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The ASAFP is guided by a multi-causal theoretical model in which health care outcomes are seen as a product of the interactions among the patient, provider, and health care process.
ASAFP services are provided by a professional team comprised of a peer counselor and an MSW (bilingual or bicultural when indicated and possible) for a period of one year following the index abnormal mammogram or PAP smear.
The MSW trains and supervises the peer counselor (who provides the bulk of the direct service) and also has to achieve and maintain integration of the ASAFP with screening and treatment providers.
Within the BCCEDP's medically underserved population of women, ASAFP serves women with abnormal screens, 5%-10% of all women screened.
However, as illustrated earlier in the ASAFP, evidence suggests that serious mental, social, and system difficulties frequently lie behind noncompliance and nonadherence.
For example, in ASAFP the peer counselor, using a scripted interview, accomplishes risk assessment and health education in the initial telephone contact with a woman.
The ASAFP is such a hybrid, combining a proven efficacious health education intervention (Lerman et al., 1992) and systems navigation (Freeman, Muth, & Kerner, 1995) with traditional elements of social work practice.
ASAFP exemplifies this integration in the primary care setting.
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