A 3-step intervention to improve adherence to cervical cancer screening: The SCAN randomized controlled trial
Autor: | João Firmino-Machado, Sofia Varela, Romeu Mendes, Amélia Moreira, Nuno Lunet, Alexandra Carmo, Ana Cancela, Ana Firmino, Ana Ramos, Antonieta Teixeira, Armando Vieira, Bárbara Badim, Carolina Tojal, Cláudia Junqueira, Conceição Pinheiro, Emília Peneda, Helena Monte, Hugo Marcelo Vieira, Inês Proença, Joana Seabra, Joana Teixeira, João Magalhães, Joaquim Batista, Justina Silva, Leonor Grijó, Liliana Beirão, Manuela Castanheira, Margarida Silva, Maria João Peixoto, Marina Ponto Santos, Mariana Neves, Miguel Amaral, Nuno Capela, Paulo Santos, Pedro Apolinário, Rita Aguiar, Rita Barbosa, Rui Amendoeira, Rui Medon, Sofia Pinheiro Torres, Susana Silva, Tiago Fernandes, Vítor Santos |
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Rok vydání: | 2018 |
Předmět: |
Adult
medicine.medical_specialty Standard of care Epidemiology Reminder Systems Primary health care Uterine Cervical Neoplasms Cervical cancer screening 01 natural sciences Risk Assessment law.invention 03 medical and health sciences 0302 clinical medicine Primary outcome Randomized controlled trial law Intervention (counseling) Outcome Assessment Health Care medicine Humans 030212 general & internal medicine 0101 mathematics Mass screening Early Detection of Cancer Vaginal Smears Text Messaging Portugal business.industry 010102 general mathematics Public Health Environmental and Occupational Health Age Factors Middle Aged Patient Acceptance of Health Care Clinical trial Logistic Models Physical therapy Patient Compliance Female Guideline Adherence business |
Zdroj: | Preventive medicine. 123 |
ISSN: | 1096-0260 |
Popis: | The aim of this study was to test the effectiveness of a stepwise intervention with an increasing level of complexity and cost to increase adherence to organized cervical cancer screening. This was a randomized (1: 1) controlled trial, conducted among 13 Portuguese primary health care units. Participants (n = 1220) were women aged 25-49 years, eligible for cervical cancer screening, with a mobile phone number available. The tested intervention was a 3-step invitation to screening, based on automated text messages/phone calls (step 1), manual phone calls (step 2) and face-to-face interviews (step 3), applied sequentially to non-adherent women after each step. Participants in the control group were invited through a written letter (standard of care). The primary outcome was the proportion of women screened, which was assessed after step 1 (45 days after the initial invitation), steps 1 + 2 (90 days after the initial invitation) and steps 1 + 2 + 3 (150 days after the initial invitation). Adherence to cervical cancer screening was significantly higher among women assigned to the intervention than those in the control group for step 1 (39.9% vs. 25.7%, p 0.001), steps 1 + 2 (48.6% vs. 30.7%, p 0.001) and steps 1 + 2 + 3 (51.2% vs. 34.0%, p 0.001). In conclusion, adherence to cervical cancer screening was higher by 17% among women invited through the 3-step intervention, compared to those receiving the standard invitation letter. The former strategy has the potential to be broadly implemented due to the low requirements of technology and training. Clinical Trial Registration: NCT03122275. |
Databáze: | OpenAIRE |
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