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Henson-Garcia M, Malthaner LQ, Jetelina KK, Mackert M, Allicock M, McKay S. Toward Tailored and Targeted Communication for the Promotion of Firearm Safety: A Qualitative Study With Firearm Retailers. Psychol Rep 2024:332941241256880. [PMID: 38819964 DOI: 10.1177/00332941241256880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2024]
Abstract
Firearm injury is a major yet understudied public health issue in the U.S. This qualitative study explored firearm retailers' perspectives to inform messaging and communication approaches to promote firearm safety among the gun owning population. Semi-structured interviews were conducted with 17 retailers at a single gun shop in Texas. Thematic analysis identified key themes related to (1) audience segmentation, (2) appropriate use of language, and (3) trusted messengers and modalities for the communication of firearm safety information. This formative work provides practical insights to optimize public health messaging in this arena and ultimately reduce firearm injuries. Overall, this study provides valuable insights to guide the development and implementation of evidence-based, social marketing efforts aiming to promote firearm safety across various gun-owning audiences.
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Affiliation(s)
- Mike Henson-Garcia
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston (UTHealth Houston), School of Public Health, Dallas Regional Campus, Dallas, TX, USA
- McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth Houston), Houston, TX, USA
| | - Lauren Q Malthaner
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston (UTHealth Houston), School of Public Health, Dallas Regional Campus, Dallas, TX, USA
| | - Katelyn K Jetelina
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston (UTHealth Houston), School of Public Health, Dallas Regional Campus, Dallas, TX, USA
| | - Michael Mackert
- The Stan Richards School of Advertising and Public Relations, University of Texas at Austin, Austin, TX, USA
| | - Marlyn Allicock
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston (UTHealth Houston), School of Public Health, Dallas Regional Campus, Dallas, TX, USA
| | - Sandra McKay
- McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth Houston), Houston, TX, USA
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Yagihashi M, Murakami M, Kato M, Yamamura A, Miura A, Hirai K. Exploratory study to characterise the individual types of health literacy and beliefs and their associations with infection prevention behaviours amid the COVID-19 pandemic in Japan: a longitudinal study. PeerJ 2024; 12:e16905. [PMID: 38406277 PMCID: PMC10894591 DOI: 10.7717/peerj.16905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 01/17/2024] [Indexed: 02/27/2024] Open
Abstract
Background During a global infectious disease pandemic such as the coronavirus disease 2019 (COVID-19), individuals' infection prevention/risk-taking behaviours are likely to differ depending on their health literacy and beliefs regarding the disease. To effectively promote infection prevention behaviours, it is necessary to enable information dissemination and risk communication that consider individuals' health literacy and beliefs. In this study, we exploratorily characterised segments based on individual health literacy and beliefs regarding COVID-19 among the Japanese during the early stage of the COVID-19 pandemic, and investigated whether infection prevention/risk-taking behaviours and fear of COVID-19 differed among these segments. Methods In this study, we conducted two web-based longitudinal surveys in Japan (PHASE 1, 1-30 November 2020, 6,000 participants; PHASE 2, 1-31 December 2020, 3,800 participants). We characterised segments of the target population using cluster analysis on health literacy and beliefs regarding COVID-19 obtained in PHASE 1. We further investigated the associations between the clusters and infection prevention/risk-taking behaviours and fear of COVID-19, obtained from PHASE 2. Results Five clusters were identified: 'Calm/hoax denial', 'Hoax affinity/threat denial', 'Minority/indifference', 'Over vigilance', and 'Optimism'. There were significant differences in infection prevention/risk-taking behaviours and fear of COVID-19 among the five clusters. The belief in susceptibility to infection, rather than affinity for hoaxes and conspiracy theories, was coherently associated with infection prevention/risk-taking behaviours and fear of infection across clusters. This study provides foundational knowledge for creating segment-specific public messages and developing interactive risk communication to encourage infection prevention behaviours.
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Affiliation(s)
- Mao Yagihashi
- Division of Scientific Information and Public Policy, Center for Infectious Disease Education and Research, Osaka University, Suita, Osaka, Japan
| | - Michio Murakami
- Division of Scientific Information and Public Policy, Center for Infectious Disease Education and Research, Osaka University, Suita, Osaka, Japan
| | - Mai Kato
- Graduate School of Human Sciences, Osaka University, Suita, Osaka, Japan
| | - Asayo Yamamura
- Graduate School of Human Sciences, Osaka University, Suita, Osaka, Japan
| | - Asako Miura
- Division of Scientific Information and Public Policy, Center for Infectious Disease Education and Research, Osaka University, Suita, Osaka, Japan
- Graduate School of Human Sciences, Osaka University, Suita, Osaka, Japan
| | - Kei Hirai
- Division of Scientific Information and Public Policy, Center for Infectious Disease Education and Research, Osaka University, Suita, Osaka, Japan
- Graduate School of Human Sciences, Osaka University, Suita, Osaka, Japan
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Akiyama M, Ishida N, Takahashi H, Takahashi M, Otsuki A, Sato Y, Saito J, Yaguchi-Saito A, Fujimori M, Kaji Y, Shimazu T. Screening practices of cancer survivors and individuals whose family or friends had a cancer diagnoses-a nationally representative cross-sectional survey in Japan (INFORM Study 2020). J Cancer Surviv 2023; 17:663-676. [PMID: 37041402 PMCID: PMC10089820 DOI: 10.1007/s11764-023-01367-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/16/2023] [Indexed: 04/13/2023]
Abstract
PURPOSE We examined cancer screening practices and related beliefs in cancer survivors and individuals with family or close friends with a cancer diagnosis compared to individuals without the above cancer history for 5 population-based (gastric, colorectal, lung, breast, cervical) and 1 opportunistic (prostate) cancer screenings using nationally representative cross-sectional survey in Japan. METHODS We analyzed 3269 data from 3605 respondents (response rate, 37.1%) and compared the screening beliefs and practices of cancer survivors (n = 391), individuals with family members (n = 1674), and close friends with a cancer diagnosis (n = 685) to those without any cancer history (n = 519). RESULTS Being a cancer survivor was associated with screening for gastric (OR, 1.75; 95% CI, 1.04-2.95), colorectal (OR, 1.56; 95% CI, 1.03-2.36), and lung cancer (OR, 1.71; 95% CI, 1.10-2.66) but not breast, cervical cancer or PSA test. Having a family cancer diagnosis was associated with colorectal and lung cancer screening. Having friends with a cancer diagnosis was associated with PSA test. Cancer survivors and family members perceived themselves as being more susceptible and worried about getting cancer than individuals without any cancer history. Cancer survivors strongly believed screening can detect cancer and were more likely to undergo screening. Subgroup analysis indicated an interrelation between gastric and colorectal cancer screening among survivors. CONCLUSIONS A cancer diagnosis in oneself or family or friend influences an individual's health-related belief and risk perception, which can increase the likelihood of cancer screening. IMPLICATIONS FOR CANCER SURVIVORS Targeted and tailored communication strategies can increase awareness of cancer screening.
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Affiliation(s)
- Miki Akiyama
- Faculty of Information Studies, Keio University, Fujisawa City, Kanagawa, Japan.
| | - Noriyuki Ishida
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Hiroyasu Takahashi
- Division of Screening Assessment and Management, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Miyako Takahashi
- Japan Cancer Survivorship Network, Tokyo, Japan
- Iwate Medical University, Morioka, Iwate, Japan
- Tokyo Jikei University School of Medicine, Tokyo, Japan
| | - Aki Otsuki
- Division of Behavioral Sciences, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Yasunori Sato
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Junko Saito
- Division of Behavioral Sciences, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Akiko Yaguchi-Saito
- Division of Behavioral Sciences, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
- Faculty of Human Sciences, Tokiwa University, Mito, Ibaraki, Japan
| | - Maiko Fujimori
- Division of Supportive Care, Survivorship and Translational Research, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Yuki Kaji
- Division of Behavioral Sciences, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Taichi Shimazu
- Division of Behavioral Sciences, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
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Shima A, Tanaka H, Okamura T, Nishikawa T, Morino A, Godai K, Tatsumi Y, Kawahara M, Kiyohara M, Kawatsu Y, Kimura T, Miyamatsu N. Offering on-site mammography in workplaces improved screening rates: Cluster randomized controlled trial. J Occup Health 2023; 65:e12389. [PMID: 36823700 PMCID: PMC9950350 DOI: 10.1002/1348-9585.12389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/17/2022] [Accepted: 01/19/2023] [Indexed: 02/25/2023] Open
Abstract
OBJECTIVES Despite evidence of breast cancer screening efficacy, the screening rate has remained less than 50% in Japan. This study aimed to evaluate the effect of an environmental approach offering on-site mammography in workplaces. METHODS Supermarket stores were randomly assigned into two groups, the intervention group (leaflet and mammography) and the control group (leaflet). From May to July 2018, participants in the intervention group were given a leaflet informing them of the subsidies for breast cancer screening and offered the opportunity to have mammography in their workplaces. Participants in the control group were given the same leaflet, but had to arrange their own screening outside the workplace. The primary outcome was the breast cancer screening rate in 2018. The odds ratio (OR) and 95% confidence interval (CI) for having screening in the intervention group compared with the control group were estimated using multilevel logistic regression. RESULTS We analyzed data from 1624 participants (mean age 53 years) from 25 supermarket stores (intervention: 8 stores, control: 17 stores). Among participants who had not attended screening in the previous year, the screening rate was 7% in the control group and 53% in the intervention group, with an adjusted OR (95% CI) of 14.22 (8.97-22.54). The effect was greater in those who had never attended screening before. CONCLUSION In a worksite-based cluster randomized controlled trial in Japanese supermarket stores, an environmental approach offering mammography in workplaces substantially increased the breast cancer screening rate within 1 year (UMIN000030465).
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Affiliation(s)
- Azusa Shima
- Department of Clinical NursingShiga University of Medical ScienceShigaJapan
- Occupational Health Care Office, Heiwado Co.ShigaJapan
| | | | - Tomonori Okamura
- Department of Preventive Medicine and Public HealthKeio University School of MedicineTokyoJapan
| | - Tomofumi Nishikawa
- Department of Health and NutritionKyoto Koka Women's UniversityKyotoJapan
| | - Ayumi Morino
- Department of Clinical NursingShiga University of Medical ScienceShigaJapan
- Occupational Health Care Office, Heiwado Co.ShigaJapan
| | - Kayo Godai
- Department of Health Promotion ScienceOsaka University Graduate School of MedicineOsakaJapan
| | - Yukako Tatsumi
- Department of Hygiene and Public HealthTeikyo University School of MedicineTokyoJapan
| | - Mizuki Kawahara
- Department of Clinical NursingShiga University of Medical ScienceShigaJapan
| | - Maiko Kiyohara
- Department of Clinical NursingShiga University of Medical ScienceShigaJapan
| | | | - Takashi Kimura
- General Incorporated Foundation Kinki Health Administration CenterShigaJapan
| | - Naomi Miyamatsu
- Department of Clinical NursingShiga University of Medical ScienceShigaJapan
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Takemura Y, Sato K, Kondo K, Kondo N. Characteristics associated with optimistic or pessimistic perception about the probability of contracting COVID-19: A cross-sectional study of Japanese older adults. SSM Popul Health 2022; 19:101186. [PMID: 35958226 PMCID: PMC9357279 DOI: 10.1016/j.ssmph.2022.101186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/16/2022] [Accepted: 07/22/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction Excessive optimistic perception about the probability of acquiring coronavirus disease (COVID-19) may hinder people from exercising preventive measures, whereas excessive pessimistic perception can induce psychological problems. Not much focus has been paid to this topic, and prior studies are only online surveys. We determined the characteristics of older adults with optimistic and pessimistic perceptions of the probability of contracting COVID-19. Methods We used data from the Japan Gerontological Evaluation Study (JAGES), including 18,045 participants aged ≥ 65 years (mean age: 75.7 years) who were physically and cognitively independent. Self-reported questionnaires were sent to 11 municipalities between November 2020 and February 2021. Multinomial logistic regression was used for data analysis. Results The characteristics of 1,596 (8.8%) participants with optimistic perception and 1,276 (7.1%) with pessimistic perception were compared with that of others (80.4%) with moderate perception. Optimism about infection probability was positively associated with older age; better perceived financial conditions but negatively associated with higher education level; trust in TV news programs, TV information programs, and government-issued newsletters; depressive symptoms; and higher levels of reciprocity. Pessimism was negatively associated with higher levels of social cohesion. In contrast, it was positively associated with engagement in paid work; trust in TV news programs, the Internet, and information from medical staff; and depressive symptoms. Conclusion Optimistic and pessimistic perceptions about the probability of acquiring infection correlated differently with various characteristics. Thus, risk communication during a pandemic should be tailored based on specific individual characteristics. The perception of COVID-19 infection probability among older adults was studied. Older age, lower education and reciprocity were associated with optimism. Lower social cohesion, employment and depression correlated with pessimism. Trust in information from the TV and Internet was associated with pessimism.
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Affiliation(s)
- Yuta Takemura
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Koryu Sato
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
- Corresponding author. Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University Floor 2, Science Frontier Laboratory, Yoshida-Konoecho, Sakyo-ku, Kyoto-shi, Kyoto, 606-8315, Japan.
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
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Oyalowo A, Forde KA, Lamanna A, Kochman ML. Effect of Patient-Directed Messaging on Colorectal Cancer Screening: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e224529. [PMID: 35357457 PMCID: PMC8972032 DOI: 10.1001/jamanetworkopen.2022.4529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
Abstract
IMPORTANCE Colorectal cancer (CRC) screening is underused in the US. Tailored message interventions have shown benefit for increasing screening uptake of mammography and Papanicolaou testing, but their role in CRC screening is less clear. OBJECTIVE To evaluate the effectiveness of a tailored message telephone intervention prior to scheduling of a screening or surveillance colonoscopy and its effect on CRC screening completion rates. DESIGN, SETTING, AND PARTICIPANTS This randomized clinical trial was conducted from July 2017 through August 2018 at the University of Pennsylvania Health System (UPHS), an urban academic medical center. Participants were asymptomatic patients aged 50 to 75 years who were eligible for CRC screening or surveillance, had been referred for colonoscopy, and did not have a scheduled colonoscopy appointment. Data analysis was conducted from January to September 2019. INTERVENTIONS Patients underwent block randomization in a 1:1:1 ratio to 1 of 3 study arms. Participants in the usual care group were contacted via a mailed letter and instructed to call to schedule a colonoscopy. In the generic message group, participants were contacted by telephone, completed an assessment, and received a uniform, nontailored message encouraging colonoscopy scheduling. Participants in the tailored message group were contacted by telephone, completed an assessment, and received a tailored message encouraging colonoscopy scheduling based on their identified assessment cohort. MAIN OUTCOMES AND MEASURES The primary outcome was colonoscopy completion rate within 120 days of enrollment. The secondary outcome was colonoscopy scheduling rate appointment within 120 days of enrollment. RESULTS A total of 600 participants (median [IQR] age, 56 [51-63] years; 373 women [62.2%]) were enrolled, including 200 participants randomized to usual care, 200 participants randomized to the generic message, and 200 participants randomized to the tailored message. The total sample included 12 Asian participants (2.0%), 324 Black participants (54.0%), and 227 White participants (37.8%), and 9 participants (1.5%) were of Latino or Hispanic ethnicity. Colonoscopy completion was significantly higher for both the tailored message group (69 participants [34.5%]) and the generic message group (64 participants [32.0%]) compared with the usual care group (37 participants [18.5%]) (P < .001 and P = .002, respectively). Scheduling rates were also significantly higher in both groups, with 106 participants (53.0%) in the tailored message group and 105 participants (52.5%) in the generic message group scheduling appointments, compared with 54 participants (27.0%) in the usual care arm (P < .001 for both). CONCLUSIONS AND RELEVANCE In this randomized clinical trial among individuals whose CRC screening was not up to date, both a tailored message intervention and a generic message intervention were significantly more effective at increasing colonoscopy scheduling and completion rates compared with usual care. These findings suggest that individualized health communications can increase individual motivation to obtain CRC screening. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03310892.
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Affiliation(s)
- Akinbowale Oyalowo
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Kimberly A. Forde
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
- Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Alicia Lamanna
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Michael L. Kochman
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
- Center for Endoscopic Innovation, Research, and Training, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
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Furukawa Y, Saito H, Hasegawa K, Ichikawa M. Assessing the quality of cancer screening leaflets using the International Patient Decision Aids Standards instrument: A cross-sectional content analysis. PATIENT EDUCATION AND COUNSELING 2021; 104:3100-3103. [PMID: 33846033 DOI: 10.1016/j.pec.2021.03.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 03/26/2021] [Accepted: 03/30/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To assess the quality of national cancer screening program leaflets in Japan from the informed-decision perspective. METHODS Cross-sectional content analysis of invitation leaflets issued by centralized organizations and used nationwide in Japan was conducted. Three members independently evaluated the materials using International Patient Decision Aids Standards six-item minimum criteria for qualifying patient decision aids. PATIENT PUBLIC INVOLVEMENT Co-author KH is a cancer patient himself. We also sought feedbacks from three other cancer survivors and two bereaved family members. RESULTS Inter-rater agreement was substantial (Fleiss' kappa=0.62). The median score was 2 out of 6 (range: 2-3). All leaflets described the cancer (Q1: 7/7) and screening modality (Q2: 7/7). None stated not undergoing screening as an option. One stated another screening modality (Q3: 1/7). None stated both the positive and negative features of multiple options (Q4: 0/7. Q5: 0/7). One described the psychological and social experience of screening but only its positive side (Q6: 1/7). CONCLUSIONS There is room for improvement in the content of the public cancer screening invitation leaflets in Japan from informed-decision perspective. PRACTICE IMPLICATIONS Cancer screening leaflets should provide evidence-based, well-balanced, easy-to-understand information to educate people on cancer screening while maintaining people's autonomy.
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Affiliation(s)
- Yuki Furukawa
- Department of Neuropsychiatry, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
| | - Hiroko Saito
- Teikyo University Graduate School of Public Health, 2-11-1, Kaga, Itabashi-ku, Tokyo 173-8605, Japan
| | - Kazuo Hasegawa
- Non-Profit Organization Lung Cancer Patient Group ONE STEP, 1-38-9, Sakuragaoka, Hodogaya-ku, Yokohama-shi, Kanagawa 240-0011, Japan
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Ueda Y, Katayama K, Yagi A, Kimura T. The Chasm We Must Cross in Japan for Re-promotion of the HPV Vaccine. Cancer Prev Res (Phila) 2021; 14:683-686. [PMID: 34272250 DOI: 10.1158/1940-6207.capr-21-0091] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 03/26/2021] [Accepted: 04/26/2021] [Indexed: 11/16/2022]
Abstract
In Japan, the human papillomavirus (HPV) vaccination rate has decreased from around 70% to less than 1% due to repeated media reports of diverse symptoms after HPV vaccination, and to suspension of the governmental recommendation. The challenges for re-promotion of the vaccine will be discussed from a marketing perspective. The adopter categories by which a new product penetrates the market can be divided into five groups, including Innovators, Early adopters, Early majority, Late majority, and Laggards The 16.0% line, which is the sum of the percentages of the innovators and the early adopters, is thought to be an important determinate of whether a new product will penetrate the market. By various initiatives, vaccination coverage has recently risen to about 10%; however, there is still a large chasm difficult to cross before reaching the majority of individuals. To cross that chasm, peer education will be essential. First, community health workers will need to be educated so that they have a firm understanding of HPV vaccine and can confidently recommend vaccination to the targeted population. That population will be expected to pass on that recommendation to their acquaintances, resulting in widening dissemination of HPV vaccine among the majority.
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Affiliation(s)
- Yutaka Ueda
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
| | - Kayoko Katayama
- Kanagawa Cancer Center Research Institute, Yokohama, Kanagawa, Japan
| | - Asami Yagi
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
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Tominaga Y, Morisky DE, Mochizuki M. A cross-sectional study clarifying profiles of patients with diabetes who discontinued pharmacotherapy: reasons and consequences. BMC Endocr Disord 2021; 21:117. [PMID: 34120602 PMCID: PMC8201823 DOI: 10.1186/s12902-021-00778-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 05/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although diabetes is one of the fastest increasing diseases in prevalence worldwide and demands significant medical resources, more than half of all patients with diabetes do not achieve the expected target level of blood glucose. As a potential cause of poor glycemic control, insufficient adherence to medication has long been discussed and variably studied. However, dropout from treatment as another plausible cause has not been fully examined. The aim of this study was to clarify profiles of patients with diabetes who discontinued pharmacotherapy (Discont group) by extracting reasons of their decisions and by comparing with those who continued (Cont group) in terms of the related factors to glycemic control. METHODS A cross-sectional, internet-based survey was conducted among Japanese with diabetes registered in a database. A self-administered questionnaire consisting of the 8-item version of the Morisky Medication Adherence Scale (MMAS-8), glycosylated haemoglobin (HbA1c) level, and demographic and disease characteristics was completed by all participants. Reasons for medication discontinuation and resumption were also received retrospectively from participants in the Discont group. To examine the risk of uncontrolled HbA1c, logistic regression analysis was conducted in each group. RESULTS In the Discont group (148 cases), older age at resumption of pharmacotherapy and current smoking habit increased the probability of uncontrolled HbA1c, whereas in the Cont group (146 cases), a familial history of diabetes and better medication adherence in MMAS-8 scores decreased the probability of uncontrolled HbA1c. A relationship between medication adherence and HbA1c level was seen in the Cont but not in the Discont group. About 70 % of those in the Discont group made their decision to terminate diabetes treatment without consulting physicians and half of them perceived their situations inappropriately. CONCLUSIONS Those who discontinued pharmacotherapy were less adherent to medication than those who did not discontinue. Risk factors for glycemic control also differed between those who discontinued and those who did not. More than one-third of participants with diabetes who discontinued pharmacotherapy had inappropriate perceptions of their disease, which medical professionals should be aware of for better interventions.
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Affiliation(s)
- Yoshiko Tominaga
- Social Pharmacy, Faculty of Pharmaceutical Sciences, Niigata University of Pharmacy and Applied Life Science, Niigata, Japan.
- Division of Hospital Pharmacy Science, Faculty of Pharmacy, Keio University, Tokyo, Japan.
| | - Donald E Morisky
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California, United States of America
| | - Mayumi Mochizuki
- Division of Hospital Pharmacy Science, Faculty of Pharmacy, Keio University, Tokyo, Japan
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Mizota Y, Yamamoto S. Rainbow of KIBOU project: Effectiveness of invitation materials for improving cancer screening rate using social marketing and behavioral economics approaches. Soc Sci Med 2021; 279:113961. [PMID: 34000582 DOI: 10.1016/j.socscimed.2021.113961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 01/27/2023]
Abstract
Studies to date have shown that individual invitation (call) and re-invitation (recall) are effective in improving cancer screening rate. Also, by dividing subjects into segments and sending unique messages to each segment, the cancer screening rate is further improved. However, this approach is not realistic in the local governments due to limited resources, so we used social marketing and nudge techniques to develop cancer screening recommendation materials that do not need to send separately. This study therefore aimed to verify the effect of these materials in the real world. We compared the cancer screening rates in municipalities within Japan that used the invitation materials we developed (colorectal, breast, lung, cervical and stomach cancer), with those from the previous year. In addition, the usefulness of the materials in the real world was examined multilaterally using RE-AIM framework (Reach, Effectiveness, Adaption, Implementation, Maintenance). From 2015 to 2018, 4.3 million residents (Reach) from 787 municipalities (Adaption) were sent invitation materials for cancer screening. Of 167 municipalities that were compared, 141 (83%) showed an increase in screening rate when our materials were used. Overall, the screening rate improved by 2.6% or 1.44 fold (p < 0.001) (Effectiveness). However, the screening rate varied greatly depending on how screening is provided. Of the four years studied, 75 municipalities used the same materials for two or more years (Implementation). The material developed in this study improved the cancer screening rate in the real world, and it may be possible to further improve the screening rate if the number of opportunities for screening and its capacity is increased at the timing of sending materials. The materials can be found on the website (http://rokproject.jp/kenshin/) and free electronic files are available to municipalities wishing to use them.
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Affiliation(s)
- Yuri Mizota
- Center for Cancer Information and Control Services, National Cancer Center, 5-1-1, Tsukij, Chuo-ku, Tokyo, 104-0045, Japan; Health Service Division, Health Service Bureau, Ministry of Health, Labour, and Welfare, 1-2-2, Kasumigaseki, Chiyoda-ku, Tokyo, 100-8916, Japan; Shizuoka Graduate University of Public Health, 4-27-2, Kitaando, Aoiku, Shizuoka, 420-0881, Japan.
| | - Seiichiro Yamamoto
- Center for Cancer Information and Control Services, National Cancer Center, 5-1-1, Tsukij, Chuo-ku, Tokyo, 104-0045, Japan; Shizuoka Graduate University of Public Health, 4-27-2, Kitaando, Aoiku, Shizuoka, 420-0881, Japan; Centre for the Fourth Industrial Revolution Japan, World Economic Forum, ARK Mori Building, 37th Floor 1-12-32, Akasaka, Minato-ku, Tokyo, 107-6037, Japan.
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Fukuyoshi J, Korenaga M, Yoshii Y, Hong L, Kashihara S, Sigel B, Takebayashi T. Increasing hepatitis virus screening uptake at worksites in Japan using nudge theory and full subsidies. Environ Health Prev Med 2021; 26:18. [PMID: 33522902 PMCID: PMC7849075 DOI: 10.1186/s12199-021-00940-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 01/19/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Despite the importance of hepatitis screening for decreasing liver cancer mortality, screening rates remain low in Japan. Previous studies show that full subsidies increase screening uptake, but full subsidies are costly and difficult to implement in low-resource settings. Alternatively, applying nudge theory to the message design could increase screening at lower costs. This study examined the effects of both methods in increasing hepatitis virus screening rates at worksites. METHODS 1496 employees from a Japanese transportation company received client reminders for an optional hepatitis virus screening before their general health checkups. Groups A and B received a client reminder designed based on the principles of "Easy" and "Attractive," while the control group received a client reminder not developed using nudge theory. Additionally, hepatitis virus screening was offered to the control group and group A for a co-payment of JPY 612, but was fully subsidized for group B. The hepatitis virus screening rates among the groups were compared using a Chi-square test with Bonferroni correction, and the risk ratios of group A and group B to the control group were also calculated. To adjust for unobservable heterogeneity per cluster, the regression analysis was performed using generalized linear mixed models. RESULTS The screening rate was 21.2%, 37.1%, and 86.3% for the control group, group A, and group B, respectively. And the risk ratio for group A was 1.75 (95% confidence interval [CI] 1.45-2.12) and that of group B was 4.08 (95% CI 3.44-4.83). The parameters of group A and group B also were significant when estimated using generalized linear mixed models. However, the cost-effectiveness (incremental cost-effectiveness ratio (ICER)) of the nudge-based reminder with the full subsidies was lower than that of only the nudge-based reminder. CONCLUSIONS While fully subsidized screening led to the highest hepatitis screening rates, modifying client reminders using nudge theory significantly increased hepatitis screening uptake at lower costs per person.
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Affiliation(s)
- Jun Fukuyoshi
- Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Shinanomachi, Tokyo, 160-8582 Japan
| | - Masaaki Korenaga
- Hepatitis Information Center, The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Ichikawa, Chiba, 272-8516 Japan
| | - Yui Yoshii
- Department of Social and Preventive Epidemiology, School of Public Health, Graduate School of Medicine, Tokyo University, Hongo, Tokyo, 113-0033 Japan
| | - Lek Hong
- Department of Policy Management, Keio University, Fujisawa, Kanagawa 252-0882 Japan
| | | | - Byron Sigel
- School of International Health, Graduate School of Medicine, Tokyo University, Hongo, Tokyo, 113-0033 Japan
| | - Toru Takebayashi
- Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Shinanomachi, Tokyo, 160-8582 Japan
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12
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Ishikawa Y, Hirai K, Saito H, Fukuyoshi J, Yonekura A, Harada K, Seki A, Shibuya D, Nakamura Y. Correction to: Cost-effectiveness of a tailored intervention designed to increase breast cancer screening among a non-adherent population: a randomized controlled trial. BMC Public Health 2020; 20:1731. [PMID: 33198694 PMCID: PMC7670720 DOI: 10.1186/s12889-020-09822-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Yoshiki Ishikawa
- Department of Public Health, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Kei Hirai
- Center of the Study for Communication Design & Support Office for Large-scale Education and Research Projects, Osaka University, Osaka, Japan
| | - Hiroshi Saito
- Screening Assessment & Management Division, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
| | | | | | - Kazuhiro Harada
- Japan Society for the Promotion of Science, Tokyo, Japan.,Faculty of Sport Sciences, Waseda University, Tokyo, Japan
| | - Aiko Seki
- Faculty of Human Sciences, Osaka University, Osaka, Japan
| | - Daisuke Shibuya
- Cancer Detection Center, Miyagi Cancer Society, Miyagi, Japan
| | - Yosikazu Nakamura
- Department of Public Health, Jichi Medical University, Shimotsuke, Tochigi, Japan
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13
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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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14
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Yuniar P, Robinson S, Moorin R, Norman R. Economic Evaluation of Breast Cancer Early Detection Strategies in Asia: A Systematic Review. Value Health Reg Issues 2020; 21:252-263. [PMID: 32388197 DOI: 10.1016/j.vhri.2020.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 12/01/2019] [Accepted: 01/05/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE This article aims to support the development of practical guidelines for early detection of breast cancer in Asia by systematically reviewing economic evaluation studies of such early detection strategies in Asian countries. METHODS A systematic literature review was conducted following the Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols checklist. The quality of reviewed studies was examined using the Consolidated Health Economic Evaluation Reporting Standards statement. RESULTS A total of 15 articles on the economic evaluation of breast cancer early detection based in Asia were reviewed. Cost-effectiveness was used in all the studies as the analytic method to compare the cost and consequences of different screening policies. Ten studies were categorized as incorporating the modeled approach. Fourteen studies analysed the cost-effectiveness of the organized population-based approach, in which mammography screening was the prevailing screening modality. Only one study evaluated the cost-effectiveness of early diagnosis for breast cancer patients in order to provide early treatment. The results from the identified economic evaluations, and consequent recommendations concerning optimal early detection strategies varied among studies, and depended on key parameters and assumption used, as well as differences in inter-country health resources, breast cancer incidence, prevalence and early detection pathways. CONCLUSIONS The economic evaluation of breast cancer early detection programs is still limited in Asia. Policy decisions on organized mammography screening in women <50 are economically attractive in the region, despite the lack of evidence to provide recommendations on opportunistic screening strategy and early diagnosis strategy. Future studies need to provide better transparency of the data used and cover more comprehensive strategies, to make them relevant and adaptable to other Asian countries, resulting in clear policy recommendations on breast cancer early detection strategies.
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Affiliation(s)
- Popy Yuniar
- School of Public Health, Curtin University, Perth, Western Australia; Universitas Indonesia, West Java, Indonesia.
| | - Suzanne Robinson
- School of Public Health, Curtin University, Perth, Western Australia
| | - Rachael Moorin
- School of Public Health, Curtin University, Perth, Western Australia
| | - Richard Norman
- School of Public Health, Curtin University, Perth, Western Australia
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15
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Mohan G, Chattopadhyay SK, Ekwueme DU, Sabatino SA, Okasako-Schmucker DL, Peng Y, Mercer SL, Thota AB. Economics of Multicomponent Interventions to Increase Breast, Cervical, and Colorectal Cancer Screening: A Community Guide Systematic Review. Am J Prev Med 2019; 57:557-567. [PMID: 31477431 PMCID: PMC6886701 DOI: 10.1016/j.amepre.2019.03.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/19/2019] [Accepted: 03/20/2019] [Indexed: 12/01/2022]
Abstract
CONTEXT The Community Preventive Services Task Force recently recommended multicomponent interventions to increase breast, cervical, and colorectal cancer screening based on strong evidence of effectiveness. This systematic review examines the economic evidence to guide decisions on the implementation of these interventions. EVIDENCE ACQUISITION A systematic literature search for economic evidence was performed from January 2004 to January 2018. All monetary values were reported in 2016 US dollars, and the analysis was completed in 2018. EVIDENCE SYNTHESIS Fifty-three studies were included in the body of evidence from a literature search yield of 8,568 total articles. For multicomponent interventions to increase breast cancer screening, the median intervention cost per participant was $26.69 (interquartile interval [IQI]=$3.25, $113.72), and the median incremental cost per additional woman screened was $147.64 (IQI=$32.92, $924.98). For cervical cancer screening, the median costs per participant and per additional woman screened were $159.80 (IQI=$117.62, $214.73) and $159.49 (IQI=$64.74, $331.46), respectively. Two studies reported incremental cost per quality-adjusted life year gained of $748 and $33,433. For colorectal cancer screening, the median costs per participant and per additional person screened were $36.63 (IQI=$7.70, $139.23) and $582.44 (IQI=$91.10, $1,452.12), respectively. Two studies indicated a decline in incremental cost per quality-adjusted life year gained of $1,651 and $3,817. CONCLUSIONS Multicomponent interventions to increase cervical and colorectal cancer screening were cost effective based on a very conservative threshold. Additionally, multicomponent interventions for colorectal cancer screening demonstrated net cost savings. Cost effectiveness for multicomponent interventions to increase breast cancer screening could not be determined owing to the lack of studies reporting incremental cost per quality-adjusted life year gained. Future studies estimating this outcome could assist implementers with decision making.
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Affiliation(s)
- Giridhar Mohan
- Community Guide Branch, Division of Public Health Information Dissemination, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sajal K Chattopadhyay
- Community Guide Branch, Division of Public Health Information Dissemination, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Donatus U Ekwueme
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Susan A Sabatino
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Devon L Okasako-Schmucker
- Community Guide Branch, Division of Public Health Information Dissemination, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Yinan Peng
- Community Guide Branch, Division of Public Health Information Dissemination, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Shawna L Mercer
- Community Guide Branch, Division of Public Health Information Dissemination, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Anilkrishna B Thota
- Community Guide Branch, Division of Public Health Information Dissemination, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia
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16
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Nakabayashi N, Hirose M, Suzuki R, Suzumiya J, Igawa M. How asymptomatic are early cancer patients of five organs based on registry data in Japan. Int J Clin Oncol 2018; 23:999-1006. [PMID: 29785620 DOI: 10.1007/s10147-018-1287-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 04/29/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND One reason for the low cancer screening rate in Japan is that people are not concerned about cancer if they do not have symptoms. METHODS The authors retrospectively analyzed 18,405 cancer patients using hospital-based cancer registry data collected between 2007 and 2013 at the 13 hospitals of Shimane Prefecture, Japan. The symptomatic rates of five cancers (stomach, colorectal, lung, breast, and cervix) at each stage and the time of early diagnosis were investigated. The early detection rates of symptomatic and asymptomatic individuals were investigated. RESULTS The percentages of symptomatic cases tended to increase with progressive stages. The odds ratio (OR) of stage IV compared with that of stage I was 12.23 for stomach, 7.21 for colorectal, 16.91 for lung, 10.30 for breast, and 51.62 for cervical cancer. The proportions of early symptomatic cases at the time of diagnosis were low. Compared with the percentage of early symptomatic cases of stomach cancer of 25.5%, the percentage of lung cancer was the lowest, at 8.2% (OR 0.26), and the percentage of breast cancer was the highest, at 30.2% (OR 1.26). The percentages of early symptomatic cases of colorectal and cervical cancer were 18.9% (OR 0.68) and 19.9% (OR 0.73), respectively. The early detection rates of the asymptomatic and symptomatic groups were 77.6 and 36.1%, respectively. CONCLUSION Cancer registry data indicate that early cancers are asymptomatic, and once symptoms appear, treatment may not be effective. Policy makers should inform people of the necessity of cancer screening before they have symptoms.
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Affiliation(s)
- Narue Nakabayashi
- Medical Services Division, Faculty of Medicine, Shimane University, 89-1 Enya-Chou, Izumo, Shimane, 693-8501, Japan.,Department of Community-Based Health Policy and Quality Management, Faculty of Medicine, Shimane University, 89-1 Enya-Chou, Izumo, Shimane, 693-8501, Japan
| | - Masahiro Hirose
- Department of Community-Based Health Policy and Quality Management, Faculty of Medicine, Shimane University, 89-1 Enya-Chou, Izumo, Shimane, 693-8501, Japan.
| | - Ritsuro Suzuki
- Center of Clinical Research, Shimane University Hospital, 89-1 Enya-Chou, Izumo, Shimane, 693-8501, Japan
| | - Junji Suzumiya
- Center for Innovative Cancer Therapy, Shimane University Hospital, 89-1 Enya-Chou, Izumo, Shimane, 693-8501, Japan
| | - Mikio Igawa
- Shimane University Hospital, 89-1 Enya-Chou, Izumo, Shimane, 693-8501, Japan
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17
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Prévention primaire et secondaire des cancers féminins : comment améliorer la sensibilisation des femmes ? Une revue de la littérature. Rev Epidemiol Sante Publique 2017; 65:453-465. [DOI: 10.1016/j.respe.2017.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 05/27/2017] [Accepted: 06/12/2017] [Indexed: 11/20/2022] Open
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18
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Harada K, Lee S, Shimada H, Lee S, Bae S, Anan Y, Harada K, Suzuki T. Distance to screening site and older adults' participation in cognitive impairment screening. Geriatr Gerontol Int 2017; 18:146-153. [PMID: 28762614 DOI: 10.1111/ggi.13133] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 05/14/2017] [Accepted: 06/13/2017] [Indexed: 12/25/2022]
Abstract
AIM To develop intervention strategies that promote screening for cognitive impairment, it is essential to identify the modifiable predictors for participation in screening. The present study aimed to examine whether a shorter distance to the screening site predicted participation in screening for cognitive impairment, and whether interactive effects of the distance and psychological factors on the participation would be observed among community-dwelling older adults. METHODS The study used a prospective design. After a baseline questionnaire survey, participation in screening for cognitive impairment was followed for 6 months (n = 9616). The distance to the screening site was measured by road distance from each residential address and categorized into four groups (<1 km, 1-1.99 km, 2-2.99 km, ≥3 km). The questionnaire measured psychological factors (behavioral intention and perceived benefits of screening), driving status and demographic factors. RESULTS A logistic regression analysis showed that compared with the <1 km group, the 2-2.99 km (adjusted odds ratio 0.62, P = 0.040) and ≥3 km (adjusted odds ratio 0.54, P = 0.015) groups did not participate in screening after adjusting for psychological and demographic factors, and driving status. The interaction of the distances and psychological factors on participation were not significant. CONCLUSIONS The distance to the screening site predicted participation in cognitive impairment screening among older adults regardless of their psychological status. This finding shows that improving access to screening sites would be effective for promoting screening for cognitive impairments among both low and highly motivated older adults. Geriatr Gerontol Int 2018; 18: 146-153.
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Affiliation(s)
- Kazuhiro Harada
- Graduate School of Human Development and Environment, Kobe University, Kobe, Hyogo, Japan.,Department of Preventive Gerontology, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Sangyoon Lee
- Department of Preventive Gerontology, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Sungchul Lee
- Department of Preventive Gerontology, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Seongryu Bae
- Department of Preventive Gerontology, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Yuya Anan
- Department of Preventive Gerontology, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.,Faculty of Wellness Studies, Kwassui Women's University, Nagasaki, Nagasaki, Japan
| | - Kenji Harada
- Department of Preventive Gerontology, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.,Graduate School of Health and Sport Sciences, Chukyo University, Toyota, Aichi, Japan
| | - Takao Suzuki
- Institute for Gerontology, J. F. Oberlin University, Machida, Tokyo, Japan
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19
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Tsiachristas A, Gittins M, Kitchener H, Gray A. Cost-effectiveness of strategies to increase cervical screening uptake at first invitation (STRATEGIC). J Med Screen 2017; 25:99-109. [PMID: 28530515 PMCID: PMC5956565 DOI: 10.1177/0969141317704679] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objective To assess the cost-effectiveness of strategies to increase cervical cancer screening uptake at first invitation (STRATEGIC trial). Methods We performed an economic analysis alongside the STRATEGIC trial, comparing each of seven novel interventions for improving cervical screening uptake with control general practices in Greater Manchester and Grampian (United Kingdom). A template was developed to measure the intervention costs. Trial estimates of screening uptake were combined with data from the literature to estimate healthcare costs of each intervention. The added lifetime costs and quality adjusted life years (QALYs) of attending cervical screening were estimated by a systematic literature review, with relevant results pooled and weighted by study quality. Trial results and estimated lifetime costs and benefits of screening were then combined in a decision analytic model, giving an incremental cost per QALY gained for each intervention. Uncertainty was addressed in probabilistic and univariate sensitivity analyses. Results Intervention costs per screening round per woman attending varied from about £1.20 (2014 UK) for the nurse navigator intervention to £62 for the unrequested HPV self-sampler kit. The meta-analysis revealed a lifetime discounted benefit from screening of 0.043 QALYs per woman attending, at an additional lifetime discounted cost of £234. The incremental cost per QALY gained in all interventions was below £13,000. Probabilistic sensitivity analyses suggested that only unrequested self-sampling and timed appointments have a high probability of being cost-effective. Conclusions Unrequested self-sampling and timed appointments are likely to be cost-effective interventions. Further research is required on the duration of effects and on implementing combinations of interventions.
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Affiliation(s)
- Apostolos Tsiachristas
- 1 Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Matthew Gittins
- 2 Centre for Biostatistics, Institute of Population Health, The University of Manchester, Manchester, UK
| | - Henry Kitchener
- 3 Institute of Cancer Sciences, The University of Manchester, St. Mary's Hospital, Manchester, UK
| | - Alastair Gray
- 1 Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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20
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Fowler LA, Holt SL, Joshi D. Mobile technology-based interventions for adult users of alcohol: A systematic review of the literature. Addict Behav 2016; 62:25-34. [PMID: 27310031 DOI: 10.1016/j.addbeh.2016.06.008] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 05/13/2016] [Accepted: 06/06/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Worldwide, 16% of people aged 15 and older engage in harmful use of alcohol. Harmful alcohol use leads to a host of preventable negative social and health consequences. Mobile technology-based interventions provide a particularly promising avenue for the widespread and cost-effective delivery of treatment that is accessible, affordable, individualized, and destigmatized to both alcohol-dependent and nondependent individuals. AIMS The present review sought to summarize the current literature on mobile technology-based interventions among adult users of alcohol and determine the efficacy of such interventions. METHODS Five databases were searched in December 2015 (Jan. 2004-Dec. 2015). Inclusion criteria were: participants aged 18 or older, interventions delivered through mobile-technology, and outcome measurement of alcohol reduction/cessation. FINDINGS Eight studies met inclusion criteria. The majority of the studies reviewed found positive effects of the intervention, even though the interventions themselves varied in design, length, dosage, and target population, and were pilot or preliminary in nature. CONCLUSIONS Findings from this review highlight the promising, yet preliminary state of research in this area. Studies with adequate power and valid design are necessary to evaluate the potential of mobile technology-based interventions on long-term alcohol behavior outcomes. Furthermore, future research should elucidate what the most effective length of time is for a mobile technology-based intervention, how often individuals should receive messages for maximum benefit, and determine the comparative effectiveness of mobile technology interventions with other efficacious interventions.
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21
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Hirai K, Ishikawa Y, Fukuyoshi J, Yonekura A, Harada K, Shibuya D, Yamamoto S, Mizota Y, Hamashima C, Saito H. Tailored message interventions versus typical messages for increasing participation in colorectal cancer screening among a non-adherent population: A randomized controlled trial. BMC Public Health 2016; 16:431. [PMID: 27220976 PMCID: PMC4877938 DOI: 10.1186/s12889-016-3069-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 04/21/2016] [Indexed: 11/29/2022] Open
Abstract
Background The purpose of this study was to examine the effectiveness and cost-efficiency of a tailored message intervention compared with a non-tailored message intervention for increasing colorectal cancer (CRC) screening rates among a non-adherent population, in a community-based client reminder program. Methods After a baseline survey for psychological segmentation, 2140 eligible individuals were randomly assigned either to a group with a tailored matched-message condition (N = 356), a group with a non-tailored unmatched-message condition (N = 355), or to two control groups, one using a typical message with a professional design (N = 717) and one without a professional design (N = 712). The main outcome measure was attendance rates in a community-organized CRC screening program within five months of receiving a print reminder. Results There was a significant difference in fecal occult blood test (FOBT) attendance rates at follow-up assessments between the tailored matched-message condition (14.0 %) and the control (9.9 %; OR = 1.48, p = 0.026), while there was no significant difference between the unmatched-message condition (11.0 %) and the control (OR = 1.12, p = 0.558), and between the matched-message condition and the unmatched-message condition (OR = 1.32, p = 0.219). The cost of a one-person increase in FOBT screening was 3,740 JPY for the tailored matched-message condition, while it was 2,747 JPY for the control. Conclusions A tailored-message intervention for segmented individuals designed to increase CRC screening rates in a community-based client reminder program was significantly effective compared to a usual reminder, but not more effective than an unmatched message in a randomized controlled trial, and was not sufficiently effective to highlight its value from a cost perspective. Therefore, the tailored intervention including target segmentation needs to be improved for future implementation in a CRC screening program for a non-adherent population. Trial registration UMIN Clinical Trials Registry UMIN000004384. Date of Registration: March 2011. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3069-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kei Hirai
- Graduate School of Human Sciences, and Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita-shi, Osaka, 565-0871, Japan.
| | - Yoshiki Ishikawa
- Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | | | | | - Kazuhiro Harada
- Graduate School of Human Development and Environment, Kobe University, Kobe, Japan
| | - Daisuke Shibuya
- Cancer Detection Center, Miyagi Cancer Society, Miyagi, Japan
| | - Seiichiro Yamamoto
- Public Health Policy Research Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan
| | - Yuri Mizota
- Public Health Policy Research Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan
| | - Chisato Hamashima
- Screening Assessment and Management Division, National Cancer Center, Tokyo, Japan
| | - Hiroshi Saito
- Screening Assessment and Management Division, National Cancer Center, Tokyo, Japan
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22
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Outcome evaluation of an educational program for Japanese midwives to promote breast awareness for women. Women Birth 2015; 28:e164-70. [DOI: 10.1016/j.wombi.2015.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 04/20/2015] [Accepted: 04/21/2015] [Indexed: 11/18/2022]
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23
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Hassan N, Ho WK, Mariapun S, Teo SH. A cross sectional study on the motivators for Asian women to attend opportunistic mammography screening in a private hospital in Malaysia: the MyMammo study. BMC Public Health 2015; 15:548. [PMID: 26065413 PMCID: PMC4465302 DOI: 10.1186/s12889-015-1892-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 05/29/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND To date, because of limited budgets and lower incidence of breast cancer, the majority of Asian countries do not have population-based screening programmes, but instead offer opportunistic screening. However, there have been few studies which have assessed the motivators for women attending such programmes and the appropriateness of the programmes in terms of targeting women at risk. METHODS We conducted a prospective cross-sectional study of 1,619 women aged 40 to 74 years attending a subsidized opportunistic screening mammogram from October 2011 to October 2013 at a private hospital in Malaysia. Breast cancer risk was estimated using the Gail Model and two-step cluster analysis was used to examine the motivators of attending screening. RESULTS Although Malaysia comprises 54.5% Malay, 24.5% Chinese and 7.3% Indian, the majority of women in the MyMammo Study were Chinese (70.1%) and 99.2% had a <2% ten-year risk of breast cancer. The most commonly cited barriers were the perception of not being at risk and fear of painful mammography. We found that highly educated women, cited doctors, family and friends as their main motivators. Of those with only secondary school education, their main motivators were doctors. CONCLUSIONS Taken together, our results suggest the women attending opportunistic mammography screening in Asia are at low risk of breast cancer and this poses challenges to cost-effective and equitable strategies for cancer control. We propose that to improve uptake of screening mammography, awareness programmes should target both doctors and members of the public.
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Affiliation(s)
- Norhashimah Hassan
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, 1 Jalan SS12/1A, Subang Jaya, 47500, Selangor, Malaysia. .,Breast Cancer Research Unit, University Malaya Cancer Research Institute, Faculty of Medicine, University Malaya Medical Centre, University Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Weang Kee Ho
- Department of Applied Mathematics, Faculty of Engineering, University of Nottingham Malaysia Campus, Jalan Broga, 43500, Semenyih, Selangor, Malaysia.
| | - Shivaani Mariapun
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, 1 Jalan SS12/1A, Subang Jaya, 47500, Selangor, Malaysia. .,Breast Cancer Research Unit, University Malaya Cancer Research Institute, Faculty of Medicine, University Malaya Medical Centre, University Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Soo Hwang Teo
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, 1 Jalan SS12/1A, Subang Jaya, 47500, Selangor, Malaysia. .,Breast Cancer Research Unit, University Malaya Cancer Research Institute, Faculty of Medicine, University Malaya Medical Centre, University Malaya, 50603, Kuala Lumpur, Malaysia.
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Young J, Cund A, Renshaw M, Quigley A, Snowden A. Improving the care of cancer patients: holistic needs assessment. ACTA ACUST UNITED AC 2015; 24:S17-20. [PMID: 25723367 DOI: 10.12968/bjon.2015.24.sup4.s17] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jenny Young
- Research Assistant, Institute Health, Nursing & Midwifery, University of the West of Scotland
| | - Audrey Cund
- Lecturer, University of the West of Scotland
| | | | | | - Austyn Snowden
- Chair in Mental Health, University of the West of Scotland
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Fujiwara H, Shimoda A, Ishikawa Y, Taneichi A, Ohashi M, Takahashi Y, Koyanagi T, Morisawa H, Takahashi S, Sato N, Machida S, Takei Y, Saga Y, Suzuki M. Effect of providing risk information on undergoing cervical cancer screening: a randomized controlled trial. Arch Public Health 2015; 73:7. [PMID: 25717376 PMCID: PMC4340285 DOI: 10.1186/s13690-014-0055-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 12/01/2014] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND In Japan, the cervical cancer screening rate is extremely low. Towards improving the cervical cancer screening rate, encouraging eligible people to make an informed choice, which is a decision-making process that relies on beliefs informed by adequate information about the possible benefits and risks of screening, has attracted increased attention in the public health domain. However, there is concern that providing information on possible risks of screening might prevent deter from participating. METHODS In total, 1,912 women aged 20-39 years who had not participated in screening in the fiscal year were selected from a Japanese urban community setting. Participants were randomly divided into 3 groups. Group A received a printed reminder with information about the possible benefits of screening, group B received a printed reminder with information about possible benefits and risks, and group C received a printed reminder with simple information only (control group). RESULTS Out of 1,912 participants, 169 (8.8%) participated in cervical cancer screening. In the intervention groups, 137 (10.9%) participated in cervical cancer screening, compared to only 32 (4.9%) of the control group (p < 0.001). In addition, logistic regression analysis revealed that there was no significant difference in screening rate between group A and group B (p = 0.372). CONCLUSIONS Providing information on the possible risks of screening may not prevent people from taking part in cervical cancer screening among a Japanese non-adherent population.
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Affiliation(s)
- Hiroyuki Fujiwara
- />Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi Japan
| | - Akihiro Shimoda
- />Department of Public Health, Cancer Scan, Shibuya-ku Tokyo, Japan
| | - Yoshiki Ishikawa
- />Department of Public Health, Cancer Scan, Shibuya-ku Tokyo, Japan
- />Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Bunkyo-ku Tokyo, Japan
| | - Akiyo Taneichi
- />Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi Japan
| | - Mai Ohashi
- />Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi Japan
| | - Yoshifumi Takahashi
- />Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi Japan
| | - Takahiro Koyanagi
- />Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi Japan
| | - Hiroyuki Morisawa
- />Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi Japan
| | - Suzuyo Takahashi
- />Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi Japan
| | - Naoto Sato
- />Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi Japan
| | - Shizuo Machida
- />Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi Japan
| | - Yuji Takei
- />Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi Japan
| | - Yasushi Saga
- />Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi Japan
| | - Mitsuaki Suzuki
- />Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi Japan
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Get screened: a randomized trial of the incremental benefits of reminders, recall, and outreach on cancer screening. J Gen Intern Med 2014; 29:90-7. [PMID: 24002626 PMCID: PMC3889981 DOI: 10.1007/s11606-013-2586-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Rates of breast cancer (BC) and colorectal cancer (CRC) screening are particularly low among poor and minority patients. Multifaceted interventions have been shown to improve cancer-screening rates, yet the relative impact of the specific components of these interventions has not been assessed. Identifying the specific components necessary to improve cancer-screening rates is critical to tailor interventions in resource limited environments. OBJECTIVE To assess the relative impact of various components of the reminder, recall, and outreach (RRO) model on BC and CRC screening rates within a safety net practice. DESIGN Pragmatic randomized trial. PARTICIPANTS Men and women aged 50-74 years past due for CRC screen and women aged 40-74 years past due for BC screening. INTERVENTIONS We randomized 1,008 patients to one of four groups: (1) reminder letter; (2) letter and automated telephone message (Letter + Autodial); (3) letter, automated telephone message, and point of service prompt (Letter + Autodial + Prompt); or (4) letter and personal telephone call (Letter + Personal Call). MAIN MEASURES Documentation of mammography or colorectal cancer screening at 52 weeks following randomization. KEY RESULTS Compared to a reminder letter alone, Letter + Personal Call was more effective at improving screening rates for BC (17.8 % vs. 27.5 %; AOR 2.2, 95 % CI 1.2-4.0) and CRC screening (12.2 % vs. 21.5 %; AOR 2.0, 95 % CI 1.1-3.9). Compared to letter alone, a Letter + Autodial + Prompt was also more effective at improving rates of BC screening (17.8 % vs. 28.2 %; AOR 2.1, 95 % CI 1.1-3.7) and CRC screening (12.2 % vs. 19.6 %; AOR 1.9, 95 % CI 1.0-3.7). Letter + Autodial was not more effective than a letter alone at improving screening rates. CONCLUSIONS The addition of a personal telephone call or a patient-specific provider prompt were both more effective at improving mammogram and CRC screening rates compared to a reminder letter alone. The use of automated telephone calls, however, did not provide any incremental benefit to a reminder letter alone.
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