A Project-Based Grant Proposal Thesis to Supplement Existing Efforts to Prevent Cervical Cancer Among Uninsured and Underinsured Women in Northwest Georgia Open Access

Decenteceo, Michelle (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/xp68kh05f?locale=en
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Abstract

The US Preventive Services Task Force (USPSTF) recommends regular cervical cancer screening for women to identify cervical abnormalities early and prevent the spread of cancer. Early detection of cervical cancer has a 5- year survival rate of approximately 92%. If, however, cervical cancer is diagnosed at a late stage, it is more difficult to treat, and the chances of survival substantially decline. The Women of W.O.R.T.H. clinic is a local non-profit dedicated to providing comprehensive reproductive health to women in Northwest Georgia. W.O.R.T.H. stands for Women's Organization for Reproductive and Total Health care. The clinic targets underserved regions in Northwest Georgia, where approximately 10% of women have never been screened for cervical cancer, and about 17% of women have not received screening as recommended on a regular basis. In fact, Northwest Georgia has been identified as one of the top areas with the highest percentage of women diagnosed with cervical cancer at a later stage. This points to the need for greater access to cervical cancer screening and intervention among women in this region. While the Women of W.O.R.T.H. clinic provides family planning and preventive health services, including cervical cancer screening, it can only do so for women who meet certain eligibility criteria. Unfortunately, many do not meet the eligibility criteria, and are unable to access screening in a timely manner. The grant proposal for Project Women are Worth It aims to provide preventive care services to women who are ineligible under the non-profit's existing program with Georgia Medicaid's Planning for Healthy Babies, and to women who are experiencing other difficulties associated with barriers to access.

Table of Contents

Table of Contents

Chapter 1 .................................................................................................................................... 1

Introduction ....................................................................................................................................... 1

Problem Statement ......................................................................................................................................... 1

Detailed Description of the Proposed Program ................................................................................. 2

Purpose Statement ......................................................................................................................................... 3

Objectives to be answered by the Grant Proposal ............................................................................ 3

Significance Statement .................................................................................................................................. 3

Definition of Terms ........................................................................................................................................ 4

Chapter 2 .................................................................................................................................... 6

Overview of the Literature Surrounding Cervical Cancer .................................................. 6

Evidence of Prevention Methods for Cervical Cancer Prevention ............................................. 6

Pap Smears ......................................................................................................................................................... 6

HPV Testing ....................................................................................................................................................... 7

HPV Vaccinations ............................................................................................................................................ 7

Biopsies/ Colposcopies ................................................................................................................................. 8

Well-Woman Visits ......................................................................................................................................... 8

Cervical Cancer and Women of Low SES ............................................................................................... 9

Cervical Cancer and Women of Low SES in Northwest Georgia .............................................. 10

Evidence of Continuity of Care in Any Clinical Setting ................................................................. 13

Overview of General Funding Sources ..................................................................................... 13

Title X- Family Planning ............................................................................................................................ 14

Georgia Planning for Healthy Babies ................................................................................................... 15

Breast and Cervical Cancer Prevention Program ........................................................................... 15

Chapter 3 ................................................................................................................................. 17

Overview of the Agencies That Grant This Type of Work ................................................. 17

Federal Agencies ........................................................................................................................................... 17

Foundations/Charitable Trusts ............................................................................................................. 18

Summary of the Grant Announcement .................................................................................... 19

The Grant Review Process ........................................................................................................... 20

Grant Proposal Reviewers ........................................................................................................... 21

David Westfall, MD, MPH .......................................................................................................................... 21

Bisma Sayed, PhD ......................................................................................................................................... 21

Geetika Arora Klevos, MD ......................................................................................................................... 22

Kanthi Dhaduvai, MD .................................................................................................................................. 22

Anna-Maria Roache, MPH ......................................................................................................................... 22

Chapter Four ........................................................................................................................... 23

Reviewer 1 Comments .................................................................................................................. 23

Reviewer 2 Comments ..................................................................................................................... 24

Reviewer 3 Comments ..................................................................................................................... 28

Reviewer 4 Comments ..................................................................................................................... 28

Reviewer 5 Comments ............................................................................................................................... 29

Chapter 5 ................................................................................................................................. 31

Abstract .............................................................................................................................................. 31

Purpose of Project Women are Worth It ................................................................................ 32

Background and Significance ..................................................................................................... 34

Project Plan ...................................................................................................................................... 38

Project Implementation Timetable with Major Milestones ............................................. 39

Evaluation Plan and Dissemination of Results ..................................................................... 41

Sustainability Plan ......................................................................................................................... 43

Bibliography ........................................................................................................................... 45

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