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.
In the ASAFP program, for example, the social worker and peer counselor frequently struggle with what takes precedence among their competing ethical responsibilities: meeting the needs that are identified for each of the program's clients (who may not all be equally needy); dealing with expectations for a limited and cost-effective intervention or facing elimination of set-Ace; and directing the necessary time and effort to the most needy or most serious problems, even when this is "expensive.
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.