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: A multisite federally qualified health center used a Failure Modes and Effects Analysis to identify and correct potential challenges to the implementation of the proactive office encounter model. This model is designed to proactively identify and close preventive care gaps through electronic medical record use, new workflows, and staff training.

Introduction: Appalachian Kentucky is recognized for elevated rates of cervical cancer, which exerts an undue burden in this medically underserved region. The purpose of this study was to examine the impact of an academic-community partnership, specifically a regional health department and a CDC Prevention Research Center, in conducting outreach aimed at improving Pap testing rates and examining barriers among under-screened women in Appalachian Kentucky. Differences between women with abnormal and negative results were also examined., Methods: The Prevention Research Center provided technical assistance to the district health department that, in turn, hosted "Women's Health Day" events at county health departments, providing incentives to women who had never had a Pap test or those who had not received one in at least 3 years to receive guideline-recommended screening., Results: From 2011 to 2014, 317 women were screened for cervical cancer; data were analyzed in 2014. The mean age was 42.1 (SD=13.6) years. More than half (54.5%) of the sample reported high school as their highest level of education, and 57.7% had an annual household income of <$25,000. The most commonly reported barriers to Pap testing were cost (28.4%) and lack of a perceived need for screening (25.6%). Approximately one in five (21.7%) women received abnormal Pap results., Conclusions: As a result of this community-academic public health partnership and its shared resources, Appalachian Kentucky women received needed cervical cancer screening and appropriate follow-up for abnormal results, thereby increasing this population's compliance with guideline-recommended screening., (Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Objective: Innovative screening methods such as self-testing for human papillomavirus (HPV) may alleviate barriers to cervical cancer screening. The purpose of this exploratory study was to determine whether Appalachian Kentucky women would be amenable to self-collecting a cervico-vaginal specimen for HPV testing., Methods: Women aged 30-64 who were overdue for guideline-recommended cervical cancer screening were recruited from a primary care clinic in southeastern Kentucky. The women were asked to self-collect a specimen, using a cervico-vaginal brush, based on verbal and printed directions provided by a research nurse. All study participants, regardless of laboratory-confirmed HPV status, received the same counseling on the importance of cervical cancer screening and offered navigation to follow-up Pap testing at the local health department., Results: Thirty-one women were approached and recruited to participate in the study, indicating a 100% acceptance rate of HPV self-testing. Of the 31 women, 26 tested negative for high-risk HPV and five tested positive. All of the women with negative results declined nurse navigation to Pap testing, whereas four of the five women with positive results accepted nurse navigation and received subsequent Pap smear screenings (all results were normal)., Conclusions: Among this sample of Appalachian Kentucky women, self-collecting a cervico-vaginal specimen for HPV testing was highly acceptable. This exploratory study provides impetus for larger studies among high-risk, medically underserved women in rural communities. Tailoring alternative cancer screening strategies to meet the complex needs of rural women is likely to lead to reductions in cervical cancer incidence and mortality among this vulnerable population., (Copyright © 2013 Elsevier Inc. All rights reserved.)