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Staley H, Shiraz A, Shreeve N, Bryant A, Martin-Hirsch PP, Gajjar K. Interventions targeted at women to encourage the uptake of cervical screening. Cochrane Database Syst Rev 2021; 9:CD002834. [PMID: 34694000 PMCID: PMC8543674 DOI: 10.1002/14651858.cd002834.pub3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND This is an update of the Cochrane review published in Issue 5, 2011. Worldwide, cervical cancer is the fourth commonest cancer affecting women. High-risk human papillomavirus (HPV) infection is causative in 99.7% of cases. Other risk factors include smoking, multiple sexual partners, the presence of other sexually transmitted diseases and immunosuppression. Primary prevention strategies for cervical cancer focus on reducing HPV infection via vaccination and data suggest that this has the potential to prevent nearly 90% of cases in those vaccinated prior to HPV exposure. However, not all countries can afford vaccination programmes and, worryingly, uptake in many countries has been extremely poor. Secondary prevention, through screening programmes, will remain critical to reducing cervical cancer, especially in unvaccinated women or those vaccinated later in adolescence. This includes screening for the detection of pre-cancerous cells, as well as high-risk HPV. In the UK, since the introduction of the Cervical Screening Programme in 1988, the associated mortality rate from cervical cancer has fallen. However, worldwide, there is great variation between countries in both coverage and uptake of screening. In some countries, national screening programmes are available whereas in others, screening is provided on an opportunistic basis. Additionally, there are differences within countries in uptake dependent on ethnic origin, age, education and socioeconomic status. Thus, understanding and incorporating these factors in screening programmes can increase the uptake of screening. This, together with vaccination, can lead to cervical cancer becoming a rare disease. OBJECTIVES To assess the effectiveness of interventions aimed at women, to increase the uptake, including informed uptake, of cervical screening. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), Issue 6, 2020. MEDLINE, Embase and LILACS databases up to June 2020. We also searched registers of clinical trials, abstracts of scientific meetings, reference lists of included studies and contacted experts in the field. SELECTION CRITERIA Randomised controlled trials (RCTs) of interventions to increase uptake/informed uptake of cervical screening. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed risk of bias. Where possible, the data were synthesised in a meta-analysis using standard Cochrane methodology. MAIN RESULTS Comprehensive literature searches identified 2597 records; of these, 70 met our inclusion criteria, of which 69 trials (257,899 participants) were entered into a meta-analysis. The studies assessed the effectiveness of invitational and educational interventions, lay health worker involvement, counselling and risk factor assessment. Clinical and statistical heterogeneity between trials limited statistical pooling of data. Overall, there was moderate-certainty evidence to suggest that invitations appear to be an effective method of increasing uptake compared to control (risk ratio (RR) 1.71, 95% confidence interval (CI) 1.49 to 1.96; 141,391 participants; 24 studies). Additional analyses, ranging from low to moderate-certainty evidence, suggested that invitations that were personalised, i.e. personal invitation, GP invitation letter or letter with a fixed appointment, appeared to be more successful. More specifically, there was very low-certainty evidence to support the use of GP invitation letters as compared to other authority sources' invitation letters within two RCTs, one RCT assessing 86 participants (RR 1.69 95% CI 0.75 to 3.82) and another, showing a modest benefit, included over 4000 participants (RR 1.13, 95 % CI 1.05 to 1.21). Low-certainty evidence favoured personalised invitations (telephone call, face-to-face or targeted letters) as compared to standard invitation letters (RR 1.32, 95 % CI 1.11 to 1.21; 27,663 participants; 5 studies). There was moderate-certainty evidence to support a letter with a fixed appointment to attend, as compared to a letter with an open invitation to make an appointment (RR 1.61, 95 % CI 1.48 to 1.75; 5742 participants; 5 studies). Low-certainty evidence supported the use of educational materials (RR 1.35, 95% CI 1.18 to 1.54; 63,415 participants; 13 studies) and lay health worker involvement (RR 2.30, 95% CI 1.44 to 3.65; 4330 participants; 11 studies). Other less widely reported interventions included counselling, risk factor assessment, access to a health promotion nurse, photo comic book, intensive recruitment and message framing. It was difficult to deduce any meaningful conclusions from these interventions due to sparse data and low-certainty evidence. However, having access to a health promotion nurse and attempts at intensive recruitment may have increased uptake. One trial reported an economic outcome and randomised 3124 participants within a national screening programme to either receive the standard screening invitation, which would incur a fee, or an invitation offering screening free of charge. No difference in the uptake at 90 days was found (574/1562 intervention versus 612/1562 control, (RR 0.94, 95% CI: 0.86 to 1.03). The use of HPV self-testing as an alternative to conventional screening may also be effective at increasing uptake and this will be covered in a subsequent review. Secondary outcomes, including cost data, were incompletely documented. The majority of cluster-RCTs did not account for clustering or adequately report the number of clusters in the trial in order to estimate the design effect, so we did not selectively adjust the trials. It is unlikely that reporting of these trials would impact the overall conclusions and robustness of the results. Of the meta-analyses that could be performed, there was considerable statistical heterogeneity, and this should be borne in mind when interpreting these findings. Given this and the low to moderate evidence, further research may change these findings. The risk of bias in the majority of trials was unclear, and a number of trials suffered from methodological problems and inadequate reporting. We downgraded the certainty of evidence because of an unclear or high risk of bias with regards to allocation concealment, blinding, incomplete outcome data and other biases. AUTHORS' CONCLUSIONS There is moderate-certainty evidence to support the use of invitation letters to increase the uptake of cervical screening. Low-certainty evidence showed lay health worker involvement amongst ethnic minority populations may increase screening coverage, and there was also support for educational interventions, but it is unclear what format is most effective. The majority of the studies were from developed countries and so the relevance of low- and middle-income countries (LMICs), is unclear. Overall, the low-certainty evidence that was identified makes it difficult to infer as to which interventions were best, with exception of invitational interventions, where there appeared to be more reliable evidence.
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Affiliation(s)
- Helen Staley
- Obstetrics & Gynaecology, Queen Charlotte's & Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK
| | | | - Norman Shreeve
- Obstetrics & Gynaecology, University of Cambridge Clinical School, Cambridge, UK
| | - Andrew Bryant
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Pierre Pl Martin-Hirsch
- Gynaecological Oncology Unit, Royal Preston Hospital, Lancashire Teaching Hospital NHS Trust, Preston, UK
| | - Ketankumar Gajjar
- Department of Gynaecological Oncology, 1st Floor Maternity Unit, City Hospital Campus, Nottingham, UK
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Schliemann D, Su TT, Paramasivam D, Treanor C, Dahlui M, Loh SY, Donnelly M. Effectiveness of Mass and Small Media Campaigns to Improve Cancer Awareness and Screening Rates in Asia: A Systematic Review. J Glob Oncol 2020; 5:1-20. [PMID: 30969807 PMCID: PMC6528732 DOI: 10.1200/jgo.19.00011] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
PURPOSE The main objective of this systematic review was to identify whether mass and small media interventions improve knowledge and attitudes about cancer, cancer screening rates, and early detection of cancer in Asia. METHODS The review was conducted according to a predefined protocol. Medline, EMBASE, CINAHL, Web of Science, Cochrane Library, and Google Scholar were searched in September 2017, and data extraction and rating of methodologic study quality (according to Joanna Briggs Institute rating procedures) were performed independently by reviewers. RESULTS Twenty-two studies (reported across 24 papers) met the inclusion criteria. Most studies (n = 21) were conducted in high or upper-middle income countries; targeted breast (n = 11), cervical (n = 7), colorectal (n = 3), or oral (n = 2) cancer; and used small media either alone (n = 15) or in combination with mass media and other components (n = 5). Studies regarding cancer screening uptake were of medium to high quality and mainly reported positive outcomes for cervical cancer and mixed results for breast and colorectal cancer. The methodologic strength of research that investigated change in cancer-related knowledge and the cost effectiveness of interventions, respectively, were weak and inconclusive. CONCLUSION Evidence indicated that small media campaigns seemed to be effective in terms of increasing screening uptake in Asia, in particular cervical cancer screening. Because of the limited number of studies in Asia, it was not possible to be certain about the effectiveness of mass media in improving screening uptake and the effectiveness of campaigns in improving cancer-related knowledge.
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Affiliation(s)
| | - Tin Tin Su
- Monash University Malaysia, Bandar Sunway, Malaysia.,University of Malaya, Kuala Lumpur, Malaysia
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Ahmadpour M, Omidvar N, Doustmohammadian A, Rahimiforoushani A, Shakibazadeh E. Children Food and Nutrition Literacy - a New Challenge in Daily Health and Life, the New Solution: Using Intervention Mapping Model Through a Mixed Methods Protocol. J Med Life 2020; 13:175-182. [PMID: 32742510 PMCID: PMC7378349 DOI: 10.25122/jml-2019-0025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 09/02/2019] [Indexed: 12/13/2022] Open
Abstract
Food and nutrition literacy is a fundamental and new idiom among health policymakers. Improving children's food and nutrition literacy is a fundamental task, and it requires detailed planning. The aim of this study is to design, implement, and evaluate a food and nutrition literacy promotion intervention in elementary school children based on the Intervention Mapping model. This is a sequential study to design, implement, and evaluate a food and nutrition literacy promotion intervention in elementary school children aged 10-12 years old in Baneh city (Kurdistan, Iran). The study has three sequential phases, six steps based on the Intervention Mapping model, and four sub-studies. The questionnaire was transformed and culturally adapted since it was previously built for the city of Tehran; the results of a population-based cross-sectional survey indicated that the score for understanding food and nutrition information of a sample of 390 students aged 10-12 was mostly moderate and low (90.3% of participants). Therefore, a qualitative study on how to fix existing barriers, and extract facilitators and the best methods of interventions for promoting food and nutrition literacy of participants was conducted. Finally, an interventional study within six months for two intervention and control groups of elementary children 10-12 years old was carried out. The findings of this research will be used to design interventions and strategies based on needs assessment for improving students' skills in food and nutrition literacy in all dimensions of food and nutrition literacy.
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Affiliation(s)
- Mohammad Ahmadpour
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Nutrition Research, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Aazam Doustmohammadian
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Nutrition Research, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Rahimiforoushani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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4
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Hou SI, Cao X. A Cross-sectional Study of Cancer Knowledge and Beliefs Among Faith-based Chinese in the USA Versus Taiwan. J Prev Med Public Health 2019; 52:60-65. [PMID: 30742762 PMCID: PMC6378384 DOI: 10.3961/jpmph.17.051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 12/04/2018] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES This study examined cancer knowledge, beliefs, and practice among faith-based Chinese in the USA versus Taiwan to gain better understandings on how environment and culture might play a role for tailored cancer education programs. METHODS A self-administered survey included a validated 10-item Cancer Screening Belief Scale (CSBS), an 8-item Cancer Screening Knowledge Test (CSKT), and a 14-item cancer Warning Signs Test (CWST) was administered. Participants were recruited from 9 Chinese churches (5 in the USA and 4 in Taiwan). RESULTS A total of 372 Chinese participated, 50% lived in the USA and 50% in Taiwan. Mean age was 44.31 (standard deviation, 14.74), 60% males, and majority had college education (85%). Taiwan participants scored higher on both CSKT (6.13 vs. 5.52; p<0.001) and CWST (6.80 vs. 5.38; p<0.001). Although perceived screening benefits and barriers were similar, Taiwan participants endorsed higher on screening norms (11.67 vs. 10.82; p<0.001). Taiwan participants also indicated more doctor recommending cancer screenings (42.1% vs. 29.6%; p=0.015), USA participants were more likely to have had annual health exams (65.4% vs. 48.9%; p=0.002). Regression results showed that those resided in the USA were 2.38 times more likely to report annual health exams. Married status (odds ratio [OR], 2.85), college education (OR, 2.38), doctor's recommendation (OR, 2.87), no family cancer history (OR, 2.47), and those with lower barriers were significant factors on annual health exams. CONCLUSIONS Taiwan participants scored higher on cancer knowledge and screening norms, while more USA participants reported annual health exams. Taiwan's universal healthcare might play a role on the different healthcare seeking patterns.
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Affiliation(s)
- Su-I Hou
- Health Management and Informatics, University of Central Florida College of Health and Public Affairs, Orlando, FL, USA
| | - Xian Cao
- Health Management and Informatics, University of Central Florida College of Health and Public Affairs, Orlando, FL, USA
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Hou SI, Fetters MD. Mixed methods in public health research in Taiwan - Using visual diagrams to communicate complex design procedures. Health Care Women Int 2018; 40:515-526. [PMID: 30484750 DOI: 10.1080/07399332.2018.1516769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Scholars introduce modern mixed methods research (MMR) and its application in public health research in Taiwan. Specifically, they showcase a multi-phased Taiwan cervical cancer screening mixed methods study using visual diagrams to communicate complex design procedures. While some previous researchers have incorporated quantitative and qualitative data in research, here we hope to provide significant clarity to guide those new to the MMR field. We have structured the article in the following way. First, we provide a brief overview of MMR. Second, we illustrate the compelling need for MMR from a public health perspective using cancer screenings as an example. Third, we introduce the Taiwan cervical cancer screening program as an exemplar of MMR application and the utility of visual diagrams. Study methodology can be applied to international researchers and scholars from interdisciplinary fields beyond public health.
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Affiliation(s)
- Su-I Hou
- a Doctoral Program in Public Affairs/Health Management & Informatics, College of Community Innovation & Education , University of Central Florida , Orlando , Florida , USA
| | - Michael D Fetters
- b Japanese Family Health Program , University of Michigan Mixed Methods Research and Scholarship Program , Family Medicine, University of Michigan Medical School , Ann Arbor , Michigan , USA
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Hou SI. Subjective and Objective Cancer Screening Knowledge Among White- and Blue-Collar Chinese Midlife Adults. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:167-173. [PMID: 27565165 DOI: 10.1007/s13187-016-1104-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Cancer is the leading cause of death among Chinese, yet little is known about cancer knowledge among this population. The study described the subjective and objective cancer screening knowledge among white- versus blue-collar Chinese midlife adults. A convenient sample of white-collar adults age 40+ years was recruited from government and academic agencies; and blue-collar adults age 40+ years were recruited from manufactory companies in Taiwan. An eight-item cancer screening knowledge test (CSKT) was used to measure objective knowledge and one five-point Likert scale item for assessing subjective (perceived) cancer screening knowledge. A total of 208 white- and 533 blue-collar workers completed the survey during 2008-2011. Mean ages between groups were comparable (41.1 versus 46.3 years), as well as family cancer history (41.5 %). About 76 % of the white-collar and 43 % of the blue-collar adults had college education. The mean score of the CSKT was lower in the blue-collar versus white-collar workers, 5.4 (SD = 1.76) versus 6.1 (SD = 1.40), indicating on average, 68 versus 76 % of the participants answered the cancer knowledge correctly. The subjective knowledge levels were, however, higher among the blue-collar workers (mean rating of 3.22 versus 2.78). The CSKT showed a good mix of relatively easy and moderately difficult items in both groups. Study showed that overall cancer screening knowledge was low among Chinese midlife adults. Although blue-collar workers scored lower on CSKT, the perceived knowledge level was higher. Results also suggest attention to communicating cancer screening information among Chinese blue-collar midlife workers in particular.
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Affiliation(s)
- Su-I Hou
- Doctoral Program in Public Affairs/Health Management & Informatics, College of Health & Public Affairs, University of Central Florida, HPA I, Room 217, 12805, Orlando, FL, 32816-1600, USA.
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Hou SI, Liu LJ. Objective and Subjective Cancer Knowledge Among Faith-Based Chinese Adults. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2018; 38:47-56. [PMID: 29298633 DOI: 10.1177/0272684x17749567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examined cancer knowledge between church-going younger versus older Chinese adults. Hou's 8-item validated cancer screening knowledge test (CSKT) and a new 14-item cancer warning signs test (CWST) were used to assess objective knowledge. Subjective knowledge was measured by one overall 5-point Likert scale item. A total of 372 Taiwanese and Chinese Americans from nine churches participated. Although there were no significant differences by age on either the CSKT scores (younger = 5.89 vs. older = 5.71; p = .297) or the CWST (younger = 6.27 vs. older = 5.86; p = .245), subjective knowledge was higher among older Chinese adults (younger = 2.44 vs. older = 3.05, p < .001). Older Chinese adults were also more likely to identify cancer warning signs correctly, while younger adults were more likely to identify false warning signs correctly. Results have implication on tailoring cancer knowledge type (subjective vs. objective) and content domain (screening vs. warning signs). Findings can help health educators better understand cancer education needs among Chinese adults.
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Affiliation(s)
- Su-I Hou
- 1 50616 College of Health and Public Affairs, University of Central Florida , Orlando, FL, USA
| | - Ling Jie Liu
- 2 Department of Health Promotion and Behavior, College of Public Health, 1355 University of Georgia , Athens, GA, USA
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Lamort-Bouché M, Sarnin P, Kok G, Rouat S, Péron J, Letrilliart L, Fassier JB. Interventions developed with the Intervention Mapping protocol in the field of cancer: A systematic review. Psychooncology 2018; 27:1138-1149. [PMID: 29247578 DOI: 10.1002/pon.4611] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 10/27/2017] [Accepted: 12/04/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The Intervention Mapping (IM) protocol provides a structured framework to develop, implement, and evaluate complex interventions. The main objective of this review was to identify and describe the content of the interventions developed in the field of cancer with the IM protocol. Secondary objectives were to assess their fidelity to the IM protocol and to review their theoretical frameworks. METHODS Medline, Web of Science, PsycINFO, PASCAL, FRANCIS, and BDSP databases were searched. All titles and abstracts were reviewed. A standardized extraction form was developed. All included studies were reviewed by 2 reviewers blinded to each other. RESULTS Sixteen studies were identified, and these reported 15 interventions. The objectives were to increase cancer screening participation (n = 7), early consultation (n = 1), and aftercare/quality of life among cancer survivors (n = 7). Six reported a complete participatory planning group, and 7 described a complete logic model of the problem. Ten studies described a complete logic model of change. The main theoretical frameworks used were the theory of planned behaviour (n = 8), the transtheoretical model (n = 6), the health belief model (n = 6), and the social cognitive theory (n = 6). The environment was rarely integrated in the interventions (n = 4). Five interventions were reported as effective. CONCLUSIONS Culturally relevant interventions were developed with the IM protocol that were effective to increase cancer screening and reduce social disparities, particularly when they were developed through a participative approach and integrated the environment. Stakeholders' involvement and the role of the environment were heterogeneously integrated in the interventions.
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Affiliation(s)
- Marion Lamort-Bouché
- UMRESTTE UMR T 9405, Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement, Univ Lyon, Université Claude Bernard Lyon 1, Lyon, France.,Collège Universitaire de Médecine Générale, Univ Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Philippe Sarnin
- Groupe de Recherche en Psychologie Sociale (GREPS-EA 4163), Univ Lyon, Université Lumière Lyon 2, Lyon, France
| | - Gerjo Kok
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
| | - Sabrina Rouat
- Groupe de Recherche en Psychologie Sociale (GREPS-EA 4163), Univ Lyon, Université Lumière Lyon 2, Lyon, France
| | - Julien Péron
- Laboratoire de Biométrie et Biologie Evolutive LBBE-UMR 5558, Univ Lyon, Université Claude Bernard Lyon 1, Lyon, France.,Service d'Oncologie Médicale, Institut de Cancérologie des Hospices Civils de Lyon (IC-HCL), Pierre-Bénite, France
| | - Laurent Letrilliart
- Collège Universitaire de Médecine Générale, Univ Lyon, Université Claude Bernard Lyon 1, Lyon, France.,Health Services and Performance Research (HESPER-EA 7425), Univ Lyon, Université Claude Bernard Lyon 1, Université Lyon 2, Lyon, France
| | - Jean-Baptiste Fassier
- UMRESTTE UMR T 9405, Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement, Univ Lyon, Université Claude Bernard Lyon 1, Lyon, France.,Service de Médecine et Santé au Travail, Hospices Civils de Lyon, Lyon, France
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Musa J, Achenbach CJ, O’Dwyer LC, Evans CT, McHugh M, Hou L, Simon MA, Murphy RL, Jordan N. Effect of cervical cancer education and provider recommendation for screening on screening rates: A systematic review and meta-analysis. PLoS One 2017; 12:e0183924. [PMID: 28873092 PMCID: PMC5584806 DOI: 10.1371/journal.pone.0183924] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 08/14/2017] [Indexed: 01/01/2023] Open
Abstract
Background Although cervical cancer is largely preventable through screening, detection and treatment of precancerous abnormalities, it remains one of the top causes of cancer-related morbidity and mortality globally. Objectives The objective of this systematic review is to understand the evidence of the effect of cervical cancer education compared to control conditions on cervical cancer screening rates in eligible women population at risk of cervical cancer. We also sought to understand the effect of provider recommendations for screening to eligible women on cervical cancer screening (CCS) rates compared to control conditions in eligible women population at risk of cervical cancer. Methods We used the PICO (Problem or Population, Interventions, Comparison and Outcome) framework as described in the Cochrane Collaboration Handbook to develop our search strategy. The details of our search strategy has been described in our systematic review protocol published in the International Prospective Register of systematic reviews (PROSPERO). The protocol registration number is CRD42016045605 available at: http://www.crd.york.ac.uk/prospero/display_record.asp?src=trip&ID=CRD42016045605. The search string was used in Pubmed, Embase, Cochrane Systematic Reviews and Cochrane CENTRAL register of controlled trials to retrieve study reports that were screened for inclusion in this review. Our data synthesis and reporting was guided by the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). We did a qualitative synthesis of evidence and, where appropriate, individual study effects were pooled in meta-analyses using RevMan 5.3 Review Manager. The Higgins I2 was used to assess for heterogeneity in studies pooled together for overall summary effects. We did assessment of risk of bias of individual studies included and assessed risk of publication bias across studies pooled together in meta-analysis by Funnel plot. Results Out of 3072 study reports screened, 28 articles were found to be eligible for inclusion in qualitative synthesis (5 of which were included in meta-analysis of educational interventions and 8 combined in meta-analysis of HPV self-sampling interventions), while 45 were excluded for various reasons. The use of theory-based educational interventions significantly increased CCS rates by more than double (OR, 2.46, 95% CI: 1.88, 3.21). Additionally, offering women the option of self-sampling for Human Papillomavirus (HPV) testing increased CCS rates by nearly 2-fold (OR = 1.71, 95% CI: 1.32, 2.22). We also found that invitation letters alone (or with a follow up phone contact), making an appointment, and sending reminders to patients who are due or overdue for screening had a significant effect on improving participation and CCS rates in populations at risk. Conclusion Our findings supports the implementation of theory-based cervical cancer educational interventions to increase women’s participation in cervical cancer screening programs, particularly when targeting communities with low literacy levels. Additionally, cervical cancer screening programs should consider the option of offering women the opportunity for self-sample collection particularly when such women have not responded to previous screening invitation or reminder letters for Pap smear collection as a method of screening.
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Affiliation(s)
- Jonah Musa
- Health Sciences Integrated PhD Program, Center for Healthcare Studies, Institute of Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, United States of America
- Center for Global Health, Institute of Public Health and Medicine, Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, United States of America
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Jos, Jos, Plateau State, Nigeria
- * E-mail: , ,
| | - Chad J. Achenbach
- Center for Global Health, Institute of Public Health and Medicine, Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, United States of America
| | - Linda C. O’Dwyer
- Galter Health Sciences Library, Feinberg School of Medicine, Northwestern University, Chicago, United States of America
| | - Charlesnika T. Evans
- Department of Preventive Medicine, Center for Health Care Studies, Global Health, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, Illinois, United States of America
| | - Megan McHugh
- Health Sciences Integrated PhD Program, Center for Healthcare Studies, Institute of Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, United States of America
| | - Lifang Hou
- Division of Cancer Epidemiology, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, United States of America
| | - Melissa A. Simon
- Department of Obstetrics and Gynecology, Preventive Medicine and Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, United States of America
| | - Robert L. Murphy
- Center for Global Health, Institute of Public Health and Medicine, Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, United States of America
| | - Neil Jordan
- Health Sciences Integrated PhD Program, Center for Healthcare Studies, Institute of Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, United States of America
- Department of Preventive Medicine, Center for Health Care Studies, Global Health, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
- Department of Psychiatry & Behavioral Science, Feinberg School of Medicine, Northwestern University, Chicago, United States of America
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Garba RM, Gadanya MA. The role of intervention mapping in designing disease prevention interventions: A systematic review of the literature. PLoS One 2017; 12:e0174438. [PMID: 28358821 PMCID: PMC5373531 DOI: 10.1371/journal.pone.0174438] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Accepted: 03/09/2017] [Indexed: 11/18/2022] Open
Abstract
Objective To assess the role of Intervention Mapping (IM) in designing disease prevention interventions worldwide. Methods Systematic search and review of the relevant literature—peer-reviewed and grey—was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Findings Only five of the twenty two included studies reviewed were RCTs that compared intervention using IM protocol with placebo intervention, and provided the outcomes in terms of percentage increase in the uptake of disease-prevention programmes, and only one of the five studies provided an effect measure in the form of relative risk (RR = 1.59, 95% CI = 1.08–2.34, p = 0.02). Of the five RCTs, three were rated as strong evidences, one as a medium evidence and one as a weak evidence, and they all reported statistically significant difference between the two study groups, with disease prevention interventions that have used the intervention mapping approach generally reported significant increases in the uptake of disease-prevention interventions, ranging from 9% to 28.5% (0.0001 ≤ p ≤ 0.02), On the other hand, all the 22 studies have successfully identified the determinants of the uptake of disease prevention interventions that is essential to the success of disease prevention programmes. Conclusion Intervention Mapping has been successfully used to plan, implement and evaluate interventions that showed significant increase in uptake of disease prevention programmes. This study has provided a good understanding of the role of intervention mapping in designing disease prevention interventions, and a good foundation upon which subsequent reviews can be guided.
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Affiliation(s)
- Rayyan M. Garba
- Department of Community Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
- * E-mail:
| | - Muktar A. Gadanya
- Department of Community Medicine, Bayero University/ Aminu Kano Teaching Hospital, Kano, Nigeria
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Kim JD. The Relationship between Cancer Screening Rates and Promotional Methods in Incheon Metropolitan City. HEALTH POLICY AND MANAGEMENT 2016. [DOI: 10.4332/kjhpa.2016.26.4.382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Fassier JB, Lamort-Bouché M, Sarnin P, Durif-Bruckert C, Péron J, Letrilliart L, Durand MJ. [The intervention mapping protocol: A structured process to develop, implement and evaluate health promotion programs]. Rev Epidemiol Sante Publique 2016; 64:33-44. [PMID: 26745997 DOI: 10.1016/j.respe.2015.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Revised: 09/21/2015] [Accepted: 10/05/2015] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Health promotion programs are expected to improve population health and reduce social inequalities in health. However, their theoretical foundations are frequently ill-defined, and their implementation faces many obstacles. The aim of this article is to describe the intervention mapping protocol in health promotion programs planning, used recently in several countries. METHODS The challenges of planning health promotion programs are presented, and the six steps of the intervention mapping protocol are described with an example. Based on a literature review, the use of this protocol, its requirements and potential limitations are discussed. RESULTS The intervention mapping protocol has four essential characteristics: an ecological perspective (person-environment), a participative approach, the use of theoretical models in human and social sciences and the use of scientific evidence. It comprises six steps: conduct a health needs assessment, define change objectives, select theory-based change techniques and practical applications, organize techniques and applications into an intervention program (logic model), plan for program adoption, implementation, and sustainability, and generate an evaluation plan. This protocol was used in different countries and domains such as obesity, tobacco, physical activity, cancer and occupational health. Although its utilization requires resources and a critical stance, this protocol was used to develop interventions which efficacy was demonstrated. CONCLUSION The intervention mapping protocol is an integrated process that fits the scientific and practical challenges of health promotion. It could be tested in France as it was used in other countries, in particular to reduce social inequalities in health.
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Affiliation(s)
- J-B Fassier
- UMR T 9405, unité mixte de recherche épidémiologique et de surveillance transport travail environnement (UMRESTTE), université Claude-Bernard Lyon 1, 8, avenue Rockefeller, 69373 Lyon cedex 08, France; CAPRIT, campus Longueuil, université de Sherbrooke, 150, place Charles-Le Moyne, bureau 200, J4K 0A8 Longueuil, QC, Canada.
| | - M Lamort-Bouché
- UMR T 9405, unité mixte de recherche épidémiologique et de surveillance transport travail environnement (UMRESTTE), université Claude-Bernard Lyon 1, 8, avenue Rockefeller, 69373 Lyon cedex 08, France; Département de médecine générale, université Claude-Bernard Lyon 1, 8, avenue Rockefeller, 69373 Lyon cedex 08, France.
| | - P Sarnin
- EA 4163, institut de psychologie, groupe de recherche en psychologie sociale (GREPS), université Lyon 2, 5, avenue P.-Mendès-France, 69656 Bron, France.
| | - C Durif-Bruckert
- EA 4163, institut de psychologie, groupe de recherche en psychologie sociale (GREPS), université Lyon 2, 5, avenue P.-Mendès-France, 69656 Bron, France.
| | - J Péron
- UMR 5558, laboratoire de biométrie et biologie évolutive (LBBE), hôpital Lyon Sud, université Claude-Bernard Lyon 1, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France.
| | - L Letrilliart
- Département de médecine générale, université Claude-Bernard Lyon 1, 8, avenue Rockefeller, 69373 Lyon cedex 08, France; EA 4129, santé individu société (SIS), institut de psychologie, université Lyon 2, 5, avenue P.-Mendès-France, 69676 Bron, France.
| | - M-J Durand
- CAPRIT, campus Longueuil, université de Sherbrooke, 150, place Charles-Le Moyne, bureau 200, J4K 0A8 Longueuil, QC, Canada.
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Intervention Mapping to Adapt Evidence-Based Interventions for Use in Practice: Increasing Mammography among African American Women. BIOMED RESEARCH INTERNATIONAL 2015; 2015:160103. [PMID: 26587531 PMCID: PMC4637430 DOI: 10.1155/2015/160103] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 09/15/2015] [Accepted: 09/20/2015] [Indexed: 12/03/2022]
Abstract
This paper describes and demonstrates the use of the systematic planning process, Intervention Mapping, to adapt an evidence-based public health intervention (EBI). We used a simplified version of Intervention Mapping (IM Adapt) to increase an intervention's fit with a new setting and population. IM Adapt guides researchers and practitioners in selecting an EBI, making decisions about whether and what to adapt, and executing the adaptation while guarding the EBI's essential elements (those responsible for effectiveness). We present a case study of a project in which we used IM Adapt to find, adapt, implement, and evaluate an EBI to improve mammography adherence for African American women in a new practice setting in Houston, Texas. IM Adapt includes the following (1) assess needs and organizational capacity; (2) find EBIs; (3) plan adaptations based on fit assessments; (4) make adaptations; (5) plan for implementation; and (6) plan for evaluation of the adapted EBI. The case study shows an example of how public health researchers and practitioners can use the tool to make it easier to find and use EBIs, thus encouraging greater uptake. IM Adapt adds to existing dissemination and adaptation models by providing detailed guidance on how to decide on effective adaptation, while maintaining the essential elements of the EBI.
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Rashid RMA, Ramli S, John J, Dahlui M. Cost effective analysis of recall methods for cervical cancer screening in Selangor--results from a prospective randomized controlled trial. Asian Pac J Cancer Prev 2015; 15:5143-7. [PMID: 25040965 DOI: 10.7314/apjcp.2014.15.13.5143] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Cervical cancer screening in Malaysia is by opportunistic Pap smear which contributes to the low uptake rate. To overcome this, a pilot project called the SIPPS program (translated as information system of Pap smear program) had been introduced whereby women aged 20-65 years old are invited for Pap smear and receive recall to repeat the test. This study aimed at determining which recall method is most cost-effective in getting women to repeat Pap smear. A randomised control trial was conducted where one thousand women were recalled for repeat smear either by registered letter, phone messages, phone call or the usual postal letter. The total cost applied for cost-effectiveness analysis includes the cost of sending letter for first invitation, cost of the recall method and cost of two Pap smears. Cost-effective analysis (CEA) of Pap smear uptake by each recall method was then performed. The uptake of Pap smear by postal letter, registered letters, SMS and phone calls were 18.8%, 20.0%, 21.6% and 34.4%, respectively (p<0.05). The CER for the recall method was lowest by phone call compared to other interventions; RM 69.18 (SD RM 0.14) compared to RM 106.53 (SD RM 0.13), RM 134.02 (SD RM 0.15) and RM 136.38 (SD RM 0.11) for SMS, registered letter and letter, respectively. ICER showed that it is most cost saving if the usual method of recall by postal letter be changed to recall by phone call. The possibility of letter as a recall for repeat Pap smear to reach the women is higher compared to sending SMS or making phone call. However, getting women to do repeat Pap smear is better with phone call which allows direct communication. Despite the high cost of the phone call as a recall method for repeat Pap smear, it is the most cost-effective method compared to others.
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Affiliation(s)
- Rima Marhayu Abdul Rashid
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya Kuala Lumpur, Malaysia E-mail :
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15
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Guvenc G, Akyuz A, Yenen MC. Effectiveness of nursing interventions to increase pap smear test screening. Res Nurs Health 2013; 36:146-57. [DOI: 10.1002/nur.21526] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2012] [Indexed: 11/10/2022]
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Ferroni E, Camilloni L, Jimenez B, Furnari G, Borgia P, Guasticchi G, Giorgi Rossi P. How to increase uptake in oncologic screening: a systematic review of studies comparing population-based screening programs and spontaneous access. Prev Med 2012; 55:587-96. [PMID: 23064024 DOI: 10.1016/j.ypmed.2012.10.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Revised: 09/10/2012] [Accepted: 10/02/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cervical, breast and colorectal cancer (CRC) screenings are universally recommended interventions. High coverage of the target population represents the most important factor in determining their success. This systematic review aimed at assessing the effectiveness of population-based screening programs in increasing coverage compared to spontaneous access. METHODS Electronic databases and national and regional websites were searched. We included all studies on interventions aimed at increasing screening participation published between 1999 and 2009; for those published before, we consulted the Jepson et al. review (2000). We compared spontaneous access (including no intervention) vs population-based screening programs actively inviting the target population. Among the latter, we compared GP-based vs invitation letter-based interventions. RESULTS The invitation letter vs no intervention showed significantly more participation (RR=1.60 95%CI 1.33-1.92; RR=1.52 95%CI 1.28-1.82; RR=1.15 95%CI 1.12-1.19, for breast, cervical and CRC screenings, respectively). GP-based interventions, although more heterogeneous, showed a significant effect when compared with no intervention for breast (RR=1.74 95%CI 1.25-2.43), but not for cervical and CRC. No significant differences were found between invitation letter-based and GP-based organization (RR=0.99 95%CI 0.94-1.05; RR=1.08 95%CI 0.99-1.17, for breast and cervical cancer, respectively). CONCLUSION Population-based programs are more effective than spontaneous screening in obtaining higher testing uptake. Both invitation letter-based and GP-based programs are effective.
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Affiliation(s)
- E Ferroni
- Laziosanità, Public Health Agency, Lazio Region, Rome, Italy
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Lu M, Moritz S, Lorenzetti D, Sykes L, Straus S, Quan H. A systematic review of interventions to increase breast and cervical cancer screening uptake among Asian women. BMC Public Health 2012; 12:413. [PMID: 22676147 PMCID: PMC3488494 DOI: 10.1186/1471-2458-12-413] [Citation(s) in RCA: 113] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Accepted: 05/12/2012] [Indexed: 12/20/2022] Open
Abstract
Background The Asian population is one of the fastest growing ethnic minority groups in western countries. However, cancer screening uptake is consistently lower in this group than in the native-born populations. As a first step towards developing an effective cancer screening intervention program targeting Asian women, we conducted a comprehensive systematic review, without geographic, language or date limitations, to update current knowledge on the effectiveness of existing intervention strategies to enhance breast and cervical screening uptake in Asian women. Methods This study systematically reviewed studies published as of January 2010 to synthesize knowledge about effectiveness of cancer screening interventions targeting Asian women. Fifteen multidisciplinary peer-reviewed and grey literature databases were searched to identify relevant studies. Results The results of our systematic review were reported in accordance with the PRISMA Statement. Of 37 selected intervention studies, only 18 studies included valid outcome measures (i.e. self-reported or recorded receipt of mammograms or Pap smear). 11 of the 18 intervention studies with valid outcome measures used multiple intervention strategies to target individuals in a specific Asian ethnic group. This observed pattern of intervention design supports the hypothesis that employing a combination of multiple strategies is more likely to be successful than single interventions. The effectiveness of community-based or workplace-based group education programs increases when additional supports, such as assistance in scheduling/attending screening and mobile screening services are provided. Combining cultural awareness training for health care professionals with outreach workers who can help healthcare professionals overcome language and cultural barriers is likely to improve cancer screening uptake. Media campaigns and mailed culturally sensitive print materials alone may be ineffective in increasing screening uptake. Intervention effectiveness appears to vary with ethnic population, methods of program delivery, and study setting. Conclusions Despite some limitations, our review has demonstrated that the effectiveness of existing interventions to promote breast and cervical cancer screening uptake in Asian women may hinge on a variety of factors, such as type of intervention and study population characteristics. While some studies demonstrated the effectiveness of certain intervention programs, the cost effectiveness and long-term sustainability of these programs remain questionable. When adopting an intervention program, it is important to consider the impacts of social-and cultural factors specific to the Asian population on cancer screening uptake. Future research is needed to develop new interventions and tools, and adopt vigorous study design and evaluation methodologies to increase cancer screening among Asian women to promote population health and health equity.
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Affiliation(s)
- Mingshan Lu
- Departments of Economics and Community Health Sciences, University of Calgary, Calgary, AB, Canada.
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Gu C, Chan CWH, Twinn S, Choi KC. The influence of knowledge and perception of the risk of cervical cancer on screening behavior in mainland Chinese women. Psychooncology 2011. [DOI: 10.1002/pon.2037] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Can Gu
- The Nethersole School of Nursing; The Chinese University of Hong Kong; Hong Kong
| | - Carmen W. H. Chan
- The Nethersole School of Nursing; The Chinese University of Hong Kong; Hong Kong
| | - Sheila Twinn
- The Nethersole School of Nursing; The Chinese University of Hong Kong; Hong Kong
| | - Kai Chow Choi
- The Nethersole School of Nursing; The Chinese University of Hong Kong; Hong Kong
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Everett T, Bryant A, Griffin MF, Martin‐Hirsch PPL, Forbes CA, Jepson RG. Interventions targeted at women to encourage the uptake of cervical screening. Cochrane Database Syst Rev 2011; 2011:CD002834. [PMID: 21563135 PMCID: PMC4163962 DOI: 10.1002/14651858.cd002834.pub2] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND World-wide, cervical cancer is the second most common cancer in women. Increasing the uptake of screening, alongside increasing informed choice is of great importance in controlling this disease through prevention and early detection. OBJECTIVES To assess the effectiveness of interventions aimed at women, to increase the uptake, including informed uptake, of cervical cancer screening. SEARCH STRATEGY We searched the Cochrane Gynaecological Cancer Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), Issue 1, 2009. MEDLINE, EMBASE and LILACS databases up to March 2009. We also searched registers of clinical trials, abstracts of scientific meetings, reference lists of included studies and contacted experts in the field. SELECTION CRITERIA Randomised controlled trials (RCTs) of interventions to increase uptake/informed uptake of cervical cancer screening. DATA COLLECTION AND ANALYSIS Two review authors independently abstracted data and assessed risk of bias. Where possible the data were synthesised in a meta-analysis. MAIN RESULTS Thirty-eight trials met our inclusion criteria. These trials assessed the effectiveness of invitational and educational interventions, counselling, risk factor assessment and procedural interventions. Heterogeneity between trials limited statistical pooling of data. Overall, however, invitations appear to be effective methods of increasing uptake. In addition, there is limited evidence to support the use of educational materials. Secondary outcomes including cost data were incompletely documented so evidence was limited. Most trials were at moderate risk of bias. Informed uptake of cervical screening was not reported in any trials. AUTHORS' CONCLUSIONS There is evidence to support the use of invitation letters to increase the uptake of cervical screening. There is limited evidence to support educational interventions but it is unclear what format is most effective. The majority of the studies are from developed countries and so the relevance to developing countries is unclear.
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Affiliation(s)
- Thomas Everett
- Addenbrooke's Hospital NHS Foundation TrustDepartment of Gynaecological OncologyBOX 242, Addenbrooke's HospitalHills RoadCambridgeUKCB2 0QQ
| | - Andrew Bryant
- Newcastle UniversityInstitute of Health & SocietyMedical School New BuildRichardson RoadNewcastle upon TyneUKNE2 4AX
| | - Michelle F Griffin
- Addenbrooke's Hospital NHS Foundation TrustDepartment of Gynaecological OncologyBOX 242, Addenbrooke's HospitalHills RoadCambridgeUKCB2 0QQ
| | - Pierre PL Martin‐Hirsch
- Royal Preston Hospital, Lancashire Teaching Hospital NHS TrustGynaecological Oncology UnitSharoe Green LaneFullwoodPrestonLancashireUKPR2 9HT
| | - Carol A Forbes
- University of YorkNHS Centre for Reviews & DisseminationHeslingtonYorkNorth YorkshireUKYO10 5DD
| | - Ruth G Jepson
- Scottish Collaboration for Public Health Research and Policy (SCPHRP)20 West Richmond StreetEdinburghScotlandUKEH8 9DX
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Schmid AA, Andersen J, Kent T, Williams LS, Damush TM. Using intervention mapping to develop and adapt a secondary stroke prevention program in Veterans Health Administration medical centers. Implement Sci 2010; 5:97. [PMID: 21159171 PMCID: PMC3057184 DOI: 10.1186/1748-5908-5-97] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2009] [Accepted: 12/15/2010] [Indexed: 12/01/2022] Open
Abstract
Secondary stroke prevention is championed by the stroke guidelines; however, it is rarely systematically delivered. We sought to develop a locally tailored, evidence-based secondary stroke prevention program. The purpose of this paper was to apply intervention mapping (IM) to develop our locally tailored stroke prevention program and implementation plan. We completed a needs assessment and the five Steps of IM. The needs assessment included semi-structured interviews of 45 providers; 26 in Indianapolis and 19 in Houston. We queried frontline clinical providers of stroke care using structured interviews on the following topics: current provider practices in secondary stroke risk factor management; barriers and needs to support risk factor management; and suggestions on how to enhance secondary stroke risk factor management throughout the continuum of care. We then describe how we incorporated each of the five Steps of IM to develop locally tailored programs at two sites that will be evaluated through surveys for patient outcomes, and medical records chart abstraction for processes of care.
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Affiliation(s)
- Arlene A Schmid
- Roudebush Veterans Administration Medical Center; Health Services Research and Development (HSR&D) Center on Implementing Evidence-Based Practice, 1481 W. 10th Street, 11 H, Indianapolis, Indiana 46202-5199, USA
- VA Stroke Quality Enhancement Research Initiative (QUERI), 1481 W. 10th Street, 11 H, Indianapolis, Indiana 46202-5199, USA
- Indiana University School of Health and Rehabilitation Science, Department of Occupational Therapy, 1140 W. Michigan Street CF 311, Indianapolis, Indiana 46202-5199, USA
- Indiana University Center for Aging Research 1001 West 10th Street, Indianapolis, Indiana 46202-5199, USA
- Regenstrief Institute, 1001 West 10th Street, Indianapolis, Indiana 46202-5199, USA
| | - Jane Andersen
- Michael E. DeBakey Veterans Administration Medical Center, 2002 Holcombe BlvdHouston, TX, USA
| | - Thomas Kent
- Michael E. DeBakey Veterans Administration Medical Center, 2002 Holcombe BlvdHouston, TX, USA
| | - Linda S Williams
- Roudebush Veterans Administration Medical Center; Health Services Research and Development (HSR&D) Center on Implementing Evidence-Based Practice, 1481 W. 10th Street, 11 H, Indianapolis, Indiana 46202-5199, USA
- VA Stroke Quality Enhancement Research Initiative (QUERI), 1481 W. 10th Street, 11 H, Indianapolis, Indiana 46202-5199, USA
- Regenstrief Institute, 1001 West 10th Street, Indianapolis, Indiana 46202-5199, USA
- Indiana University School of Medicine, Department of Neurology, 1001 West 10th Street, Indianapolis, Indiana 46202-5199, USA
| | - Teresa M Damush
- Roudebush Veterans Administration Medical Center; Health Services Research and Development (HSR&D) Center on Implementing Evidence-Based Practice, 1481 W. 10th Street, 11 H, Indianapolis, Indiana 46202-5199, USA
- VA Stroke Quality Enhancement Research Initiative (QUERI), 1481 W. 10th Street, 11 H, Indianapolis, Indiana 46202-5199, USA
- Indiana University Center for Aging Research 1001 West 10th Street, Indianapolis, Indiana 46202-5199, USA
- Regenstrief Institute, 1001 West 10th Street, Indianapolis, Indiana 46202-5199, USA
- Indiana University School of Medicine, Department of General Internal and Geriatrics, 1001 West 10th Street, Indianapolis, Indiana 46202-5199, USA
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Suzuki R, Peterson JJ, Weatherby AV, Buckley DI, Walsh ES, Kailes JI, Krahn GL. Using intervention mapping to promote the receipt of clinical preventive services among women with physical disabilities. Health Promot Pract 2010; 13:106-15. [PMID: 21059870 DOI: 10.1177/1524839910382624] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article describes the development of Promoting Access to Health Services (PATHS), an intervention to promote regular use of clinical preventive services by women with physical disabilities. The intervention was developed using intervention mapping (IM), a theory-based logical process that incorporates the six steps of assessment of need, preparation of matrices, selection of theoretical methods and strategies, program design, program implementation, and evaluation. The development process used methods and strategies aligned with the social cognitive theory and the health belief model. PATHS was adapted from the workbook Making Preventive Health Care Work for You, developed by a disability advocate, and was informed by participant input at five points: at inception through consultation by the workbook author, in conceptualization through a town hall meeting, in pilot testing with feedback, in revision of the curriculum through an advisory group, and in implementation by trainers with disabilities. The resulting PATHS program is a 90-min participatory small-group workshop, followed by structured telephone support for 6 months.
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Affiliation(s)
- Rie Suzuki
- University of Michigan-Flint, Michigan, USA.
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Tung WC, Lu M, Cook D. Papanicolaou screening in Taiwan: perceived barriers and self-efficacy. Health Care Women Int 2010; 31:421-34. [PMID: 20390663 DOI: 10.1080/07399330903349699] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Cervical cancer remains a leading cause of death in Taiwan, and frequency of screening remains low. We surveyed Taiwanese women about beliefs and practices related to cervical screening, searching for perceived barriers and self-efficacy using the transtheoretical model. We assessed demographics, 12 perceived barriers, and seven self-efficacy measures for 222 Taiwanese women. Data were analyzed descriptively and with multiple linear regression. Barriers related to worry, embarrassment, stigma, and the lack of female physicians were significant in the relapse stage. All self-efficacy measures were significant across various stages of change. Interventions should focus on relapsers and on information related to self-efficacy.
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Affiliation(s)
- Wei-Chen Tung
- School of Community Health Sciences, University of Nevada-Reno, NV 89557, USA.
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Tortolero SR, Markham CM, Parcel GS, Peters RJ, Escobar-Chaves SL, Basen-Engquist K, Lewis HL. Using intervention mapping to adapt an effective HIV, sexually transmitted disease, and pregnancy prevention program for high-risk minority youth. Health Promot Pract 2005; 6:286-98. [PMID: 16020623 DOI: 10.1177/1524839904266472] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although many programs have been developed to reduce adolescent pregnancy and sexually transmitted diseases (STDs) (including HIV), with some showing promise in reducing sexual risk-taking behavior, little guidance has been given as to how to adapt existing interventions to new communities. When adapting a program, effective elements deemed necessary to change behaviors need to be preserved, while cultural competence and relevance for the new population must be considered in creating new elements. To address these needs, the authors describe the application of a systematic process, intervention mapping (IM), to adapt a theory-based, multicomponent HIV, STD, and pregnancy prevention program titled Safer Choices to a new target population, at-risk youth attending alternative schools and at risk of dropping out. IM is a detailed process that provides planners with a systematic method for decision making in each phase of developing or adapting an intervention to influence changes in behavior and environmental conditions.
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Affiliation(s)
- Susan R Tortolero
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center, Houston, Texas, USA
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Díez E, Juárez O, Villamarín F. [Health promotion interventions based on theoretical models]. Med Clin (Barc) 2005; 125:193-7. [PMID: 16153363 DOI: 10.1157/13077143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Elia Díez
- Agència de Salut Pública de Barcelona, Barcelona, Spain
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Hou SI, Luh WM. Psychometric Properties of the Cervical Smear Belief Inventory for Chinese Women. Int J Behav Med 2005; 12:180-91. [PMID: 16083321 DOI: 10.1207/s15327558ijbm1203_7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
This study examines the reliability and validity of the scores of Cervical Smear Belief Inventory (CSBI) among Chinese women in Taiwan. Women who were nonadherent to cervical screening guidelines were recruited (N = 424). Reliabilities showed good internal consistency for the perceived Pros, Cons, and Susceptibility scales (a ranged from .78 to .87). Factor analysis showed good construct validity of the scores of CSBI that revealed concordant patterns with existing social and behavioral theories, except that the Norms scale was loaded with the Pros scale. Moreover, two items in the Cons scale appeared to be "cultural belief toward virginity." Item-discrimination analysis showed that all items in the CSBI successfully discriminated women with favorable cervical smear beliefs from those with unfavorable beliefs (p < .001). In summary, many psychometric properties of the CSBI showed that the scores of the inventory were reliable and valid to assess belief toward cervical smear among Chinese women.
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Affiliation(s)
- Su-I Hou
- Department of Health Promotion and Behavior, The University of Georgia, Athens, Georgia 30602-6522, USA.
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Hou SI. Stage of adoption and impact of direct-mail communications with and without phone intervention on Chinese women's cervical smear screening behavior. Prev Med 2005; 41:749-56. [PMID: 16120455 DOI: 10.1016/j.ypmed.2005.07.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2004] [Revised: 07/12/2005] [Accepted: 07/14/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND The purposes of the study were to (1) assess the impact of direct-mail communications with and without phone intervention, and (2) examine the characteristics of women who were more likely to respond. METHODS Women were recruited from female family members of inpatients admitted to one of the major teaching hospitals in Taiwan (n = 424), and were randomly assigned into an intervention group, who received direct-mails and a phone follow-up, or a control group, who received placebo messages. RESULTS Logistic regression analysis showed that women in the intervention group (ORadj. = 2.31) and contemplation stage (ORadj. = 4.18) were more likely to receive a screening at the end of the program. Among women in the intervention group, contemplators were 5.58 times more likely to receive a screening before the phone intervention (early adopters); and 40% of the screening adopters responded after the phone intervention (late adopters). Late and early adopters were similar in their stage, age, and education. CONCLUSIONS Stage and intervention are both significant predictors of screening adoption. The study provides justification for programs to target women in contemplation stage. It also suggests that the boost of a later phone intervention may be consequential for encouraging more women with similar demographics to take action.
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Affiliation(s)
- Su-I Hou
- Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, 309 Ramesy Center, GA 30602, USA.
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Hou SI, Fernandez ME, Parcel GS. Development of a cervical cancer educational program for Chinese women using intervention mapping. Health Promot Pract 2004; 5:80-7. [PMID: 14965438 DOI: 10.1177/1524839903257311] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article describes the development of a program to increase Pap screening behavior among women in Taiwan. Intervention mapping, an innovative process of intervention design, guided the development of this program. The development process included a needs assessment identifying factors influencing Pap screening behavior relevant to Chinese women. The program used methods such as information transmission, modeling, persuasion, and facilitation. Strategies included direct mail communication, role-model stories and testimonials, and a telephone-counseling component. The delineation of specific plans for implementation and evaluation are also described.
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Affiliation(s)
- Su-I Hou
- Health Promotion and Behavior, University of Georgia, Athens, GA, USA
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Affiliation(s)
- Su-I Hou
- Department of Health Promotion and Behavior, University of Georgia, Athens, GA, USA
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