Increasing the uptake of cervical screening at cornerstone medical practice.
Increasing the uptake of cervical screening at cornerstone medical practice.
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DOI：
10.1136/bmjoq-2020-001126
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发表时间：
2021-09
期刊：
影响因子：
1.4
通讯作者：
Bircher J
中科院分区：
文献类型：
--
作者：
Oyegbite A;Roberts J;Bircher J
在全国范围内，子宫颈筛查的普及率不高，尽管研究表明该方案在预防子宫颈癌方面非常有效。基石是位于英格兰西北部索尔福德的一个小诊所。从历史上看，这里的筛查率一直低于平均水平。我们的执业名单上有656名合格妇女，其中177名在项目开始时未经筛选。我们名单上最大的非白人英国人或爱尔兰人群体（13人）将波兰语作为第一语言。我们使用质量改进方法：改进模型，驱动图和计划，做，研究，行动周期。具体来说，我们针对177名以前没有反应的妇女，以及保持定期筛查服务。我们在项目期间设法联系了120名妇女。我们测试了邀请妇女参加宫颈检查的不同方法：电话，短信和信件。后来，文字邀请中还附带了视频链接。有关测试的信息传单被添加到信件中。这封信也被翻译成波兰语。吸收得到改善，达到了目的。护士的电话增加了摄入量，但占用了其他工作的时间，因此对我们的实践来说不是一个可持续的变化。一封说明测试证据基础的信和一封翻译成波兰语的信显示改善有限。当我们分析数据时，发送带有信息传单的信件和带有视频链接的短信获得了类似的回复率，没有统计学意义。提供延长工作时间和灵活的预约时间显示出非常积极的结果。采用附有视频的短信作为针对持续无应答者的有效方法。该项目进入第二年，正在扩大到整个初级保健网络。
Nationally, cervical screening uptake is suboptimal, even though research shows that the programme is highly effective at preventing cervical cancer. Cornerstone is a small practice located in Salford in the North West of England. Historically, screening uptake here has been lower than average. There were 656 eligible women on our practice list and 177 of them were unscreened at the start of the project. The largest group of non-white British or Irish people on our list (13) spoke Polish as their first language. We used quality improvement methods: the model for improvement, a driver diagram and Plan, Do, Study, Act cycles. Specifically, we targeted 177 women who were previously non-responders, as well as keeping up the regular screening service. We managed to contact 120 women during the project. We tested different methods of inviting women to attend cervical screening: telephone calls, text messages and letters. Later, a video link was also included in the text invitation. Information leaflets about the tests were added to letters. The letter was also translated into Polish. Uptake improved and the aim was reached. Telephone calls from the nurse increased uptake but took time away from other work, so was not a sustainable change for our practice. A letter stating evidence basis for the test, and a letter translated into Polish showed limited improvement. Sending letters with information leaflets and text messages with video links achieved similar response rates with no statistical significance when we analysed the data. Offering extended hours and flexible appointment times showed very positive results. The text message with a video attached was adopted as an effective method for targeting persistent non-responders. The project in its second year is being scaled up across the Primary Care Network.