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3. IMPROVING ACCESSIBILITY AND QUALITY OF MEDICAL CARE, EDUCATION, AND REFERRAL SERVICES 17 3. IMPROVING ACCESSIBILITY AND QUALITY OF MEDICAL CARE, EDUCATION, AND REFERRAL SERVICES HRSA asked the committee to address the need to improve accessibility and quality of education and referral services among RECA populations. Given uncertainty concerning the health benefits of intensive medical screening, improving the accessibility and quality of health education is of paramount importance. Among the things education programs will provide to the target population is an increase in their ability to participate fully and freely in decision-making regarding medical screening and medical evaluation. Education programs may also enable the target populations to avail themselves of the legal remedies provided by RECA. Improving the accessibility and quality of education lies within the framework of intervention. Success in RESEPâs mission will require changing the behavior of the target audience (patients, clinicians, and related government agencies). Barriers to that goal must be identified and addressed by appropriate intervention strategies. Among the barriers are knowledge deficits and skills, psychosocial issues, such as fear of physicians, diverse cultural norms, and turf battles; lack of organizational resources, for example, medical technology, and staff; and public policies that fail to allocate adequate resources to the program. Appropriate behavior-change theories must be selected and applied, including adult learning theory and educational best practices (Chickering and Gamson, 1991). Much research has been done on addressing the barriers to behavior with intervention strategies. The table below displays the connections among barriers, interventions, and outcomes. Barriers to Behavior Change Intervention Strategies Outcomes Knowledge deficits and skills Educational programs Reduction of deficits and skills Individual psychosocial Issues Psychosocial Strategies, such as use of Resolution of psychosocial barriers informed opinion leaders Lack of organizational resources Examination and remediation of Resolution of the organizational barriers organizational barriers to accelerate change Public-policy problems Identification of public-policy Development of supportive strategy components that interfere with goals