Comparative effectiveness of two outreach strategies for cervical cancer screening

Preventive Medicine
Erin J Aiello BowlesDiana S M Buist

Abstract

Test-specific reminder letters can improve cancer screening adherence. Little is known about the effectiveness of a reminder system that targets the whole person by including multiple screening recommendations per letter. We compared the effectiveness of a Pap-specific reminder letter sent 27months after a woman's last Pap, to a reminder letter that included up to seven preventive service recommendations sent before a woman's birthday ("birthday letter") on Pap smear adherence from a natural experiment occurring in routine clinical care. Participants included 82,016 women from Washington State who received 72,615 Pap-specific letters between 2003 and 2007 and 100,218 birthday letters between 2009 and 2012. We defined adherence as having a Pap test within a six month window around the Pap test due date. Using logistic regression, we calculated adjusted odds ratios (OR) for adherence with 95% confidence intervals (CI) following the birthday letter with 1-2 recommendations, 3-5 recommendations, and 6-7 recommendations compared to the Pap-specific letter. All analyses were stratified by whether a woman was up-to-date or overdue for screening at the time she received a letter. Adjusted ORs showed reduced adherence following the birt...Continue Reading

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Citations

Mar 26, 2019·The Journal of Nursing Research : JNR·Gonul Kurt, Aygul Akyuz
Nov 20, 2016·Journal of Racial and Ethnic Health Disparities·Susan BrandzelDiana S M Buist

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