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Van Iseghem T, Jacobs I, Vanden Bossche D, Delobelle P, Willems S, Masquillier C, Decat P. The role of community health workers in primary healthcare in the WHO-EU region: a scoping review. Int J Equity Health 2023; 22:134. [PMID: 37474937 PMCID: PMC10357780 DOI: 10.1186/s12939-023-01944-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/26/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Existing evidence on the role of community health workers (CHWs) in primary healthcare originates primarily from the United States, Canada and Australia, and from low- and middle-income countries. Little is known about the role of CHWs in primary healthcare in European countries. This scoping review aimed to contribute to filling this gap by providing an overview of literature reporting on the involvement of CHWs in primary healthcare in WHO-EU countries since 2001 with a focus on the role, training, recruitment and remuneration. METHODS This systematic scoping review followed the guidelines of the Preferred Reporting Items for Systematic reviews and Meta-Analyses, extension for Scoping Reviews. All published peer-reviewed literature indexed in PubMed, Web of Science, and Embase databases from Jan 2001 to Feb 2023 were reviewed for inclusion. Included studies were screened on title, abstract and full text according to predetermined eligibility criteria. Studies were included if they were conducted in the WHO-EU region and provided information regarding the role, training, recruitment or remuneration of CHWs. RESULTS Forty studies were included in this review, originating from eight countries. The involvement of CHWs in the WHO-EU regions was usually project-based, except in the United Kingdom. A substantial amount of literature with variability in the terminology used to describe CHWs, the areas of involvement, recruitment, training, and remuneration strategies was found. The included studies reported a trend towards recruitment from within the communities with some form of training and payment of CHWs. A salient finding was the social embeddedness of CHWs in the communities they served. Their roles can be classified into one or a combination of the following: educational; navigational and supportive. CONCLUSION Future research projects involving CHWs should detail their involvement and elaborate on CHWs' role, training and recruitment procedures. In addition, further research on CHW programmes in the WHO-EU region is necessary to prepare for their integration into the broader national health systems.
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Affiliation(s)
- Tijs Van Iseghem
- Interuniversity Centre for Health Economics Research (ICHER), Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Ilka Jacobs
- Equity Research Group, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Dorien Vanden Bossche
- Unit Family Medicine, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Peter Delobelle
- Chronic Diseases Initiative for Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa
- MENT Research Group, Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
| | - Sara Willems
- Equity Research Group, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Caroline Masquillier
- 'Family Medicine and Population Health' - FAMPOP, Faculty of Medical Sciences & 'Centre for Family, Population and Health', Faculty of Social sciences, University of Antwerp, Antwerp, Belgium
| | - Peter Decat
- Unit Family Medicine, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
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Okasako-Schmucker DL, Peng Y, Cobb J, Buchanan LR, Xiong KZ, Mercer SL, Sabatino SA, Melillo S, Remington PL, Kumanyika SK, Glenn B, Breslau ES, Escoffery C, Fernandez ME, Coronado GD, Glanz K, Mullen PD, Vernon SW. Community Health Workers to Increase Cancer Screening: 3 Community Guide Systematic Reviews. Am J Prev Med 2023; 64:579-594. [PMID: 36543699 PMCID: PMC10033345 DOI: 10.1016/j.amepre.2022.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/21/2022] [Accepted: 10/25/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Many in the U.S. are not up to date with cancer screening. This systematic review examined the effectiveness of interventions engaging community health workers to increase breast, cervical, and colorectal cancer screening. METHODS Authors identified relevant publications from previous Community Guide systematic reviews of interventions to increase cancer screening (1966 through 2013) and from an update search (January 2014-November 2021). Studies written in English and published in peer-reviewed journals were included if they assessed interventions implemented in high-income countries; reported screening for breast, cervical, or colorectal cancer; and engaged community health workers to implement part or all of the interventions. Community health workers needed to come from or have close knowledge of the intervention community. RESULTS The review included 76 studies. Interventions engaging community health workers increased screening use for breast (median increase=11.5 percentage points, interquartile interval=5.5‒23.5), cervical (median increase=12.8 percentage points, interquartile interval=6.4‒21.0), and colorectal cancers (median increase=10.5 percentage points, interquartile interval=4.5‒17.5). Interventions were effective whether community health workers worked alone or as part of a team. Interventions increased cancer screening independent of race or ethnicity, income, or insurance status. DISCUSSION Interventions engaging community health workers are recommended by the Community Preventive Services Task Force to increase cancer screening. These interventions are typically implemented in communities where people are underserved to improve health and can enhance health equity. Further training and financial support for community health workers should be considered to increase cancer screening uptake.
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Affiliation(s)
- Devon L Okasako-Schmucker
- Community Guide Office, Office of the Associate Director for Policy and Strategy (OADPS), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Yinan Peng
- Community Guide Office, Office of the Associate Director for Policy and Strategy (OADPS), Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Jamaicia Cobb
- Community Guide Office, Office of the Associate Director for Policy and Strategy (OADPS), Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Ka Zang Xiong
- Community Guide Office, Office of the Associate Director for Policy and Strategy (OADPS), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Shawna L Mercer
- Community Guide Office, Office of the Associate Director for Policy and Strategy (OADPS), 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 (NCCDPHP), Centers for Disease Control and Prevention, Atlanta Georgia
| | - Stephanie Melillo
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention, Atlanta Georgia
| | - Patrick L Remington
- Department of Population Health Sciences, Madison School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Shiriki K Kumanyika
- Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania
| | - Beth Glenn
- Department of Health Policy & Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
| | - Erica S Breslau
- Healthcare Delivery Research Program, Division of Cancer Control & Population Sciences, National Cancer Institute, Rockville, Maryland
| | - Cam Escoffery
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Maria E Fernandez
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas
| | | | - Karen Glanz
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Patricia D Mullen
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas
| | - Sally W Vernon
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas
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Predicting Factors of Mammography Adherence among Iranian Women Based on Transtheoretical Model. JOURNAL OF RESEARCH DEVELOPMENT IN NURSING AND MIDWIFERY 2020. [DOI: 10.52547/jgbfnm.17.2.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Lin ML, Huang JJ, Li SH, Lee FH, Hou MF, Wang HH. Effects of different reminder strategies on first-time mammography screening among women in Taiwan. BMC Health Serv Res 2020; 20:114. [PMID: 32050951 PMCID: PMC7017575 DOI: 10.1186/s12913-020-4948-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 01/30/2020] [Indexed: 11/18/2022] Open
Abstract
Background The study’s purpose was to examine the effectiveness of different reminder strategies on first-time free mammography screening among middle-aged women in Taiwan. Methods A quasi-experimental design with random assignment was adopted to divide the participants into three Reminder Strategies groups (mail reminder, telephone reminder, and combined mail and telephone reminders) and one control group. This study recruited 240 eligible middle-aged women, and 205 of them completed the study. Upon the completion of data collection, mail reminders were provided to women of the first group; telephone reminders were provided to the second group; mail followed by telephone reminders were provided to the third group, and the usual postcards were provided to the control group 1 month after the interventions. Two follow-up assessments were conducted 1 and 3 months after the intervention to collect mammography-screening behaviors from all groups. Results The findings showed that, compared to the control group, more participants in the intervention groups underwent mammography screening after receiving reminder interventions. Telephone contact as reminder was found to have the most significant influence among the interventions (OR = 5.0556; 95% CI = 2.0422–13.5722). Conclusions Government and healthcare providers are recommended to consider adopting the telephone reminder strategy to encourage women to undergo their first-time mammography screening.
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Affiliation(s)
- Miao-Ling Lin
- Long-Term Care Division, Department of Health, Kaohsiung City Government, No. 2, Sihwei 3rd Road, Lingya District, Kaohsiung City, 80203, Taiwan.,College of Nursing, Kaohsiung Medical University, No. 2, Sihwei 3rd Road, Lingya District, Kaohsiung City, 80203, Taiwan
| | - Joh-Jong Huang
- Graduate Institute of Gender Studies, Kaohsiung Medical University, No. 100 Shih-Chuan 1st Road, San-Ming District, Kaohsiung, 80708, Taiwan
| | - Shu-Hua Li
- Long-Term Care Division, Department of Health, Kaohsiung City Government, No. 2, Sihwei 3rd Road, Lingya District, Kaohsiung City, 80203, Taiwan
| | - Fang-Hsin Lee
- Department of Nursing, Chung Hwa University of Medical Technology, No. 89, Wenhua 1st St., Rende District, Tainan, 71703, Taiwan
| | - Ming-Feng Hou
- Graduate Institute of Clinical Medicine, Kaohsiung Medical University, No. 100 Shih-Chuan 1st Road, San-Ming District, Kaohsiung, 80708, Taiwan
| | - Hsiu-Hung Wang
- College of Nursing, Kaohsiung Medical University, No. 2, Sihwei 3rd Road, Lingya District, Kaohsiung City, 80203, Taiwan. .,College of Nursing, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung, 807, Taiwan.
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Beauchamp A, Mohebbi M, Cooper A, Pridmore V, Livingston P, Scanlon M, Davis M, O’Hara J, Osborne R. The impact of translated reminder letters and phone calls on mammography screening booking rates: Two randomised controlled trials. PLoS One 2020; 15:e0226610. [PMID: 31923178 PMCID: PMC6953872 DOI: 10.1371/journal.pone.0226610] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 11/26/2019] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Participation in mammographic screening for breast cancer in Australia is approximately 54% among the general population, but screening among women from some culturally and linguistically diverse (CALD) backgrounds is lower. BreastScreen Victoria apply strategies to increase screening including reminder letters and phone calls; however, these are usually provided in English. Using intervention strategies generated from the Ophelia (OPtimise HEalth LIteracy and Access) community co-design process, translated mammography reminder letters and in-language phone calls were tested within two randomised control trials (RCTs). METHODS AND ANALYSIS Women aged 50-75 years who were due for their 2-yearly screening mammography (for RCT#1) or were under-screened, i.e. ≥27 months since last screen (for RCT#2) were randomised into intervention or control groups. RCT#1 compared sending women routine reminder letters (English only) with translated (Arabic or Italian) letters. RCT#2 compared reminder telephone calls to women in their preferred language (Arabic or Italian) to no telephone call. The primary outcome for each trial was screening booking rates within 14-days. Primary outcomes were tested using Pearson's chi-square test. Rates within language group (incidence ratio: IR) were compared using the Cochran-Mantel-Haenszel test. RESULTS For RCT#1 (letters) 1,032 women were randomised into the intervention arm or to usual care. Uptake of screening bookings was similar between both groups, with no differences observed by language group. For RCT#2 (phone calls), 195 women were randomised to the intervention group or to usual care. Overall, 64.2% of women in the intervention arm and 6% in the control arm booked a screening appointment within 14 days (p<0.0001). The IR (95%CI) of booking was 10.1 (3.9, 26.3) times higher among Italian women, and 11.6 (2.9, 46.5) times higher among Arabic women in the intervention compared to usual care groups. DISCUSSION AND CONCLUSION A service improvement initiative derived from community members and breast screen providers was found to be highly effective. This evidence informed the service provider, BreastScreen Victoria, who have implemented these improvements into routine practice to improve screening among CALD groups and reduce health inequalities.
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Affiliation(s)
- Alison Beauchamp
- Department of Medicine–Western Health, University of Melbourne, Melbourne, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Melbourne, Australia
- Faculty of Health, Deakin University, Geelong, Australia
- Monash Rural Health, Warragul, Australia
| | | | | | | | | | | | | | | | - Richard Osborne
- Faculty of Health, Deakin University, Geelong, Australia
- Centre for Global Health and Equity, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Australia
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Sharma N, Harris E, Lloyd J, Mistry SK, Harris M. Community health workers involvement in preventative care in primary healthcare: a systematic scoping review. BMJ Open 2019; 9:e031666. [PMID: 31852698 PMCID: PMC6937114 DOI: 10.1136/bmjopen-2019-031666] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 11/04/2019] [Accepted: 11/25/2019] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To review effective models of community health worker (CHW) involvement in preventive care for disadvantaged culturally and linguistically diverse (CALD) patients in primary healthcare (PHC) that may be applicable to the Australian context. DESIGN Systematic scoping review. DATA SOURCES The studies were gathered through searching Medline, EMBASE, EMCARE, PsycINFO, CINAHL and online portals of relevant organisations. ELIGIBILITY CRITERIA All selected studies were original research studies which essentially evaluated preventive intervention undertake by CHWs in PHC. The intervened population were adults with or without diagnosed chronic health disease, culturally and linguistically diverse, or vulnerable due to geographic, economic and/or cultural characteristics that impede or compromise their access to healthcare. DATA EXTRACTION AND SYNTHESIS Data extraction was undertaken systematically in an excel spreadsheet while the findings were synthesised in a narrative manner. The quality appraisal of the selected studies was performed using effective public health practice project quality assessment tool. RESULTS A total of 1066 articles were identified during the initial search of six bibliographic databases. After screening the title, abstract and full text, 37 articles met the selection and methodological criteria and underwent data extraction. A high-quality evidence-base supporting the positive impact of CHWs supporting patients' access to healthcare and influencing positive behaviour change was found. Positive impacts of CHW interventions included improvements in clinical disease indicators, screening rates and behavioural change. Education-focused interventions were more effective in improving patient behaviour, whereas navigation interventions were most effective in improving access to services. Implementation was enhanced by cultural and linguistic congruence and specific training of CHWs in the intervention but reduced by short duration interventions, dropouts and poor adherence of patients. CONCLUSION The evidence generated from this systematic scoping review demonstrates the contribution of CHWs to improving access to preventive care for patients from CALD and disadvantaged backgrounds by providing both education and navigational interventions. More research is needed on CHW training and the incorporation of CHWs into primary health care (PHC) teams.
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Affiliation(s)
- Nila Sharma
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
| | - Elizabeth Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
| | - Jane Lloyd
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
| | - Sabuj Kanti Mistry
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
| | - Mark Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
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Brown VB, Oluwatosin OA. Feasibility of implementing a cellphone-based reminder/recall strategy to improve childhood routine immunization in a low-resource setting: a descriptive report. BMC Health Serv Res 2017; 17:703. [PMID: 29219093 PMCID: PMC5773899 DOI: 10.1186/s12913-017-2639-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background Reminder/recall systems are effective ways to improve immunization rates, but their feasibility in primary health care (PHC) settings in Nigeria has not been adequately evaluated. In this study we describe the acceptability and adaptability of immunization reminder/recall system in an urban setting in southwest Nigeria. Methods This is a descriptive report of a cluster randomized controlled trial. Four local government areas (LGAs) were randomly assigned into a cellphone reminder/recall intervention group or a usual care control group. Within each LGA, PHC centers were purposively selected to participate in the study. In each PHC center, mothers and their infants aged 0–3 months were enrolled into the two groups during the infants’ first immunization visit. Mothers (or other contact persons) in the intervention group received cellphone calls reminding them to take their child for scheduled immunizations. Follow-up of all the children lasted till the final scheduled immunization visit for each child. The intervention lasted for 13 months. Results A total of 595 mothers/infants pairs (295 in the intervention group and 300 in the control group) participated in the study. Almost all mothers (n = 590, 99.2%) had access to their own cellphone or had access to a cellphone belonging to a significant other. Ninety-eight percent (n = 584) of all mothers were willing to receive immunization reminder/recall phone calls. Eighty-seven percent (n = 2023) of all calls (n = 2324) for the reminder/recall intervention went through to the recipients and of these calls, 1948 (96.3%) were received. The mean cost of each call in US Dollars was about 5 cents. Immunization compliance rate (the receipt of required number of doses of routine vaccines at the appropriate age at recommended interval) was 79.2% among the children in intervention group and 46.4% in the control group (p < 0.001). Conclusion Results demonstrate that cellphone reminder/recall interventions to improve routine childhood immunization are feasible in PHC settings in limited-resource settings with wide cellphone coverage, such as urban areas in Nigeria. Further research to test the potential for scale up in a variety of settings is recommended. Trial registration PACTR201702002043415; Date of registration: 17 February 2017. (Retrospectively registered).
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Affiliation(s)
| | - O Abimbola Oluwatosin
- Department of Nursing, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Bellhouse S, McWilliams L, Firth J, Yorke J, French DP. Are community-based health worker interventions an effective approach for early diagnosis of cancer? A systematic review and meta-analysis. Psychooncology 2017; 27:1089-1099. [DOI: 10.1002/pon.4575] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 10/16/2017] [Accepted: 10/17/2017] [Indexed: 01/31/2023]
Affiliation(s)
- Sarah Bellhouse
- Christie Patient Centred Research Group, School of Oncology; The Christie NHS Foundation Trust; UK
| | - Lorna McWilliams
- Christie Patient Centred Research Group, School of Oncology; The Christie NHS Foundation Trust; UK
| | - Joseph Firth
- Division of Psychology and Mental Health, School of Health Sciences; University of Manchester; UK
- NICM, School of Science and Health; University of Western Sydney; Australia
| | - Janelle Yorke
- Christie Patient Centred Research Group, School of Oncology; The Christie NHS Foundation Trust; UK
- Division of Nursing, Midwifery and Social Work, School of Health Sciences; University of Manchester; UK
| | - David P. French
- Manchester Centre for Health Psychology, School of Health Sciences; University of Manchester; UK
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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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Duffy SW, Myles JP, Maroni R, Mohammad A. Rapid review of evaluation of interventions to improve participation in cancer screening services. J Med Screen 2016; 24:127-145. [PMID: 27754937 PMCID: PMC5542134 DOI: 10.1177/0969141316664757] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Objective Screening participation is spread differently across populations, according to factors such as ethnicity or socioeconomic status. We here review the current evidence on effects of interventions to improve cancer screening participation, focussing in particular on effects in underserved populations. Methods We selected studies to review based on their characteristics: focussing on population screening programmes, showing a quantitative estimate of the effect of the intervention, and published since 1990. To determine eligibility for our purposes, we first reviewed titles, then abstracts, and finally the full paper. We started with a narrow search and expanded this until the search yielded eligible papers on title review which were less than 1% of the total. We classified the eligible studies by intervention type and by the cancer for which they screened, while looking to identify effects in any inequality dimension. Results The 68 papers included in our review reported on 71 intervention studies. Of the interventions, 58 had significant positive effects on increasing participation, with increase rates of the order of 2%–20% (in absolute terms). Conclusions Across different countries and health systems, a number of interventions were found more consistently to improve participation in cancer screening, including in underserved populations: pre-screening reminders, general practitioner endorsement, more personalized reminders for non-participants, and more acceptable screening tests in bowel and cervical screening.
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Affiliation(s)
- Stephen W Duffy
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Jonathan P Myles
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Roberta Maroni
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Abeera Mohammad
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Jacobsen KK, von Euler Chelpin M, Vejborg I, Lynge E. Impact of invitation schemes on breast cancer screening coverage: A cohort study from Copenhagen, Denmark. J Med Screen 2016; 24:20-26. [PMID: 27206815 PMCID: PMC5414897 DOI: 10.1177/0969141316641982] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The purpose of mammography screening is to decrease breast cancer mortality. To achieve this a high coverage by examination is needed. Within an organized screening programme, we examined the impact of changes in the invitation schedule on the interplay between coverage and participation. Method We studied nine cohorts aged 50-51 when first targeted by mammography screening in Copenhagen, Denmark. Population data were retrieved from the Danish Civil Registration System; invitation and attendance data from the screening programme database. Data were linked using unique personal identification numbers. Coverage by invitation was defined as (number of invited women/number of targeted women), coverage by examination as (number of screened women/number of targeted women), and participation rate as (number of screened women/number of invited women). Results Coverage by invitation was close to or above 95% for all newly recruited cohorts. In subsequent invitation rounds, both technical errors and changes in the invitation scheme affected the coverage by invitation. Coverage by examination at first invitation was 72.5% for the first cohort, but dropped to 64.2% for the latest cohort. Furthermore, coverage by examination dropped by increasing invitation number and with omission of re-invitation of previous non-attenders. Participation rate closely reflected changes in the invitation scheme. Conclusion Changes in the invitation schemes influenced coverage by invitation, coverage by examination, and participation rate. We observed a considerable gap between coverage by examination and participation rate, strongly indicating that the latter cannot without reservations, be taken as an indicator of the first.
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Affiliation(s)
- Katja Kemp Jacobsen
- 1 Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Ilse Vejborg
- 2 Department of Radiology, Center of Diagnostic Imaging, Copenhagen University Hospital, Copenhagen, Denmark
| | - Elsebeth Lynge
- 1 Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Allgood PC, Maxwell AJ, Hudson S, Offman J, Hutchison G, Beattie C, Tuano-Donnelly R, Threlfall A, Summersgill T, Bellis L, Robinson C, Heaton S, Patnick J, Duffy SW. A randomised trial of the effect of postal reminders on attendance for breast screening. Br J Cancer 2016; 114:171-6. [PMID: 26784123 PMCID: PMC5154292 DOI: 10.1038/bjc.2015.451] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 11/30/2015] [Accepted: 12/01/2015] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Some women make an informed choice not to attend breast screening, whereas others may have forgotten about the appointment. We report on a randomised trial that investigates whether a reminder letter affects attendance. METHODS Women scheduled for a breast screening appointment were randomised to either receive a reminder letter a few days before their breast screening appointment in addition to the standard invitation letter (intervention) or not (control). The primary outcome was attendance within 30 days of the first offered appointment. Secondary outcomes were attendance within 90 and 180 days. RESULTS In all, 11,383 (49.9%) women were randomised to the intervention and 11,445 (50.1%) to the control. In the intervention arm, 7759 (68.2%) attended within 30 days of the first offered appointment compared with 7349 (64.2%) in the control arm. This difference was significant (P<0.001). The odds ratio (OR) (95% confidence interval) for the primary end point was 1.19 (1.13-1.26). This was not significantly affected by age, socioeconomic status or type of screen (prevalent or incident). Secondary endpoint analyses supported these results. Results did differ, however, between the different centres studied. CONCLUSIONS This study found that postal reminders increase breast screening uptake, and could be practicable to implement in the NHS Breast Screening Programme.
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Affiliation(s)
- Prue C Allgood
- Centre for Cancer Prevention, Wolfson Institute for Cancer Prevention, Charterhouse Square, London EC1M 6BQ, UK
| | - Anthony J Maxwell
- Nightingale Centre and Genesis Prevention Centre, University Hospital of South Manchester, Southmoor Road, Wythenshawe, Manchester, M23 9QZ, UK
| | - Sue Hudson
- Peel and Shriek Consulting, 182 Highbury Hill, London, N5 1AU, UK
| | - Judith Offman
- Centre for Cancer Prevention, Wolfson Institute for Cancer Prevention, Charterhouse Square, London EC1M 6BQ, UK
| | - Gillian Hutchison
- Bolton Hospital NHS Foundation Trust, Minerva Road, Farnworth, Greater Manchester, BL4 0JR, UK
| | - Cathryn Beattie
- Royal Liverpool University Hospital, Prescot Street, Liverpool, Merseyside, L7 8XP, UK
| | - Raquel Tuano-Donnelly
- Wrightington, Wigan and Leigh NHS Foundation Trust, Appley Bridge, Wigan, Lancashire, WN6 9EP, UK
| | | | - Tina Summersgill
- Wrightington, Wigan and Leigh NHS Foundation Trust, Appley Bridge, Wigan, Lancashire, WN6 9EP, UK
| | - Lesley Bellis
- Royal Liverpool University Hospital, Prescot Street, Liverpool, Merseyside, L7 8XP, UK
| | - Collette Robinson
- Bolton Hospital NHS Foundation Trust, Minerva Road, Farnworth, Greater Manchester, BL4 0JR, UK
| | - Samantha Heaton
- Bolton Hospital NHS Foundation Trust, Minerva Road, Farnworth, Greater Manchester, BL4 0JR, UK
| | - Julietta Patnick
- Visiting Professor in Cancer Screening, University of Oxford, Cancer Epidemiology Unit, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF, UK
| | - Stephen W Duffy
- Centre for Cancer Prevention, Wolfson Institute for Cancer Prevention, Charterhouse Square, London EC1M 6BQ, UK
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13
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Kerrison RS, Shukla H, Cunningham D, Oyebode O, Friedman E. Text-message reminders increase uptake of routine breast screening appointments: a randomised controlled trial in a hard-to-reach population. Br J Cancer 2015; 112:1005-10. [PMID: 25668008 PMCID: PMC4366892 DOI: 10.1038/bjc.2015.36] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 01/06/2015] [Accepted: 01/12/2015] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND There is a need for interventions to promote uptake of breast screening throughout Europe. METHODS We performed a single-blind randomised controlled trial to test whether text-message reminders were effective. Two thousand two hundred and forty women receiving their first breast screening invitation were included in the study and randomly assigned in a 1 : 1 ratio to receive either a normal invitation only (n=1118) or a normal invitation plus a text-message reminder 48 h before their appointment (n=1122). FINDINGS In the intention-to-treat analysis, uptake of breast screening was 59.1% among women in the normal invitation group and 64.4% in the text-message reminder group (χ(2)=6.47, odds ratio (OR): 1.26, 95% confidence intervals (CI): 1.05-1.48, P=0.01). Of the 1122 women assigned to the text-message reminder group, only 456 (41%) had a mobile number recorded by their GP and were thereby sent a text. In the per-protocol analysis, uptake by those in the control group who had a mobile number recorded on the GP system was 59.77% and by those in the intervention group who were sent a reminder 71.7% (χ(2)=14.12, OR=1.71, 95% CI=1.29-2.26, P<0.01). INTERPRETATION Sending women a text-message reminder before their first routine breast screening appointment significantly increased attendance. This information can be used to allocate resources efficiently to improve uptake without exacerbating social inequalities.
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Affiliation(s)
- R S Kerrison
- Health Behaviour Research Centre, Research Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, London WC1E 6BT, UK
| | - H Shukla
- Public Health England, Wellington House, 133–155 Waterloo Road, London SE1 8UG, UK
| | - D Cunningham
- West of London Breast Screening Service, Imperial College Healthcare NHS Trust, First Floor, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK
| | - O Oyebode
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
| | - E Friedman
- London Borough of Sutton, Civic Offices, St Nicholas Way, Sutton SM1 1EA, UK
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14
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Lin H, Wu X. Intervention strategies for improving patient adherence to follow-up in the era of mobile information technology: a systematic review and meta-analysis. PLoS One 2014; 9:e104266. [PMID: 25100267 PMCID: PMC4123963 DOI: 10.1371/journal.pone.0104266] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 07/07/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Patient adherence to follow-up plays a key role in the medical surveillance of chronic diseases and affects the implementation of clinical research by influencing cost and validity. We previously reported a randomized controlled trial (RCT) on short message service (SMS) reminders, which significantly improved follow-up adherence in pediatric cataract treatment. METHODS RCTs published in English that reported the impact of SMS or telephone reminders on increasing or decreasing the follow-up rate (FUR) were selected from Medline, EMBASE, PubMed, and the Cochrane Library through February 2014. The impacts of SMS and telephone reminders on the FUR of patients were systematically evaluated by meta-analysis and bias was assessed. RESULTS We identified 13 RCTs reporting on 3276 patients with and 3402 patients without SMS reminders and 8 RCTs reporting on 2666 patients with and 3439 patients without telephone reminders. For the SMS reminders, the majority of the studies (>50%) were at low risk of bias, considering adequate sequence generation, allocation concealment, blinding, evaluation of incomplete outcome data, and lack of selective reporting. For the studies on the telephone reminders, only the evaluation of incomplete outcome data accounted for more than 50% of studies being at low risk of bias. The pooled odds ratio (OR) for the improvement of follow-up adherence in the SMS group compared with the control group was 1.76 (95% CI [1.37, 2.26]; P<0.01), and the pooled OR for the improvement of follow-up adherence in the telephone group compared with the control group was 2.09 (95% CI [1.85, 2.36]; P<0.01); both sets showed no evidence of publication bias. CONCLUSIONS SMS and telephone reminders could both significantly improve the FUR. Telephone reminders were more effective but had a higher risk of bias than SMS reminders.
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Affiliation(s)
- Haotian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiaohang Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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15
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Broberg G, Jonasson JM, Ellis J, Gyrd-Hansen D, Anjemark B, Glantz A, Söderberg L, Ryd ML, Holtenman M, Milsom I, Strander B. Increasing participation in cervical cancer screening: Telephone contact with long-term non-attendees in Sweden. Results from RACOMIP, a randomized controlled trial. Int J Cancer 2013; 133:164-71. [DOI: 10.1002/ijc.27985] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Accepted: 11/12/2012] [Indexed: 11/10/2022]
Affiliation(s)
| | | | - Joy Ellis
- Department of Obstetrics and Gynecology; Institute of Clinical Science; Sahlgrenska Academy at University of Gothenburg; Sweden
| | | | | | - Anna Glantz
- Department of Obstetrics and Gynecology; Institute of Clinical Science; Sahlgrenska Academy at University of Gothenburg; Sweden
| | | | - Mare-Liis Ryd
- Regional Cancer Centre; Western Health Care Region; Gothenburg; Sweden
| | - Mikael Holtenman
- Regional Cancer Centre; Western Health Care Region; Gothenburg; Sweden
| | - Ian Milsom
- Department of Obstetrics and Gynecology; Institute of Clinical Science; Sahlgrenska Academy at University of Gothenburg; Sweden
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