Molina Yamile, San Miguel Cindy, Sanz Stephanie, San Miguel Liliana, Rankin Kristin, Handler Arden
1 University of Illinois at Chicago, Chicago, IL, USA.
2 California Department of Public Health, San Diego, CA, USA.
Health Promot Pract. 2019 Jul;20(4):600-607. doi: 10.1177/1524839918776012. Epub 2018 May 14.
Understanding how safety net programs adapt to systemic health care changes is pivotal for creating feasible recommendations for policy implementation. This study characterizes perspectives of Lead Agency (LA) coordinators of the Illinois Breast and Cervical Cancer Program (IBCCP) in response to sociopolitical changes at state and national levels. Our cross-sectional study included 29 semistructured telephone interviews between December 2015 and January 2016. Respondents indicated some changes in the priority population served, changes in referrals and clinical services, and, a continued commitment to IBCCP. Our findings suggest that IBCCP and other safety net programs will need to be flexible to meet the ongoing needs of historically vulnerable populations in a complex, shifting environment. Implications for public health practice and policy include the need to ensure that program personnel are aware of evidence-based strategies to reach different priority populations and are kept abreast of organizational and system changes that may affect referral patterns as well as the need to educate health care providers working with safety net programs about changes in the delivery and coordination of services.
了解安全网计划如何适应系统性医疗保健变革，对于制定可行的政策实施建议至关重要。本研究描述了伊利诺伊州乳腺癌和宫颈癌计划（IBCCP）牵头机构（LA）协调员针对州和国家层面社会政治变革的观点。我们的横断面研究在2015年12月至2016年1月期间进行了29次半结构化电话访谈。受访者指出了所服务的优先人群的一些变化、转诊和临床服务的变化，以及对IBCCP的持续承诺。我们的研究结果表明，IBCCP和其他安全网计划需要保持灵活性，以满足历史上弱势群体在复杂多变环境中的持续需求。对公共卫生实践和政策的启示包括，需要确保项目人员了解针对不同优先人群的循证策略，并及时了解可能影响转诊模式的组织和系统变化，以及需要对参与安全网计划的医疗保健提供者进行服务提供和协调方面变化的教育。
