Research Associates - Division of Emergency Medicine

The goal of this study is to examine the outcome of RA assessment of non-urgent patients and their visitors in an urban community hospital ED for their prior compliance with cancer screening recommendations followed by a structured response to screening deficiencies.

RAs serve one 4-hour shift per week in the Emergency Department for an academic semester. They are trained in basic concepts of clinical research, ethical issues of informed consent and confidentiality, ED safety issues and the specifics of the particular studies being conducted. They are case finders, data collectors and facilitators for these studies. As part of their orientation to the spring, summer and fall semesters 2013, RAs at NARAP-institutions will receive instruction on the concepts and importance of cancer screening, particularly those for breast and cervical cancer, within the context of primary health care. They will be taught to implement a scripted screening study protocol.

The following screening characteristics from the U.S. Preventive Services Task Force will be utilized:

1. The USPSTF recommends screening for cervical cancer in women ages 21 to 65 years with cytology (Pap test) every 3 years or, for women ages 30 to 65 years who want to lengthen the screening interval, screening with a combination of cytology and human papillomavirus (HPV) testing every 5 years. This is a Grade A recommendation.
2. The USPSTF recommends biennial screening mammography for women aged 50 to 74 years. This is a Grade B recommendation.

The script the RAs will use for the study will be embedded in the Research Electronic Data Capture (REDCap) system for display on the computer carried into the room by the RA.

The following data will be collected for all participants:

• age, gender and ethnicity.
• their status with primary care and OB-Gyn access and last visits.
• the timing of their prior cervical cancer and, if applicable, breast cancer screening.

All participants will receive:

• a statement regarding the research.
• the results of their screening.
• a fact sheet advising them of the USPSTF guidelines appropriate to them for cancer screening.

If there are deficiencies in their compliance with cancer screening, specific instructions for how to access these screenings at the particular institution will be given to the participant. At twenty-seven to thirty days from their ED visits, those participants with identified deficiencies will be called by an RA and asked whether they have had identified overdue primary care visit and/or cancer screening a) performed or b) scheduled and their reactions to the research procedures. For this follow-up portion of the study, a written consent will be obtained.

The data from the results of the screening will be analyzed and presented within the strictures of a convenience sample.