HEALTHTOUCH-COMPUTER-ASSISTED CANCER PREVENTION

THIS STUDY WILL EVALUATE A TOUCH SCREEN PATIENT-INITIATED COMPUTER SYSTEM DESIGNED TO INTEGRATE CANCER AND OTHER ADULT PREVENTIVE SERVICES INTO THE PRIMARY CARE ENVIRONMENT. THE COMPUTER SYSTEM, NAMED HEALTH TOUCH, WAS PREVIOUSLY DEVELOPED BY A WORKING GROUP OPERATING FROM THE DEPARTENT OF FAMILY PRACTICE AT THE MEDICAL COLLEGE OF VIRGINIA. A NUMBER OF PRELIMINARY EVALUATION STUDIES HAVE BEEN CONDUCTED TO SUPPORT THE CURRENT PROPOSAL. TWO VALIDATION STUDIES HAVE BEEN CONDUCTED TO ASSESS THE ACCURACY OF THE PATIENT INFORMATION COLLECTED BY HEALTH TOUCH IN COMPARISON TO PATIENT INFORMATION COLLECTED BY PRIMARY HEALTH CARE PROFESSIONALS. THREE FOCUS GROUPS HAVE BEEN CONDUCTED, USING SUBSTANTIALLY DIFFERENT PATIENT AUDIENCES, TO ASSESS PATIENTS' UNDERSTANDING AND ACCEPTANCE OF THE SYSTEM. EXPERT REVIEW HAS BEEN PROVIDED BY A COMPUTER USER INTERFACE EXPERT. A BASELINE STUDY OF THE RATE OF CONDUCT OF VARIOUS PREVENTIVE PROCEDURES HAS BEEN COMPLETED AT THE PHASE I EVALUATION SITE. ACCORDING TO THE INVESTIGATORS, ASCERTAINING PRIMARY HEALTH CARE PROVIDER'S (PHYSICIANS AND NURSES) AND STAFF'S (RECEPTIONISTS) ACCEPTANCE OF, AND WILLINGNESS TO USE HEALTH TOUCH IS THE NEXT STEP IN THE EVALUATION AND REFINEMENT OF THE SYSTEM. THE ACTIVITIES WILL INCLUDE: (1) INTRODUCING HEALTH TOUCH INTO A BUSY FAMILY PRACTICE (WHICH SERVES 12.000 PATIENTS) IN ORDER TO EVALUATE ITS USE BY PATIENTS, RECEPTIONISTS, NURSES AND PHYSICIANS; (2) IDENTIFYING THE BARRIERS AND FACILITATING FACTORS EXPERIENCED BY CARE PROVIDERS AND OFFICE STAFF; AND (3) MEASURING THE IMPACT OF THE SYSTEM ON THE DELIVERY OF CANCER PREVENTION ACTIVITIES, INCLUDING MAMMOGRAM, BSE, PHYSICIAN BREAST EXAMINATION, PAP SMEARS, FLEXIBLE SIGMOIDOSCOPY, FECAL OCCULT BLOOD TESTS, DIGITAL RECTAL EXAMS, AND ORAL EXAMINATIONS. HEALTY TOUCH WILL BE INTRODUCED INTO THE PRACTICE FOR THREE MONTHS. A SURVEY AND INTERVIEW OF CARE PROVIDERS AND OFFICE STAFF WILL BE CONDUCTED APPROXIMATELY SIX WEEKS INTO THE INTERVENTION TO PROVIDE FORMATIVE INFORMATION. INTERVIEWS AND STAFF SURVEY, CHART AUDIT, AND LOG LABORATORY AUDITS WILL BE PERFORMED POST-INTERVENTION TO PROVIDE SUMMATIVE INFORMATION. STATISTICAL TESTS WILL BE CONDUCTED ON THE CHART AUDIT AND LOG LABORATORY AUDIT DATA TO MAKE TWO COMPARISONS: (1) PATIE