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Cancer prevention in rural primary care. An academic-practice partnership.

BACKGROUND: Cancer screening rates are particularly low among poor, minority, and rural women, those segments of the population with the highest cancer mortality risk. Therefore, targeted strategies to increase screening in these population groups are needed. METHODS: This paper describes a partnership between the University of Alabama at Birmingham (UAB) and Family HealthCare of Alabama, a nonprofit health care agency, initiated to promote cancer control and prevention in a predominantly low-income, African-American population in rural western Alabama. The partnership has collaborated in the development of two research proposals designed specifically to evaluate cancer control strategies within the context of routine health care delivery. RESULTS: The UAB/Family HealthCare partnership is conducting two randomized treatment outcome studies funded by the National Cancer Institute to evaluate theory-based patient management strategies to promote patient adherence to screening recommendations for cervical cancer and breast cancer. CONCLUSIONS: The success of this academic-practice partnership can be seen in the funded research projects, the enhancement of preventive services in rural primary care, and in the potential to disseminate theory-based cancer control strategies throughout an extended primary care network.

Academic Medical Centers↗

The North Carolina experiment: academia-practice partnerships.

Bringing academia and public health practice closer is a major challenge to the field. The Institute of Medicine's report, The Future of Public Health, emphasizes the need for practice scholarship and closer relationships between schools of public health and the practice arena. However, little has been written on the "how to" of developing these partnerships. This article describes four approaches utilized by the North Carolina Institute for Public Health for sustainable partnerships. Each approach is depicted along with its strengths and weaknesses identified. Characteristics of the approaches are described as well as being depicted by diagrams. A time context for each approach suggests the type of events for which the approach works. Culture and requirements of the respective partners' organization must be taken into consideration in utilizing any of the approaches. Some events in the practice setting cannot wait for an academia calendar. Therefore, all successful partnerships approach must be built on realistic expectation and trust.

Cooperative Behavior↗

Creating a practice partnership: a clinical application of case management.

Using the framework of case management, a team partnership was developed for the head and neck surgery population undergoing reconstruction with free tissue transfers ("free flaps"). The focus of the partnership was to improve care coordination from surgery scheduling through discharge. Practice agreements were negotiated, pre-printed on a clinical path, and further supported by pre-printed physician's orders, teaching materials, and a variance tracking tool. In the 6 months since implementing this partnership, patients have recovered more quickly, reducing length of stay by 25% and costs by 15% to 20%.

Case Management↗

Seven habits of highly effective global public-private health partnerships: practice and potential.

Global public-private health partnerships (GHPs) have become an established mechanism of global health governance. Sufficient evaluations have now been conducted to justify an assessment of their strengths and weaknesses. This paper outlines seven contributions made by GHPs to tackling diseases of poverty. It then identifies seven habits many GHPs practice that result in sub-optimal performance and negative externalities. These are skewing national priorities by imposing external ones; depriving specific stakeholders a voice in decision-making; inadequate governance practices; misguided assumptions of the efficiency of the public and private sectors; insufficient resources to implement partnership activities and pay for alliance costs; wasting resources through inadequate use of recipient country systems and poor harmonisation; and inappropriate incentives for staff engaging in partnerships. The analysis highlights areas where reforms are desirable and concludes by presenting seven actions that would assist GHPs to adopt better habits which, it is hoped, would make them highly effective and bring about better health in the developing world.

Cooperative Behavior↗