General practitioners and mammographic screening uptake: Influence of different modalities of general practitioner participation
General practitioners and mammographic screening uptake: Influence of different modalities of general practitioner participation
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DOI：
10.1177/030089160008600203
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发表时间：
2000-03-01
期刊：
影响因子：
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通讯作者：
Del Turco, MR
中科院分区：
文献类型：
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作者：
Giorgi, D;Giordano, L;Del Turco, MR
目的和背景：比较不同形式的全科医生(GP)参与，包括引入目标报酬，对意大利有组织的以人群为基础的乳腺癌筛查计划的出席率的影响。研究设计：研究于1994年至1996年在四个开展乳房X光检查计划的意大利城市进行：加尔塔尼塞塔(CL)、菲伦泽(FI)、莫德纳(MO)和都灵(TO)：在每个中心测试基于积极的全科医生参与的不同邀请策略对出席率的影响。还评估了经济激励措施的额外影响。结果：在Firenze项目中，由全科医生和项目协调员签署的邀请函参与率有统计学意义(差值：4.2%，x(2)=7.42，P=0.006)。在卡尔塔尼塞塔和都灵，全科医生联系的团体对邮寄提醒的回复率显著增加了约7%。结论：全科医生参与的主要贡献包括：“清理”邀请名单，特别是当目标人群的乳房X光检查历史没有计算机化档案时；通过签署邀请函，通过咨询和积极参与邀请阶段，增加妇女的参与；在提醒阶段，通过召回第一次邀请时不回答的妇女进行合作。目标支付的提议对筛选吸收有一定的影响，但不容易与邀请函的GP签名区分开来；应计划进一步研究适当的设计。组织因素，如非应答者名单的可获得性，可能是提高全球定位系统行动效果的关键。
Aims and background: To compare the impact of different modalities of general practitioner (GP) involvement, including the introduction of target payments, on the attendance rate of organized population-based screening programs for breast cancer in Italy.Study design: The study was conducted between 1994 and 1996 in four Italian cities where mammographic screening programs are active: Caltanissetta (CL), Firenze (FI), Modena (MO) and Torino (TO): The impact on attendance rate of different invitation strategies based on active GP involvement was tested in each center. The additional effect of economic incentives was also assessed. The incentives were proportional to the lever of compliance attained by each GP and weighted by the size of his eligible patients' list.Results: In the Firenze project, an invitation signed by the GP and the project co-ordinator attained a statistically significant higher participation (difference: 4.2%, chi(2) = 7.42, P = 0.006). In Caltanissetta and Torino there was a significant increase of about 7% in the response rate to the postal reminder in the groups contacted by the GPs. No difference was observed in the Modena project between the two groups.Conclusions: The main contributions of GP involvement can he: "cleaning up" the invitation lists, especially when computerized archives with the mammographic history of the target population are not available; increasing the women's participation by signing the invitation letter, by counseling and active participation in the invitation phase; co-operating in the reminder phase by recalling women non responders at first invitation. The offer of target payment had a certain impact on the screening uptake, but not easily distinguishable from GP signature of the invitation letter; further studies of appropriate design should he planned. Organizational factors, such as availability of a list of non-responders, might be crucial in order to enhance the effect of the Gps' action.