A Randomized Controlled Trial to Increase Cancer Screening and Reduce Depression Among Low-Income Women.

Area of Science:

• Public Health
• Clinical Medicine
• Health Services Research

Background:

• Low-income women of color face disparities in cancer screening and higher depression rates.
• Depression can significantly hinder participation in crucial cancer screenings.

Purpose of the Study:

• To compare the effectiveness of two interventions for improving cancer screening and reducing depression in underserved women.
• To assess interventions aimed at increasing colorectal, breast, and cervical cancer screening rates.
• To evaluate the impact on depression levels among women with existing depression.

Main Methods:

• A comparative effectiveness randomized controlled trial (RCT) involving 757 women aged 50-64.
• Participants were randomized to either a collaborative depression care plus cancer screening intervention (CCI + PCM) or a primary care management (PCM) intervention alone.
• Interventions were telephone-based, delivered over 12 months, and assessed using electronic health records and the PHQ-9 for depression.

Main Results:

• Both intervention groups showed statistically significant increases in up-to-date cancer screening for colorectal, breast, and cervical cancers.
• Depression symptoms improved in both the CCI + PCM and PCM groups.
• No statistically significant differences were found between the two interventions regarding improvements in cancer screening rates or depression reduction.

Conclusions:

• Both collaborative depression care plus cancer screening (CCI + PCM) and primary care management (PCM) interventions effectively improved cancer screening and reduced depression in underserved communities.
• Neither intervention demonstrated a superior advantage in outcomes, suggesting implementation decisions may depend on practice context.
• Further consideration of practice resources and priorities is recommended when selecting between these effective interventions.