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Preventing Chronic Disease: Public Health Research, Practice and Policy

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Emerging Infectious Diseases Journal


Volume 7: No. 3, May 2010

Developing Partnerships to Reduce Disparities in Cancer Screening

This figure shows the 5 phases of the Team Up pilot program, grouped as follows: Phases 1 through 4 are program activities. Phase 5 is evaluation activities. The phases are identified as 1) development, 2) partnership formation and building, 3) capacity building, 4) implementation of evidence-based strategies, and 5) process, impact, and outcome evaluation. A timeline that runs horizontally below the figure shows that the pilot project began in mid-2003 and ended at the end of 2007.

Figure 1. Team Up: Pilot program (2001-2007) and evaluation (2003-2008) phases.

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This figure depicts the structural framework of the Team Up partnership. National partners are listed horizontally across the top: American Cancer Society (ACS), Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the United States Department of Agriculture (USDA). In the next row, state and county partners from Alabama, Georgia, Kentucky, Missouri, South Carolina, and Tennessee appear at the left. The row consists of the Division of Cancer Control local staff (under ACS), the National Breast and Cervical Cancer Early Detection Program outreach workers and educators (under CDC), the Cancer Information Service Partnership Program (under NCI), and the Cooperative State Research, Education, and Extension Service agents (under USDA). The final row, headed target population, consists of women who have rarely or never been screened for cervical or breast cancer. Horizontal and vertical arrows indicate reciprocal relationship between all partners.

Figure 2. Structural framework of Team Up partnership.
Abbreviations: ACS, American Cancer Society; AL, Alabama; CDC, Centers for Disease Control and Prevention; GA, Georgia; KY, Kentucky; MO, Missouri; NCI, National Cancer Institute; SC, South Carolina; TN, Tennessee; USDA, United States Department of Agriculture.

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This figure is titled “Team Up evaluation organizational framework.” There are 3 rows headed, from top to bottom, process, impact, and outcome. Items in the first row are partnership formation, partnership function, partnership synergy, and partnership effectiveness. Items in the second row are current intervention use, select EBI, adapt EBI, and implement EBI use. The third row has 2 components: to the left, current screening of never/rarely, and on the far right, increase screening of never/rarely. A timeline runs horizontally below, showing that the pilot was launched in the first quarter of 2003 and concluded at the end of 2007. Arrows in each row point from the first item in each row to the next, until the last item. Under the item partnership synergy, 4 arrows point to items in the next row: select EBI, adapt EBI, and implement EBI use. EBI is an abbreviation for evidence-based intervention.

The legend defines partnership synergy and evidence-based intervention. The legend says:

  1. Partnership synergy is a collaborative process that enables a group of people and organizations to combine complementary knowledge, skills, and resources to accomplish more as a group than as individuals (Lasker and Weiss, 2003). The Lasker and Weiss Partnership Self-Assessment Tool identifies a partnership’s strengths and weaknesses in areas known to be related to synergy: leadership, efficiency, administration and management, and sufficiency of resources. Response categories are based on 5-point Likert scales (extremely well [5] to not at all well [1]; excellent [5] to poor [1]; all of what it needs [5] to none of what it needs [1]). Overall synergy results are based on a compilation of definitive questions with the resulting categorical scores: Danger Zone (1.0-2.9) requires a lot of improvement; Work Zone (3.0-3.9) requires effort to maximize the partnership’s collaborative potential; Headway Zone (4.0-4.5) encourages greater potential to progress further; and Target Zone (4.6-5.0) requires focus to maintain a synergistic partnership (
  2. EBI: Evidence-based intervention. The term “evidence-based intervention” refers to an intervention that has been tested through randomly controlled experiments with efficacious results that have been published in peer-reviewed journals ( ADDGS_Evidence_Based_FAQ.doc).

Figure 3. Team Up evaluation organizational framework.

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The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.


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