2-1-1 is a nationally designated 3-digit telephone exchange – like 9-1-1 for emergencies or 4-1-1 for directory assistance – that links callers to health and social services in their community. It is often a United Way program operated by state and local systems, in partnership with local public or private agencies. There are 209 active 2-1-1 systems in 41 states and Washington, DC, covering 65% of the U.S. population. Callers are poor and disproportionately women and minorities, and the overwhelming majority are seeking to meet basic human needs such as housing, shelter, electricity, heat, and food.
In 2007, CPCRN’s Washington University Network Center recognized the potential to reach underserved populations and deliver much needed health interventions via 2-1-1, and formed a research partnership with the Missouri 2-1-1 service. Their pilot work revealed not only that 2-1-1 callers were receptive to receiving health interventions via 2-1-1, but also that callers to 2-1-1 had more cancer risk factors and prevention needs than the average person. Compared to state and national averages, callers were more likely to smoke, less likely to have a smoke-free home policy, less likely to have been screened for cancer, and less likely to have health insurance.
In late 2008, building on Washington University’s pilot work, four more CPCRN Network Centers at Harvard, University of North Carolina, University of Texas, and University of Washington ventured to build research partnerships with the 2-1-1 Centers in their states. These efforts led to a broader pilot study implemented in NC, TX, & WA where, like in Washington University’s pilot study, 2-1-1 callers were given a cancer control needs assessment and (based on their results) offered referrals for free and low-cost services. The results of these studies are expected to be published soon.
In late 2009, CPCRN was pleased to participate in the first meeting of the 2-1-1 Consortium, a newly formed group comprised of leaders of 2-1-1 systems and researchers working with 2-1-1’s across the country. This group will publish papers making the case and establishing guidelines for research with 2-1-1.
The preliminary work done by CPCRN’s Network Centers in MO, NC, TX, and WA provided encouraging results about the promising potential of research partnerships with 2-1-1. So, in January of 2010, Emory’s Michelle Kegler led a CPCRN effort to obtain funding from the National Cancer Institute to administer a smoke-free homes intervention via 2-1-1. If funded, this grant will provide funds to coordinate efforts at Emory, Washington University, University of North Carolina, and University of Texas to develop, test, and disseminate the intervention with their local 2-1-1s, and eventually, nationwide.
Following encouraging results of their pilot work with Houston’s 2-1-1, Maria Fernandez led an effort at the University of Texas to obtain funding to further their research partnership with 2-1-1. In March 2010, Dr. Fernandez received a $961,021 grant from the Cancer Prevention and Research Institute of Texas to build on their prior work with 2-1-1 and provide a cancer control navigation intervention to increase cancer screening and HPV vaccination. In this study, phone navigators housed at the 211 Gulf Coast and 211 Tip of Texas call centers will provide 2-1-1 callers with counseling and navigation services aimed at meeting their cancer screening and vaccination needs. Using this in-depth approach, University of Texas hopes to increase use of these services among participants who need them by 25%.
CPCRN’s partnership with 2-1-1 has truly blossomed since it was started by Matt Kreuter at Washington University in Saint Louis in 2007. Our Network’s work has demonstrated that not only are 2-1-1 callers in greater than average need for cancer control services and other health care needs, but that they are receptive to receiving health interventions when calling 2-1-1. Our work has also demonstrated that the 2-1-1 system as a whole is receptive to being tapped as a point of health intervention, and that 2-1-1 call centers and CPCRN Network Centers can work together to effectively administer these interventions.
Our work with 2-1-1 and the 2-1-1 Consortium continues to grow and expand. This sort of synergistic research partnership benefits all involved – it gives CPCRN access to a valuable point of intervention with underserved populations, it gives 2-1-1 access to needed resources and the ability to provide more services to its clients, and it gives 2-1-1 callers more and better access to much needed services to protect their health. The Network is excited to continue to nurture this partnership in the coming months and years!