Gregory-Mercado Karen Y, Will Julie, True Susan, Royalty Janet, Starcher E Thomas, Khavjou Olga, Helsel William, Kammerer William, Howe William
Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Prev Chronic Dis. 2007 Oct;4(4):A89. Epub 2007 Sep 15.
Integrating one or more public health programs may improve the ability of programs to achieve common goals. Expanding knowledge on how program integration occurs, how it benefits each individual program, and how it contributes to the achievement of common goals is an important area of inquiry in public health.
The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and the Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) program combined data from 10 of their overlapping state or tribal programs to calculate prevalence estimates of repeat mammography at 18 months. The data were stratified by whether women attended the combined program or only the NBCCEDP. Logistic regression analyses were conducted to identify factors that were thought to independently contribute to a greater likelihood of a woman receiving a repeat mammogram.
Women who participated in both programs were 1.5 to 5.1 times as likely to be rescreened, depending on program location, as women who participated only in the NBCCEDP. WISEWOMAN participants who received a follow-up WISEWOMAN screening for chronic disease risk factors within a year of their initial WISEWOMAN screening were 5 times more likely to return for a follow-up mammogram through the NBCCEDP than were WISEWOMAN participants who did not.
Participation in both the NBCCEDP and the WISEWOMAN program is associated with a greater likelihood of a woman returning for a follow-up mammogram within 18 months of her initial examination. Collecting more in-depth information on motivational factors and on the association between receipt of multiple services and a woman's engagement in a health program should be the subject of future research.
整合一个或多个公共卫生项目可能会提高这些项目实现共同目标的能力。拓展关于项目整合如何发生、如何使每个单独项目受益以及如何有助于实现共同目标的知识，是公共卫生领域一个重要的研究方向。
国家乳腺癌和宫颈癌早期检测项目（NBCCEDP）与全国妇女综合筛查与评估项目（WISEWOMAN）合并了10个重叠的州或部落项目的数据，以计算18个月时重复乳腺钼靶检查的患病率估计值。数据按女性是参加了合并项目还是仅参加了NBCCEDP进行分层。进行逻辑回归分析，以确定那些被认为独立促使女性更有可能接受重复乳腺钼靶检查的因素。
根据项目地点不同，同时参加两个项目的女性接受再次筛查的可能性是仅参加NBCCEDP的女性的1.5至5.1倍。在首次WISEWOMAN筛查后一年内接受WISEWOMAN慢性病风险因素后续筛查的WISEWOMAN参与者，通过NBCCEDP进行后续乳腺钼靶检查的可能性是未接受后续筛查的WISEWOMAN参与者的5倍。
参加NBCCEDP和WISEWOMAN项目都与女性在初次检查后18个月内返回接受后续乳腺钼靶检查的可能性增加有关。收集关于动机因素以及接受多种服务与女性参与健康项目之间关联的更深入信息，应是未来研究的主题。
