BACKGROUND: Achieving @entity5 early-detection goals remains a challenge, especially among @entity258 and minority populations. DESIGN/SETTING: A randomized trial based in 62 community health centers for the underserved in New York, New Jersey, and western Connecticut. Family physicians were on staff at most of the centers. INTERVENTION: Workshops, materials, and ongoing advice for center leaders promoted implementation of a preventive services office system to identify @entity1 in need of services at each visit through use of medical record flow sheets, other tools, and staff involvement. EVALUATION END POINTS: The proportion of randomly selected @entity1 by center who were up to date for indicated services at baseline (n = 2645) and follow-up (n = 2864) record review. RESULTS: Only 1 service (breast self-examination advice) increased more in intervention centers. Seven of 8 target services increased significantly for the 62 centers overall. During the study, the medical director changed in 26 centers (42%). Keeping the same medical director at intervention centers was associated with improvements in services. CONCLUSIONS: @entity5 early-detection services are improving in community health centers, but the intervention had only a small impact, as determined by record review. To have an impact, the intervention required that there be no change in medical director. The relationship of changes in the practice environment to services delivered is complex and deserves more study.

XXXX early-detection services in community health centers for the underserved. A randomized controlled trial.

@entity5 :: ('MESH:D009369', 'Disease') :: ['Cancer', 'cancer'] @entity1 :: ('9606', 'Species') :: ['patients'] @entity258 :: ('MESH:D009800', 'Disease') :: ['low-income']
@entity5 :: (MESH:D009369,Disease) :: ['Cancer']
