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Increasing women's compliance with opportunistic cervical cancer screening: a randomized trial
1Faculty of Medicine, University of Newcastle, New South Wales, Australia.
Abstract:
Our objective was to evaluate the efficacy and acceptability of two interventions designed to increase opportunistic cervical cancer screening. We designed a randomized trial of two interventions additional to usual care. We recruited 17 male general practitioners selected at random from the inner metropolitan region of Sydney, Australia. The patients were 202 women, between 20 and 65 years of age, eligible for a Pap smear. We allocated minimal and maximal interactional interventions to obtain consent for a Pap smear. Our main outcome measure was women's having a Pap smear during the consultation or within one month. We also measured acceptability of interventions to practitioners and women. These were our results: minimal: 55% of women had a Pap smear; maximal: 67% of women had a Pap smear; total when both approaches are combined: 61%. We conclude that brief advice is as effective as maximal persuasion in increasing women's compliance with opportunistic screening in routine consultations. Both interventions were acceptable to women. Practitioners preferred the minimal intervention. We demonstrate opportunistic screening is an effective and acceptable way to encourage women at risk to have a Pap smear.
Insights
Brief advice and maximal persuasion effectively increase opportunistic cervical cancer (Pap smear) screening rates in women. Both methods were acceptable, with practitioners preferring minimal intervention for Pap smear compliance.
Area of Science:
- Public Health
- Preventive Medicine
- Gynecology
Background:
- Cervical cancer screening is crucial for early detection and prevention.
- Opportunistic screening during routine consultations can improve uptake.
Purpose of the Study:
- To evaluate the efficacy and acceptability of two interventions to increase opportunistic cervical cancer screening.
- To compare minimal versus maximal interactional interventions for Pap smear consent.
Main Methods:
- Randomized trial involving 17 general practitioners and 202 women aged 20-65 eligible for Pap smears.
- Interventions: minimal and maximal interactional approaches to obtain consent for Pap smears.
- Outcome measures: Pap smear uptake during consultation or within one month, and acceptability to practitioners and women.
Main Results:
- Pap smear uptake was 55% with minimal intervention and 67% with maximal intervention.
- Overall uptake combining both approaches was 61%.
- Both interventions were acceptable to women; practitioners preferred the minimal intervention.
Conclusions:
- Brief advice is as effective as maximal persuasion in enhancing women's compliance with opportunistic Pap smear screening.
- Opportunistic screening is an effective and acceptable strategy to encourage Pap smear uptake.
- Minimal intervention is preferred by practitioners for opportunistic cervical cancer screening.