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        Emerging Infectious Diseases Journal
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        Volume 5: No. 2, April 2008

        SPECIAL TOPIC
        The WISEWOMAN Program: Reflection and Forecast

        This flow chart consists of four boxes labeled "Who," "What," "How," and "Why." The boxes are connected from left to right by arrows and are accompanied by the following explanations:

        Who: multiple levels of influence ?socioecologic model (15).

        What: innovations and evidence-based programs ? innovative strategies with sound theoretical underpinnings and guides detailing effective programs.

        How: change strategies ?diffusion of innovations theory (24), 5As (25), organization change theories (26), PATCH (27), MATCH (28).

        Why: public health impact and value ?RE (21), RE-AIM (22), and economic theory.

        Figure 1. Organizing framework, WISEWOMAN, United States.

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        This figure consists of two rows of text boxes. The top row has to two unconnected boxes, one labeled "Who" and one labeled "What." They are accompanied by the following explanations:

        Who: individual recruited from NBCCEDP program

        What: program aimed at behavior change

        The second row begins with a group of boxes connected with arrows flowing left to right and with the overall label of "How." The first two boxes in this section are side-by-side and contain the following information:

        Assess ?contributing factors

        Advise ?brief risk factor counseling

        After the second box, the boxes split into two tiers with the upper tier labeled "Low Risk" and the lower, "High Risk." Each tier has three boxes, connected left to right, with the following information:

        Low risk: Agree ?set goals to maintain low risk

        Assist ?link to community resources

        Arrange ?survey follow-up

        High risk:

        Agree ?set goals to lower risk

        Assist ?provide clinical and lifestyle services

        Arrange ?clinical follow-up

        The last box in the figure stands alone and is labeled "Why":

        Why ?maximize public health impact

        Figure 2. Example of an individual behavior change model, WISEWOMAN, United States.
        NBCCEDP indicates National Breast and Cervical Cancer Early Detection Program

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        This figure consists of three rows of text boxes. The first row has to two boxes, one labeled "Who" and one labeled "What." They are accompanied by the following explanations:

        Who: NBCCEDP program sites

        What: WISEWOMAN multicomponent intervention

        The second row consists of eight boxes connected left to right by arrows. Beginning with the left-most box, they contain the following information: create urgency, form a powerful coalition, create a vision, communicate the vision, empower others, create short-term wins, consolidate improvements, and institutionalize.

        The last box in the figure stands alone and is labeled "Why" and is accompanied by the following information:

        Why: maximize public health impact

        Figure 3. Example of an organizational, community, and policy change model, WISEWOMAN, United States.
        NBCCEDP indicates National Breast and Cervical Cancer Early Detection Program

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        The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors’ affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.


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