Table 2.
Program Name | Priority Population and Strength of Effect | Logic Model of the Problem: Health, Behavior, Determinants | Organizational Fit (Resources) | Adaptations Needed? |
---|---|---|---|---|
Breast Cancer Screening among Nonadherent Women (Lipkus et al., 2000) |
Good: Females age 40+; African American and White Un- or under-screened Non-compliant HMO members Good: Intervention Impact 3.5 |
Good: Targets breast cancer; mammography, and most barriers. Does not target fear of abandonment if cancer is discovered. Although, most barriers are covered, does not include local language or detail. Does not target the specific behavior of appointment keeping once an appointment is made. | Excellent: Phone based counseling program; One call per patient; Average call time 6 minutes. Fits with organizational assessment. Original implementation by research staff rather than clinic staff. |
Add appointment keeping as specific behavior. Streamline implementation to adjust to clinical setting. Edit barrier scripts to include specific local barriers, language and detail. Develop communication training to help clinic staff (rather than research staff hold natural conversations on the telephone while still eliciting and addressing specific barriers. |
The Forsyth County Cancer Screening Project (FoCaS) (Paskett, 1999) |
Good: Females age 40+ African American Medically underserved Moderate: Intervention Impact 2.0 |
Good: Breast cancer, mammography, targets fear barriers and faith. Also, environmental change not relevant to logic model of the problem |
Poor: Resource intensive clinic and community outreach (e.g., monthly classes, parties, and one-to-one) Also, physician behavior change (increasing referrals) is part of the program and not possible in current project |
NA. Intervention is not a good fit based on community outreach vs. clinical implementation. |
Friend to Friend (Slater, 1988) |
Good: Females ages 40+ African American, Hispanic, White Medically underserved Excellent: Intervention Impact 4.35 |
Good: Breast cancer, mammography, social networks, peer pressure, social support, modeling. Most of the barriers targeted do not match the logic model of the problem (physician recommendation, age, no family history, fear of radiation). | Moderate: Requires community outreach and education and continued outreach by participants | NA. Intervention is not a good fit based on community outreach vs clinical implementation. |
Witness Project (Erwin, 1999) |
Moderate: Females ages 19+ African American Medically underserved Moderate: Intervention Impact 3.0 |
Good: Breast Cancer, Mammography, modeling, social support. Targets fear related barriers. Other barriers targeted are context specific and depend on the experience of the women serving as witnesses. | Poor: Requires site visits, 8 hours of training followed by program sessions conducted in local churches. | NA. Program is not a good fit based on community outreach vs. clinical implementation. |