a telephone information and referral system that serves millions of Americans living in poverty and has well-established processes and infrastructure for assessing their needs and delivering referrals to community resources.…”

“…Callers to 2-1-1 are predominantly women, unemployed, low-income, and where race or ethnicity is reported, disproportionately black or Hispanic relative to the local population. 15 Most callers seek help meeting basic needs such as paying for food, shelter, heating and cooling, or seeking employment. Callers learn about the 2-1-1 service through 2-1-1 's marketing efforts, word-of-mouth from interpersonal sources and other social service agencies, and in some cases from calling established telephone hotlines such as United Way's helplines or aging helplines that have been integrated into the three-digit 2-1-1 exchange.…”

“…The existing literature includes cost-benefit analyses, 18-20 business plans and reports, (e.g., 21,22 ) descriptions of the use of 2-1-1 in disaster management, 23,24 and a pilot study examining integration of cancer control referrals into 2-1-1 systems. 15 The benefits of 2-1-1 include cost savings to states and localities (e.g., less resources spent on calls for services not provided), to callers (e.g., diagnosis of, and help accessing, basic needs), and to taxpayers (e.g., less use of 9-1-1 for non-emergencies). Additionally, 2-1-1 helps with volunteer placement, providing a cost savings to non-profit organizations.…”

Impact of the Cancer Prevention and Control Research Network: Accelerating the Translation of Research Into Practice

“…6 This work was highlighted in a Supplement to the American Journal of Preventive Medicine, “Research Collaboration with 2-1-1 to Eliminate Health Disparities.” 7 Later studies tested interventions among 2-1-1 callers, demonstrating the effectiveness of using proactive referrals and phone navigation to connect callers with cancer control services. 8 In an NCI-funded study, CPCRN researchers developed an intervention to promote smoke-free home policies to 2-1-1 callers and tested it in an initial efficacy trial in Atlanta and two effectiveness trials in North Carolina and Houston; all demonstrated intervention effectiveness, 9 and the intervention is currently being disseminated to 2,410 people at 2-1-1s in Akron, Cleveland, Orlando, Tulsa, and Alabama.…”

The cost of implementing a 2-1-1 call center-based cancer control navigator program

“…A majority of the 2-1-1 calls are from disproportionately low income or minority groups which suffer cancer prevention and treatment disparities (Eddens & Kreuter, 2011). The embedded 2-1-1 cancer prevention program includes a cancer risk assessment to understand the callers' cancer screening or prevention needs, education about cancer screening or prevention, and referrals to affordable and accessible services.…”