Evaluation of a worksite cervical screening initiative to increase Pap smear uptake in Malaysia: a cluster randomized controlled trial.
Evaluation of a worksite cervical screening initiative to increase Pap smear uptake in Malaysia: a cluster randomized controlled trial.
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DOI：
10.1155/2013/572126
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发表时间：
2013
影响因子：
--
通讯作者：
Su TT
中科院分区：
文献类型：
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作者：
Abdullah F;O'Rorke M;Murray L;Su TT
背景尽管宫颈癌的负担很重，但马来西亚像许多中等收入国家一样，依赖于机会性宫颈筛查，而不是更有组织的基于人口的计划。本研究的目的是确定工作场所的筛查倡议的有效性后，巴氏涂片检查（巴氏试验）在马来西亚受过教育的职业妇女的摄取。方法. 2010年1月至11月期间，从吉隆坡40所公立中学招募了403名从未或很少参加巴氏检查的女教师参加一项整群随机试验。干预组参加了一个工作场所的子宫颈普查倡议，而对照组接受常规护理，从现有的子宫颈普查计划。进行多变量logistic回归分析，以确定干预计划对24周随访后巴氏涂片摄取的影响。结果干预组参加巴氏涂片检查的妇女比例显著高于对照组（18.1% vs 10.1%，P值< 0.05），工作场所筛查倡议使巴氏涂片检查增加了一倍，校正比值比为2.44（95%CI：1.29-4.62）。结论工作场所健康促进干预措施可以有效提高中等收入国家合格工人的宫颈涂片检查率。这些国家的决策者和卫生保健提供者应将此类干预措施纳入减少宫颈癌负担的战略。本试验注册于IRCT 201103186088 N1。
Background. Despite the significant burden of cervical cancer, Malaysia like many middle-income countries relies on opportunistic cervical screening as opposed to a more organized population-based program. The aim of this study was to ascertain the effectiveness of a worksite screening initiative upon Papanicolaou smear test (Pap test) uptake among educated working women in Malaysia. Methods. 403 female teachers who never or infrequently attended for a Pap test from 40 public secondary schools in Kuala Lumpur were recruited into a cluster randomized trial conducted between January and November 2010. The intervention group participated in a worksite cervical screening initiative whilst the control group received usual care from the existing cervical screening program. Multivariate logistic regression was performed to determine the impact of the intervention program on Pap smear uptake after 24 weeks of followup. Results. The proportion of women attending for a Pap test was significantly higher in the intervention than in the control group (18.1% versus 10.1%, P value < 0.05) with the worksite screening initiative doubling the Pap smear uptake, adjusted odds ratio 2.44 (95% CI: 1.29–4.62). Conclusion. Worksite health promotion interventions can effectively increase cervical smear uptake rates among eligible workers in middle-income countries. Policy makers and health care providers in these countries should include such interventions in strategies for reducing cervical cancer burden. This trial is registered with IRCT201103186088N1.