***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES We conducted a trial to evaluate the effectiveness of a cervical cancer control intervention for Vietnamese American women that used lay health workers . METHODS The study group included 234 women who had not received a Papanicolaou ( Pap ) test in the last 3 years . Experimental group participants received a lay health worker home visit . Our trial endpoint was Pap test receipt within 6 months of r and omization . Pap testing completion was ascertained through women 's self-reports and medical record review s. We examined intervention effects among women who had ever received a Pap test ( prior to r and omization ) and women who had never received a Pap test . RESULTS Three quarters of the women in the experimental group completed a home visit . Ever-screened experimental group women were significantly more likely to report Pap testing ( P < .02 ) and to have records verifying Pap testing ( P < .04 ) than were ever-screened control group women . There were no significant differences between the trial arms for women who had never been screened . CONCLUSIONS Our findings indicate that lay health worker-based interventions for Vietnamese American women are feasible to implement and can increase levels of Pap testing use among ever-screened women but not among never-screened women Despite free colorectal cancer screening in France , participation remains low and low socioeconomic status is associated with a low participation . Our aim was to assess the effect of a screening navigation program on participation and the reduction in social inequalities in a national-level organized mass screening program for colorectal cancer by fecal-occult blood test ( FOBT ) . A multicenter ( 3 French departments ) cluster r and omized controlled trial was conducted over two years . The cluster was a small geographical unit stratified according to a deprivation index and the place of residence . A total of 14,556 subjects ( 72 clusters ) were included in the control arm where the FOBT program involved the usual postal reminders , and 14,373 subjects ( 66 clusters ) were included in the intervention arm . Intervention concerned only non-attended subjects with a phone number available defined as the navigable population . A screening navigator was added to the usual screening organization to identify and eliminate barriers to CRC screening with personalized contact . The participation rate by strata increased in the intervention arm . The increase was greater in affluent strata than in deprived ones . Multivariate analyses demonstrated that the intervention mainly with phone navigation  increased individual participation ( OR=1.19 [ 1.10 , 1.29 ] ) in the navigable population . For such interventions to reduce social inequalities in a country with a national level organized mass screening program , they should first be administered to deprived population s , in accordance with the principle of proportionate universalism . Clinical Trials.gov Identifier : NCT01555450 IMPORTANCE Patient navigation ( PN ) to improve cancer screening in low-income and racial/ethnic minority population s usually focuses on navigating for single cancers in community health center setting s. OBJECTIVE We evaluated PN for breast , cervical , and colorectal cancer screening using a population -based information technology ( IT ) system within a primary care network . DESIGN , SETTING , AND PARTICIPANTS R and omized clinical trial conducted from April 2014 to December 2014 in 18 practice s in an academic primary care network . All patients eligible and overdue for cancer screening were identified and managed using a population -based IT system . Those at high risk for nonadherence with completing screening were identified using an electronic algorithm ( language spoken , number of overdue tests , no-show visit history ) , and r and omized to a PN intervention ( n = 792 ) or usual care ( n = 820 ) . Navigators used the IT system to track patients , contact them , and provide intense outreach to help them complete cancer screening . MAIN OUTCOMES AND MEASURES Mean cancer screening test completion rate over 8-month trial for each eligible patient , with all overdue cancer screening tests combined using linear regression models . Secondary outcomes included the proportion of patients completing any and each overdue cancer screening test . RESULTS Among 1612 patients ( 673 men and 975 women ; median age , 57 years ) , baseline patient characteristics were similar among r and omized groups . Of 792 intervention patients , patient navigators were unable to reach 151 ( 19 % ) , deferred 246 ( 38 % ) ( eg , patient declined , competing comorbidity ) , and navigated 202 ( 32 % ) . The mean proportion of patients who were up to date with screening among all overdue screening examinations was higher in the intervention vs the control group for all cancers combined ( 10.2 % vs 6.8 % ; 95 % CI [ for the difference ] , 1.5%-5.2 % ; P < .001 ) , and for breast ( 14.7 % vs 11.0 % ; 95 % CI , 0.2%-7.3 % ; P = .04 ) , cervical ( 11.1 % vs 5.7 % ; 95 % CI , 0.8%-5.2 % ; P = .002 ) , and colon ( 7.6 % vs 4.6 % ; 95 % CI , 0.8%-5.2 % ; P = .01 ) cancer compared with control . The proportion of overdue patients who completed any cancer screening during follow-up was higher in the intervention group ( 25.5 % vs 17.0 % ; 95 % CI , 4.7%-12.7 % ; P < .001 ) . The intervention group had more patients completing screening for breast ( 23.4 % vs 16.6 % ; 95 % CI , 1.8%-12.0 % ; P = .009 ) , cervical ( 14.4 % vs 8.6 % ; 95 % CI , 1.6%-10.5 % ; P = .007 ) , and colorectal ( 13.7 % vs 7.0 % ; 95 % CI , 3.2%-10.4 % ; P < .001 ) cancer . CONCLUSIONS AND RELEVANCE Patient navigation as part of a population -based IT system significantly increased screening rates for breast , cervical , and colorectal cancer in patients at high risk for nonadherence with testing .  Integrating patient navigation into population health management activities for low-income and racial/ethnic minority patients might improve equity of cancer care . TRIAL REGISTRATION clinical trials.gov Identifier : NCT02553538 Imprisonment provides opportunities for the diagnosis and successful treatment of HIV , however , the benefits of antiretroviral therapy are frequently lost following release due to suboptimal access and utilization of health care and services . In response , some have advocated for development of intensive case-management interventions spanning incarceration and release to support treatment adherence and community re-entry for HIV-infected releasees . We conducted a r and omized controlled trial of a motivational Strengths Model bridging case management intervention ( BCM ) beginning approximately 3 months prior to and continuing 6 months after release versus a st and ard of care prison-administered discharge planning program ( SOC ) for HIV-infected state prison inmates . The primary outcome variable was self-reported access to post-release medical care . Of the 104 inmates enrolled , 89 had at least 1 post-release study visit . Of these , 65.1 % of BCM and 54.4 % of SOC assigned participants attended a routine medical appointment within 4 weeks of release ( P > 0.3 ) . By week 12 post-release , 88.4 % of the BCM arm and 78.3 % of the SOC arm had at attended at least one medical appointment ( P = 0.2 ) , increasing in both arms at week 24–90.7 % with BCM and 89.1 % with SOC ( P > 0.5 ) . No participant without a routine medical visit by week 24 attended an appointment from weeks 24 to 48 . The mean number of clinic visits during the 48 weeks post release was 5.23 ( SD = 3.14 ) for BCM and 4.07 ( SD = 3.20 ) for SOC ( P > 0.5 ) . There were no significant differences between arms in social service utilization and re-incarceration rates were also similar . We found that a case management intervention bridging incarceration and release was no more effective than a less intensive pre-release discharge planning program in supporting health and social service utilization for HIV-infected individuals released from prison OBJECTIVE To assess the impact of health coaching on patients ' in their primary care provider . METHODS R and omized controlled trial comparing health coaching with usual care . PARTICIPANTS Low-income English or Spanish speaking patients age 18 - 75 with poorly controlled type 2 diabetes , hypertension and /or hyperlipidemia . MAIN OUTCOME MEASURE Patient trust in their primary care provider measured by the 11-item Trust in Physician Scale , converted to a 0 - 100 scale . ANALYSIS Linear mixed modeling . RESULTS A total of 441 patients were r and omized to receive 12 months of health coaching ( n=224 ) vs. usual care ( n=217 ) . At baseline , the two groups were similar to those in the usual care group with respect to demographic characteristics and levels of trust in their provider . After 12 months , the mean trust level had increased more in patients receiving health coaching ( 3.9 vs. 1.5 , p=0.47 ) , this difference remained significant after adjustment for number of visits to primary care providers ( adjusted p=.03 ) . CONCLUSIONS Health coaching appears to increase patients trust in their primary care providers . PRACTICE IMPLICATION S Primary care providers should consider adding health coaches to their team as a way to enhance their relationship with their patients OBJECTIVES We compared the effectiveness of a telephone outreach approach versus a direct mail approach in improving rates of colorectal cancer ( CRC ) screening in a predominantly Black population . METHODS A r and omized trial was conducted between 2000 and 2003 that followed 456 participants in the New York metropolitan area who had not had recent CRC screening . The intervention group received tailored telephone outreach , and the control group received mailed printed material s. The primary outcome was medically documented CRC screening 6 months or less after r and omization . RESULTS CRC screening was documented in 61 of 226 ( 27.0 % ) intervention participants and in 14 of 230 ( 6.1 % ) controls ( prevalence rate difference=20.9 % ; 95 % CI = 14.34 , 27.46 ) . Compared with the control group , the intervention group was 4.4 times more likely to receive CRC screening within 6 months of r and omization . CONCLUSIONS Tailored telephone outreach can increase CRC screening in an urban minority population PURPOSE : Awareness of and enrollment in outpatient cardiac rehabilitation ( OCR ) following a cardiac event or procedure remain suboptimal . Thus , it is important to identify new approaches to improve these outcomes . The objectives of this study were to identify ( 1 ) the contributions of a patient navigation ( PN ) intervention and other patient characteristics on OCR awareness ; and ( 2 ) the contributions of OCR awareness and other patient characteristics on OCR enrollment among eligible cardiac patients up to 12 weeks posthospitalization . METHODS : In this r and omized controlled study , 181 eligible and consenting patients were assigned to either PN ( n = 90 ) or usual care ( UC ; n = 91 ) prior to hospital discharge .  Awareness of OCR was assessed by telephone interview at 12 weeks posthospitalization , and OCR enrollment was confirmed by staff at collaborating OCR programs . Of the 181 study participants , 3 died within 1 month of hospital discharge and 147 completed the 12-week telephone interview . RESULTS : Participants in the PN intervention arm were nearly 6 times more likely to have at least some awareness of OCR than UC participants ( OR = 5.99 ; P = .001 ) . Moreover , participants who reported at least some OCR awareness were more than 9 times more likely to enroll in OCR ( OR = 9.27 , P = .034 ) and participants who were married were less likely to enroll ( P = .031 ) . CONCLUSIONS : Lay health advisors have potential to improve awareness of outpatient rehabilitation services among cardiac patients , which , in turn , can yield greater enrollment rates in a program BACKGROUND The study aim ed to determine the effect of preference-based tailored navigation on colorectal cancer ( CRC ) screening adherence and related outcomes among African Americans ( AAs ) . METHODS We conducted a r and omized controlled trial that included 764 AA patients who were age 50 to 75 years , were eligible for CRC screening , and had received care through primary care practice s in Philadelphia . Consented patients completed a baseline telephone survey and were r and omized to either a St and ard Intervention ( SI ) group ( n = 380 ) or a Tailored Navigation Intervention ( TNI ) group ( n = 384 ) . The SI group received a mailed stool blood test kit plus colonoscopy instructions , and a reminder . The TNI group received tailored navigation ( a mailed stool blood test kit or colonoscopy instructions based on preference , plus telephone navigation ) and a reminder . A six-month survey and a 12-month medical records review were completed to assess screening adherence , change in overall screening preference , and perceptions about screening . Multivariable analyses were performed to assess intervention impact on outcomes . RESULTS At six months , adherence in the TNI group was statistically significantly higher than in the SI group ( OR = 2.1 , 95 % 
    Output:
    
Our findings indicate that patient navigator programs improve processes of care , although few studies assessed patient experience , clinical outcomes or costs .