Comparative effectiveness of two outreach strategies for cervical cancer screening
Comparative effectiveness of two outreach strategies for cervical cancer screening
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DOI：
10.1016/j.ypmed.2016.01.016
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发表时间：
2016-05-01
影响因子：
5.1
通讯作者：
Buist, Diana S. M.
中科院分区：
文献类型：
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作者：
Bowles, Erin J. Aiello;Gao, Hongyuan;Buist, Diana S. M.
Objective.特定测试提醒信可以提高癌症筛查依从性。很少有人知道的有效性的提醒系统，针对整个人，包括多个筛选建议每letter. Methods。我们比较了在女性最后一次巴氏检查后27个月发送的巴氏特异性提醒信的有效性，以及在女性生日（“生日信”）之前发送的关于巴氏涂片依从性的七项预防服务建议的提醒信，这些建议来自常规临床护理中发生的自然实验。参与者包括来自华盛顿州的82，016名女性，她们在2003年至2007年期间收到了72，615封专门针对Papa的信件，在2009年至2012年期间收到了100，218封生日信件。我们将依从性定义为在巴氏试验到期日前后六个月内进行巴氏试验。使用logistic回归，我们计算了与Pap-specific信件相比，生日信中有1-2条建议，3-5条建议和6-7条建议的依从性的调整比值比（OR）和95%置信区间（CI）。所有的分析都按照女性在收到信件时是否是最新的或过期的筛查进行分层。调整后的OR显示，与Pap-specific信相比，生日信后的依从性降低，无论信中是否有1-2条建议（OR = 0.37，95%CI = 0.36-0.39）、3-5个推荐（OR = 0.44，95%CI = 0.42-0.45）或6-7个推荐（OR = 0.36，95%CI = 0.32-0.40）。我们注意到，逾期妇女的信类型之间的巴氏试验依从性没有差异。总之，对于定期坚持筛查的女性，与Pap-specific信件相比，包含多种预防服务提醒的年度生日信在促进宫颈癌筛查方面的效果较差。(C)2016 Elsevier Inc. All rights reserved.
Objective. Test-specific reminder letters can improve cancer screening adherence. Little is known about the effectiveness of a reminder system that targets the whole person by including multiple screening recommendations per letter.Methods. We compared the effectiveness of a Pap-specific reminder letter sent 27 months after a woman's last Pap, to a reminder letter that included up to seven preventive service recommendations sent before a woman's birthday ("birthday letter") on Pap smear adherence from a natural experiment occurring in routine clinical care. Participants included 82,016 women from Washington State who received 72,615 Pap-specific letters between 2003 and 2007 and 100,218 birthday letters between 2009 and 2012. We defined adherence as having a Pap test within a six month window around the Pap test due date. Using logistic regression, we calculated adjusted odds ratios (OR) for adherence with 95% confidence intervals (CI) following the birthday letter with 1-2 recommendations, 3-5 recommendations, and 6-7 recommendations compared to the Pap-specific letter. All analyses were stratified by whether a woman was up-to-date or overdue for screening at the time she received a letter.Results. Adjusted ORs showed reduced adherence following the birthday letter compared with the Pap-specific letter for up-to-date women whether the letter had 1-2 recommendations (OR = 0.37, 95%CI = 0.36-0.39), 3-5 recommendations (OR = 0.44, 95%CI = 0.42-0.45), or 6-7 recommendations (OR = 0.36, 95%CI = 0.32-0.40). We noted no difference in Pap-test adherence between letter types for overdue women.Conclusions. In conclusion, for women regularly adherent to screening, an annual birthday letter containing reminders for multiple preventive services was less effective at promoting cervical cancer screening compared with a Pap-specific letter. (C) 2016 Elsevier Inc. All rights reserved.