Development and first application of an audit system for screening programs based on the PRECEDE-PROCEED model: an experience with breast cancer screening in the region of Lombardy (Italy).

Gruppo PRECEDE-PROCEED

Research output: Contribution to journalArticlepeer-review

Abstract

Background: High participation and performance are necessary conditions for the effectiveness of breast cancer screening programs. Here we describe the process to define and test a planning software application and an audit cycle based on the PRECEDE-PROCEED model applied to improving breast cancer screening. We developed a planning software application following the phases of the PRECEDE-PROCEED model. The application was co-designed by local cancer screening program coordinators. An audit model was also developed. The revised application and the audit model were tested by all the coordinators of 15 breast cancer screening programs in the region of Lombardy in a 3-day workshop. The project plans produced using the application were compared with those produced in the previous year for clarity and completeness. Results: The 9 phases of the PRECEDE-PROCEED model were adapted to screening as follows: 1) identification of program goals (i.e., participation, sensitivity, false positive); 2) epidemiological issues; 3) best practices analysis; 4) evidence-based actions to be implemented in the screening center and the relationships with partners and stakeholders; 5) priority setting and identification of solutions for each issue; 6) definition of indicators; 7) monitoring; 8) evaluation; 9) impact assessment. The application automatically generated reports for each phase. During the audit cycle, the regional health authority negotiated the targets to be reached with local authorities and collected the improvement plans generated by the application. The plans produced after the application was adopted were more standardized and had clearer indicators for monitoring and evaluation compared to those produced in the previous year. Conclusions: The software application helps standardize criteria for planning interventions to improve screening programs and facilitates the implementation of the audit cycle.

Original languageEnglish
Article number1778
JournalBMC Public Health
Volume20
Issue number1
DOIs
Publication statusPublished - Dec 2020

Keywords

  • Breast cancer
  • Health intervention planning
  • Mass screening
  • PRECEDE-PROCEED model, audit

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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