Economic Evaluation of Interventions to Increase Colorectal Cancer Screening at Federally Qualified Health Centers.

The Centers for Disease Control and Prevention (CDC) has a long-standing commitment to increase colorectal cancer (CRC) screening for vulnerable populations. In 2005, the CDC began a demonstration in five states and, with lessons learned, launched a national program, the Colorectal Cancer Control Program (CRCCP), in 2009. The CRCCP continues today and its current emphasis is the implementation of evidence-based interventions to promote CRC screening.

The effect of delivery structure on costs, screening and health promotional services in state level National Breast and Cervical Cancer Early Detection Programs.

Purpose: We estimated the costs and effectiveness of state programs in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) based on the type of delivery structure.

Methods: Programs were classified into three delivery structures: (1) centralized, (2) decentralized, and (3) mixed. Centralized programs offer clinical services in satellite offices, but all other program activities are performed centrally.

Awardee-specific economic costs of providing cancer screening and health promotional services to medically underserved women eligible in the National Breast and Cervical Cancer Early Detection Program.

Objectives: To estimate awardee-specific costs of delivering breast and cervical cancer screening services in their jurisdiction and to assess potential variation in the cost of key activities across awardees.

Methods: We developed the cost assessment tool to collect resource use and cost data from the National Breast and Cervical Cancer Early Detection Program awardees for 3 years between 2006 and 2010 and generated activity-based cost estimates. We estimated awardee-specific cost per woman served for all activities, clinical screening delivery services, screening promotion interventions, and overarching program support activities.

Centers for Disease Control and Prevention's National Breast and Cervical Cancer Early Detection Program: Increasing Access to Screening.

The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides breast and cervical cancer screening and diagnostic services to low-income, uninsured, and underinsured women across the nation. Although the program has provided services to more than 5 million women since 1991, there remains a significant burden of breast and cervical cancer with inequities among certain populations. To reduce this burden and improve health equity, the NBCCEDP is expanding its scope to include population-based strategies to increase screening in health systems and communities through the implementation of patient and provider evidence-based interventions, connecting women in communities to clinical services, increasing opportunities to access screening, and enhancing the targeting of women in need of services.

Identifying optimal approaches to scale up colorectal cancer screening: an overview of the centers for disease control and prevention (CDC)'s learning laboratory.

Use of recommended screening tests can reduce new colorectal cancers (CRC) and deaths, but screening uptake is suboptimal in the United States (U.S.).

A conceptual framework and metrics for evaluating multicomponent interventions to increase colorectal cancer screening within an organized screening program.

Background: Multicomponent, evidence-based interventions are viewed increasingly as essential for increasing the use of colorectal cancer (CRC) screening to meet national targets. Multicomponent interventions involve complex care pathways and interactions across multiple levels, including the individual, health system, and community.

Methods: The authors developed a framework and identified metrics and data elements to evaluate the implementation processes, effectiveness, and cost effectiveness of multicomponent interventions used in the Centers for Disease Control and Prevention's Colorectal Cancer Control Program.

The history and use of cancer registry data by public health cancer control programs in the United States.

Because cancer registry data provide a census of cancer cases, registry data can be used to: 1) define and monitor cancer incidence at the local, state, and national levels; 2) investigate patterns of cancer treatment; and 3) evaluate the effectiveness of public health efforts to prevent cancer cases and improve cancer survival. The purpose of this article is to provide a broad overview of the history of cancer surveillance programs in the United States, and illustrate the expanding ways in which cancer surveillance data are being made available and contributing to cancer control programs. The article describes the building of the cancer registry infrastructure and the successful coordination of efforts among the 2 federal agencies that support cancer registry programs, the Centers for Disease Control and Prevention and the National Cancer Institute, and the North American Association of Central Cancer Registries.

CDC Grand Rounds: the future of cancer screening.

Cancer is the second leading cause of death in the United States, with 52% of deaths caused by cancers of the lung and bronchus, female breast, uterine cervix, colon and rectum, oral cavity and pharynx, prostate, and skin (melanoma). In the 1930s, uterine cancer, including cancer of the uterine cervix, was the leading cause of cancer deaths among women in the United States. With the advent of the Papanicolaou (Pap) test in the 1950s to detect cellular level changes in the cervix, cervical cancer death rates declined significantly.

Preventing premature deaths from breast and cervical cancer among underserved women in the United States: insights gained from a national cancer screening program.

This commentary highlights some of the valuable insights gained from a special collection of papers that utilized data from the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and appear in this special issue. The data and experiences of the NBCCEDP can inform the identification of new opportunities and directions for meeting the cancer screening needs of underserved women in a complex and changing health care environment.

Implementation of the National Breast and Cervical Cancer Early Detection Program: the beginning.

In 1990, Congress passed the Breast and Cervical Cancer Mortality Prevention Act because of increases in the number of low-income and uninsured women being diagnosed with breast cancer. This act authorized the Centers for Disease Control and Prevention (CDC) to establish the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) to provide high-quality and timely breast and cervical cancer screening and diagnostic services to low-income, uninsured women. The program started in 1991, and, in 1993, Congress amended the act to allow the CDC to fund American Indian and Alaska Native tribes and tribal organizations.

The Influence of the VERB campaign on children's physical activity in 2002 to 2006.

Objectives: We evaluated physical activity outcomes for children exposed to VERB, a campaign to encourage physical activity in children, across campaign years 2002 to 2006.

Methods: We examined the associations between exposure to VERB and (1) physical activity sessions (free time and organized) and (2) psychosocial outcomes (outcome expectations, self-efficacy, and social influences) for 3 nationally representative cohorts of children. Outcomes among adolescents aged 13 to 17 years (cohort 1, baseline) and children aged 9 to 13 years from cohorts 2 and 3 were analyzed for dose-response effects.

The VERB campaign's strategy for reaching African-American, Hispanic, Asian, and American Indian children and parents.

The VERB campaign promoted physical activity to U.S. children aged 9-13 years (tweens) by surrounding them with appealing messages that were associated with the VERB brand and tag line It's what you do! To maximize the impact of the campaign, VERB had a two-level strategy for its marketing.

The VERB campaign: applying a branding strategy in public health.

A branding strategy was an integral component of the VERB Youth Media Campaign. Branding has a long history in commercial marketing, and recently it has also been applied to public health campaigns. This article describes the process that the CDC undertook to develop a physical activity brand that would resonate with children aged 9-13 years (tweens), to launch an unknown brand nationally, to build the brand's equity, and to protect and maintain the brand's integrity.

It's what you do! Reflections on the VERB campaign.

This article shares the first-hand experiences of the CDC's VERB team in planning, executing, and evaluating a campaign that used social marketing principles, which involved paid media advertising, promotions, and national and community partnerships to increase physical activity among children aged 9-13 years (tweens). VERB staff gained valuable experience in applying commercial marketing techniques to a public health issue. This article describes how marketing, partnership, and evaluation activities were implemented to reach a tween audience.

Evaluation of a national physical activity intervention for children: VERB campaign, 2002-2004.

Background: Amid concern for the consequences of physical inactivity among children, the Centers for Disease Control and Prevention started a campaign using commercial marketing methods to promote physical activity to children.

Design: Longitudinal study using a telephone survey to assess physical activity behaviors and attitudes at baseline and for 2 years of follow-up. Relationships of campaign awareness to behavioral and psychosocial effects were analyzed with use of propensity scoring.

Effects of a mass media campaign to increase physical activity among children: year-1 results of the VERB campaign.

Objective: To determine the effects of a mass media campaign on the levels of physical activity among children 9 to 13 years of age.

Design: A prospective, longitudinal, quasi-experimental design was used. A baseline survey was conducted in April to June 2002, before the launch of VERB advertising.