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Interventions to improve uptake of breast screening in inner city Cardiff general practices with ethnic minority
T S Bell1, L K Branston, R G Newcombe
1Research and Evaluation Department, Breast Test Wales, Cardiff.
Insights
Targeted interventions significantly increased breast screening uptake in ethnic minority women. Translated materials and language support proved effective, though transport was not utilized.
Area of Science:
- Public Health
- Health Services Research
- Health Disparities
Background:
- Low breast screening uptake is a concern in inner-city general practices serving ethnic minority populations.
- Previous screening rounds showed low attendance rates in targeted Cardiff practices.
Purpose of the Study:
- To enhance breast screening uptake among ethnic minority patients in three inner-city general practices.
- To identify effective interventions for reaching underserved ethnic minority groups for cancer screening.
Main Methods:
- A preliminary, non-randomized study in Cardiff, Wales, targeting practices with high ethnic minority patient lists.
- Interventions included identifying ethnic language groups, GP endorsement letters, translated literature (leaflets, invitations), and language support.
- Free transport to the screening centre was also offered.
Main Results:
- Breast screening uptake increased from 35.2% to 50.7% (a 15.5% statistically significant rise) among 369 invited women.
- Uptake was highest for Urdu and Gujarati speakers.
- Bengali and Somali speakers represented the hardest-to-reach groups.
Conclusions:
- Translated literature, GP endorsement, and language support by linkworkers significantly improved screening attendance.
- Free transport was ineffective and underutilized.
- Targeted strategies are essential for improving ethnic minority screening rates, but can be resource-intensive.
Objective:
To increase the uptake of breast screening in three inner city GP practices with a high proportion of ethnic minority patients.
Setting:
The study was carried out in May and June 1997 in the South East Wales division of Breast Test Wales (BTW). Three inner city general practices in Cardiff, with a low uptake in the previous round of breast screening and a high proportion of ethnic minority women on their lists, were targeted to receive interventions to increase uptake. This preliminary study was not randomized but sought to offer insights into the interventions which may be worth pursuing and the groups that are harder to reach.
Interventions:
identification of ethnic language groups; GP endorsement letter; translated literature including: multilingual leaflet, GP letter, screening invitation; transport to the screening centre; language support.
Results:
Of 369 women invited, 187 attended for screening. This gives an uptake of 50.7% compared with an uptake of 35.2% in the previous screening round, a statistically significant increase of 15.5%. (95% CI +8.2% to +22.5%).
Conclusion:
Findings show that translated literature, GP endorsement letter and language support by linkworkers were beneficial. The provision of free transport was ineffective and under-utilized. Uptake was highest amongst Urdu and Gujarati speaking groups and lowest for Bengali and Somali speakers which are hardest to reach. There is scope for improving the attendance rate amongst ethnic minority groups but this can costly.
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