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Last Updated: 8/23/2009
| Jo Anne L Earp, Sc.D.
Professor |  |
Research Interests
Dr. Jo Anne Earp is a medical sociologist. In her research, she applies a behavioral science perspective to an understanding of the role that social and attitudinal factors play in explaining variation in health behaviors among groups of people, especially women. She has done research with both chronic and acutely ill patients, as well as with members of high-risk, often stigmatized or marginal groups (e.g., abused women, rape victims, low literacy minorities). She is an expert in the design of data collection instruments, especially personal interviews with difficult-to-interview respondents, and regularly consults on methodological issues related to community health and patient education research. For more than 30 years she has been a principal or co-principal investigator on cancer-specific and STI-related grants, as well as numerous small grants, with students, on women's health and patient advocacy issues. She is principal investigator of Lineberger's cancer control education program (R25) training grant, now in its eighteenth year of funding and recently renewed for another five years.
For ten years Dr. Earp was the principal investigator on a 3.3 million dollar NCI-funded study, the North Carolina Breast Cancer Screening Program (NC-BCSP). As principal investigator, Dr. Earp directed the NC-BCSP team of university staff, students, and post-docs, community outreach specialists, and lay health advisors to achieve NC-BCSP's primary aims: 1) increasing initial and repeat breast cancer screening mammography by Black women ages 40 years and older living in five rural eastern North Carolina counties; 2) improving follow-up of positive screening mammograms; and 3) establishing partnerships between health care providers and communities to maintain increased breast cancer screening and follow-up. A physician-training component, funded for six years by the Susan G. Komen Foundation, encouraged providers through the use of two CD-ROMs on stage-based counseling using the Ask, Advise, Assist program to more effectively recommend mammograms to older women. A cervical cancer screening initiative, funded by NC-BCSP's second of two three-year grants from the Kate B. Reynolds Foundation, also allowed NC-BCSP to train more than fifty new lay health advisors and provide "booster sessions" to many of the original LHAs. A major aspect of the more recent training was the translation of the Trans Theoretical Model's Stages of Change theory to an older, African-American audience as a tool for understanding a woman's barriers to screening and quickly assessing her stage with respect to getting regular mammograms.
NC-BCSP's natural helper lay health advisor intervention has been shown to be an effective public health approach to increasing screening mammography in low income, rural populations. In a stratified random sample of 801 African-American women (390 interventions; 411 comparison) who completed both baseline (1993-1994) and first follow-up (1996-1997) surveys, the intervention was associated with an overall 6-percentage point increase in community-wide mammography use. Low-income women in intervention counties reported an 11-percentage point increase in use above that reported by low-income women in comparison counties. In 2003, Dr. Earp successfully turned NC-BCSP over to two community groups who were trained to continue supporting three counties of LHAs. The next year she received three years support from NCI for an R21 grant that would allow her to understand better why some of NC-BCSP's counties were more successful than others in increasing the rate of African-Americans receiving regular breast cancer screening.
Dr. Earp teaches or has taught several department courses, including: HBHE 750 (Survey Research Methods in Health Education) for 12 years; the Professional Development Seminar unit for doctoral students (HBHE 710); Public Health Perspective on Women's Health (HBHE 160); Advanced Evaluation Research Methods (HBHE 753); and directed HBHE 600, Social and Behavioral Sciences in Public Health, a core course for non-HBHE majors in the School of Public Health, from 1996-2003. Currently she teaches HBHE 850, Research Manuscript Preparation, for advanced doctoral students, and in the Fall HBHE 727, Patient Advocacy: Healing the Health Care System, for graduate health affairs students. She received the McGavran Award for Excellence in Teaching from UNC's School of Public Health in 1983, the Greenberg Alumni Endowment Award in 1996, and the John E. Larsh award for Mentorship in 2005. In 2008 she was honored with the campus-wide UNC's Women's Leadership Council's Mentoring Award for her mentoring of students over the years. Some years ago the Jo Anne L. Earp Fellowship in Health Behavior and Health Education was established in her name. She was chair of the Department of Health Behavior and Health Education for nine years, before stepping down in 2005 to rejoin the faculty as a professor.
In 2008 she became department chair again for a period of 3 years, serving until August, 2011.
Recent Accomplishments and Honors
Teaching, mentoring awards listed in last paragraph of research interests
Publications
Earp, J.A., Viadro, C.I., Vincus, A.A., Altpeter, M., Flax, V., Eng, E. "Lay Health Advisors: A Strategy for 'Getting the Word Out' about Breast Cancer." Health Education and Behavior, 24(4):432-451, August, 1997.
Flax, V.L., Earp, J.A. "Counseled Women's Perspectives on Their Interactions with Lay Health Advisors: A Feasibility Study." Health Education Research, 14(1):15-24, 1999.
Hawley, S.T., Earp, J.A., O'Malley, M., and Ricketts, T.C. "The Role of Physician Recommendation in Women's Mammography Use; Is It a 2-Stage Process?" Medical Care, 38(4):392-403, 2000.
O'Malley, M.S., Earp, J.A., Hawley, S.T., Schell, M.J., Mathews, H.F., Mitchell, J. "Who Gets the Message about Breast Cancer Screening? Race, Socioeconomic Status, and Physician Recommendation for Mammography" American Journal of Public Health, 91, (1):49-54; January, 2001.
Earp, J. A., Eng., E., O'Malley, M. S., Altpeter, M., Rauscher, G. H., Mayne, L., Mathews, H. F., Lynch, K. S., and Qaqish, B. "Increasing Use of Mammography among Older, Rural African-American Women: Results from a Community Trial." American Journal of Public Health, 92(4):646-654, April, 2002.
Bishop, C., Earp, J. A., Eng, E., and Lynch, K. S. Implementing a "Natural Helper" Lay Health Advisor Program: Lessons Learned from Unplanned Events. Health Promotion Practice, 3(2):233-244, April, 2002.
Mayne, L. and Earp, J.A. "Initial and Repeat Mammography Screening: Different Behaviors/Different Predictors." The Journal of Rural Health, 19(1):63-71, 2003.
Rauscher, G.H., Hawley, S.T., and Earp, J.A. "Baseline Predictors of Initiation Versus Maintenance of Regular Mammography Use Among Rural Women." Preventive Medicine, 40(6):822-830, June, 2005.
Rauscher, G.H., Earp, J.A., and O'Malley, M. "Relation Between Intervention Exposures, Changes in Attitudes, and Mammography Use in the North Carolina Breast Cancer Screening Program." Cancer Epidemiology, Biomarkers & Prevention, 13(5):741-747, May, 2004.
Earp, J.A., Lown, B.A., and Kalet, A. "The Perspective from Patient Advocacy Experts." Commentary in Professionalism in Medicine, Eds., Spandorfer, J., Pohl, C., Rattner, S.L., and Nasca, T., Cambridge University Press, New York, New York, in press.
Earp, J.A., French, E.A., and Gilkey, M.B. (eds.) Patient Advocacy for Healthcare Quality: Strategies for Achieving Patient-Centered Care, Jones and Bartlett, Sudbury, MA, 2007.
Moore, A. and Earp, J.A. "The Long Reach to Basic Healthcare Services: Partnering with Lay Health Advisors to Improve Health Equity." In Patient Advocacy for Healthcare Quality: Strategies for Achieving Patient-Centered Care. Eds., Earp, J.A., French, E.A., and Gilkey, M.B., Jones and Bartlett, Sudbury, MA, 2007.
Gilkey, M.B., Earp, J.A., and French, E.A. "What is Patient Advocacy?" In Patient Advocacy for Healthcare Quality: Strategies for Achieving Patient-Centered Care. Eds., Earp, J.A., French, E.A., and Gilkey, M.B., Jones and Bartlett, Sudbury, MA, 2007.
Earp, J.A., Emmet, K.M., and French, E.A. "Next Steps: Where do we go from here?" In Patient Advocacy for Healthcare Quality: Strategies for Achieving Patient-Centered Care. Eds., Earp, J.A., French, E.A., and Gilkey, M.B., Jones and Bartlett, Sudbury, MA, 2007.
E-mail: jearp@email.unc.edu
Telephone: (919) 966-3903
FAX: (919) 966-2921
Address: 363 Rosenau Hall, CB# 7440 Chapel Hill, NC 27599-7440
