Case Study 4: A Time Series Design for a Community-Based Participatory Evaluation

R. Windsor, G. Cutter, and J. Kronenfeld, et al., “Increasing Utilization of Rural Cervical Cancer Detection Program.” American Journal of Public Health (June 1981), 641-643 (see publication for references).

Background and Objectives

The Alabama Department of Public Health established a Cervical Cancer Screening Program (CSP), initially with NCI support, to remove barriers to service availability, accessibility, acceptability, and cost in local rural communities. The CSP was designed to increase service use by women who have never used the program. A “Practice and Community-Based Participatory Research” effort was begun with representatives from the University of Alabama-Birmingham (UAB) public health faculty, Alabama Health Department-CSP program, Cooperative Extension Service, and leadership of 36 women’s groups This group planned and evaluated a rural, county-wide Cervical Cancer Screening and Communications Program.

Our objective was to significantly increase the number of women who had never had a Pap test using the Hale County CSP during the second (Intervention) quarter of year 2 and 3. Eligible CSP residents were predominantly black, poor, and rural, with available but limited access to primary care services. The Hale County program was selected as a demonstration site because it had a large pool of women > 35 years of age (3,500) who had not been screened, was similar to a number of counties in south central Alabama, and was operational for two years.

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