Final report on evaluation results for OPEL Grant # 96-N-16. Evaluation of village-based women's preventive health services by community health aides/practitioners.

This study was to evaluate two related pilot project initiatives recently implemented to increase the prevalence of cervical and breast cancer screening and STD screening, and reduce tobacco use among Native women in isolated villages in Southwest rural Alaska through Community Health Aids/Practitioners (CHA/Ps) in village-based clinics. The Yukon Kuskokwim Health Corporation (YKHC) conducted the long term, comprehensive evaluation to determine if this the largest health corporation in rural Alaska, should expand its village-based preventive health care services through training of all CHA/Ps in the region with additional community health education. Approximately 1400 women over 18 years of age, predominantly Yupik Eskimo, in eight remote village communities served by YKHC were screened to address the important implication of unmet medical needs in rural communities. The evaluation of the pilot project included: 1) comparison of screening rates in the intervention and control villages by CHA/P personnel for; Pap Smears, breast exams, STDs, tobacco education; assessment of quality of Pap Smears and cervical cancer screening services provided by CHA/Ps; 2) consumer satisfaction survey of selective services provided by CHA/Ps as compared to other health care providers; and 3) evaluation of effectiveness of community health education intervention. The evaluation extended for 18 months after initial health aide training to address the impact and feasibility of sustaining the initiatives. The findings of the study address the objectives of the Alaska Area to increase cancer prevention and screening and reduce morbidity and mortality from lung, breast and cervical cancer. The data collected by the project initiatives and the positive outcomes of this evaluation demonstrated that it was feasible to increase accessibility to selected health services for women in the Y-K Delta by providing a carefully planned advanced training and ongoing program support. This project promoted quality preventive health care services and community education efforts in villages.