Promoting Positive Health Behaviors

Improving female preventive health care delivery
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Breast cancer and cervical screening remains relatively low in Nebraska primary care despite the awareness in the importance of the exercise and the implementation of Every Woman Matters program which assists women in the low-income bracket. GAPS model was used to identify the barriers and to improve breast and cervical cancer screening services delivery. The GAPS model is a practice-based intervention (Backer et al., 2005).
Prior to the implementation of GAPS, the Every Woman Matters Program was solely responsible for helping low income earning women access the screening services. EWM is a state-run program targeted at raising awareness of the risk of breast and cervical cancer and making screening more financially accessible to low income women between the ages of 40 and 64. Women below the age of 40 and beyond the age of 64 are not eligible for the program. Qualified women get breast examination services, Papanicolaou smear test and mammography services at a subsidized or no cost. Other services available such as heart and diabetes screening go beyond the scope of this paper (Schwartz et al., 2010).
Enrolling for the program is moderately easy. Women willing to participate in the program contact Every Woman Matters for enrollment; alternatively, they can contact a doctor as many doctors are part of the program. However, even with the program being accessible, breast and cervical cancer screening fall below the expected levels (DHHS Internet Website).
Several attempts that have been made to improve preemptive services delivery have only given meager improvement; interventions that alter the physician’s practice have only shown modest achievement. Reviews show the practice as a complex system and calls for more effective strategies to assist the entire practice initiate change. Behavioral change encompasses a large team including the clinician and staff. It also requires flexibility and willingness to change based on personalized methods of intervention and a system’s unique pattern. The GAPS model for preventive health care is built on these concepts (Roos 2012). Of the seven methods that were carried out on the GAPS model, two of them were most successful; practice 1 and 7.
Practice 1: In this practice, a single provider was building a financial base for patients. The physician was not prevention oriented but his wife, as the office manager, saw an opportunity to provide a service that would generate more income and encourage patients to return for free advice as well as care.
The goals of the project were: 1. Develop a chart for the staff to easily identify those in need of the care. 2. Develop a card for patients who had screening tests elsewhere to have the results sent back to the hospital. 3. Increase awareness by making information more readily available. 4. Create a reminder list for patients in need of the service of screening.
The program’s success was due to the following reasons. The staff involved worked closely and as a team and progressed on all their plans. The chart increased documentation of patients significantly; 67.4 to 76.9% and 25% to 38.9% for Papanicolaou smears and mammograms r...