Information given to women invited for cervical screening: results of two postal surveys seven years apart

2005 ◽  
Vol 15 (2) ◽  
pp. 267-272
Author(s):  
H. V. Duggal ◽  
B. Olowokure ◽  
M. Caswell ◽  
S. A. Wardle
Keyword(s):  
Older Women ◽  
Random Sample ◽  
Screening Program ◽  
Cervical Screening ◽  
Information Provision ◽  
Bivariate Analysis ◽  
Cervical Smear ◽  
Age Related ◽  
To Receive ◽  
Women’S Views

In South Staffordshire, England, we compared women's views on information provided to them at different stages of the cervical screening program in 1994 with that provided in 2001. An age-stratified random sample of women aged 20–64 years who had a cervical smear taken between January and March 1994 (3856) or between January and March 2001 (4057) were sent postal questionnaires in June 1994 and July 2001, respectively. Response rates in 1994 (3124/3856, 81%) and 2001 (3288/4057, 81%) were similar. Compared to 1994, the proportion of women who thought the invitation letter was clear to read in 2001 increased (70% vs 98%, P < 0.0001); however, letters were thought to be less reassuring in 2001 compared to 1994 (P < 0.0001). In both study periods, 66% of women reported that the procedure was explained to them before the smear was taken. A greater proportion of women received their results by letter in 2001 compared to 1994 (57% vs 41%, P < 0.0001); however, 49% of women waited >4 weeks to receive their results in 2001 compared to 26% in 1994 (P < 0.0001). Bivariate analysis suggests that responses were age related, with older women (≥45 years) experiencing poorer information provision. The issues highlighted by this study deserve further investigation in other areas.

scholarly journals Cervical Screening of Arabic-Speaking Women in Australian General Practice

1997 ◽  
Vol 4 (2) ◽  
pp. 107-111 ◽  
Author(s):  
Margaret Lesjak ◽  
Jeanette Ward ◽  
Chris Rissel
Keyword(s):  
Cervical Cancer ◽  
At Risk ◽  
Older Women ◽  
Smoking Status ◽  
Cervical Screening ◽  
Cervical Smear ◽  
Women Studies ◽  
Australian General Practice ◽  
Arabic Speaking ◽  
Sydney Australia

Abstract Objective— To determine recency and predictors of cervical screening among Arabic-speaking women in Sydney, Australia. Method— A consecutive sample of Arabic-speaking women, attending 20 Arabic-speaking general practitioners, was asked to complete a self administered health risk questionnaire available in Arabic or English which included three questions about cervical screening knowledge and behaviour. Results— Of 756 eligible women, 526 (70%) returned completed questionnaires. Of these, 69 (13%) did not know what a cervical smear was. Sixteen per cent of overseas-born compared with 2% of Australian-born women at risk had not heard of a cervical smear. Women were defined as being at risk of cervical cancer if they had both been married and not had a hysterectomy. Of 318 women at risk for cervical cancer who knew what a cervical smear was, 66% had had a smear in the last two years, a further 7% were attending for one that day while 11% had not had a smear for at least two years, 9% had never had one and 7% did not answer/could not remember. Religion, age, and residence in Australia for more than 10 years were significant and independent predictors of screening after adjustment for other variables in a simultaneous logistic regression model (P = 0.002, P = 0.002, and P = 0.040 respectively). Muslim women and older women were more likely to be under-screened, and women with more than 10 years' residence in Australia were more likely to have been screened in the last two years. Acculturation, smoking status, health status, duration of relationship with participating doctor, and chronic disease were not significant predictors of a recent smear. Conclusion— As only 73% of women at risk had been screened in the last two years, including women attending on the day, and 9% had never been screened, Arabic-speaking women should be a priority for public campaigns, particularly Muslim and older women. Studies to evaluate the effectiveness and acceptability of reminders by ethnic general pratitioners are recommended.

Dilemmas of nudging in public health: an ethical analysis of a Danish pamphlet

2020 ◽  
Author(s):  
Jacob Busch ◽  
Emilie Kirstine Madsen ◽  
Antoinette Mary Fage-Butler ◽  
Marianne Kjær ◽  
Loni Ledderer
Keyword(s):  
Public Health ◽  
Ethical Issues ◽  
Screening Programme ◽  
Screening Program ◽  
Ethical Analysis ◽  
Choice Making ◽  
The Face ◽  
Information Materials ◽  
The Individual ◽  
To Receive

Summary Nudging has been discussed in the context of public health, and ethical issues raised by nudging in public health contexts have been highlighted. In this article, we first identify types of nudging approaches and techniques that have been used in screening programmes, and ethical issues that have been associated with nudging: paternalism, limited autonomy and manipulation. We then identify nudging techniques used in a pamphlet developed for the Danish National Screening Program for Colorectal Cancer. These include framing, default nudge, use of hassle bias, authority nudge and priming. The pamphlet and the very offering of a screening programme can in themselves be considered nudges. Whether nudging strategies are ethically problematic depend on whether they are categorized as educative- or non-educative nudges. Educative nudges seek to affect people’s choice making by engaging their reflective capabilities. Non-educative nudges work by circumventing people’s reflective capabilities. Information materials are, on the face of it, meant to engage citizens’ reflective capacities. Recipients are likely to receive information materials with this expectation, and thus not expect to be affected in other ways. Non-educative nudges may therefore be particularly problematic in the context of information on screening, also as participating in screening does not always benefit the individual.

Adenoma detection by Endocuff-assisted versus standard colonoscopy in an organized screening program: the “ItaVision” Randomized Controlled Trial

Endoscopy ◽  
2021 ◽  
Author(s):  
Manuel Zorzi ◽  
Cesare Hassan ◽  
Jessica Battagello ◽  
Giulio Antonelli ◽  
Maurizio Pantalena ◽  
...  
Keyword(s):  
Screening Program ◽  
Controlled Trial ◽  
Withdrawal Time ◽  
Adenoma Detection ◽  
Organized Screening Program ◽  
Immunochemical Test ◽  
Medical Design ◽  
Standard Colonoscopy ◽  
To Receive ◽  
Screening History

Objective Endocuff Vision (EV, Arc Medical Design Ltd., Leeds, England) has shown to increase mucosal exposure, and consequently adenoma detection rate (ADR), during colonoscopy. This nationwide multicentre study assessed possible benefits and harms of implementing EV in a Faecal Immunochemical Test (FIT)-based screening program. Design Patients undergoing colonoscopy after a FIT+ test were randomised 1:1 to receive colonoscopy with EV or standard colonoscopy, stratified by gender, age, and screening history. Primary outcome was ADR, Secondary outcomes were ADR stratified by endoscopists’ ADR, advanced ADR (AADR), adenoma per colonoscopy (APC), withdrawal time (WT), and adverse events (AE). Results Overall, 1,864 patients were enrolled in 13 centres. After exclusions, 1,813 (males: 53.7%; mean age: 60.1 years) were randomised, 908 in the EV arm and 905 in the control. ADR was significantly higher in the EV arm (47.8% vs 40.8%; RR 1.17, 95%CI 1.06-1.30) with no differences between arms regarding size or morphology. When stratifying for endoscopists’ ADR, only low detectors (ADR< 33.3%) showed a statistically significant ADR increase (EV = 41.1%, 95%CI 35.7-46.7 vs control = 26%, 95%CI 21.3-31.4 . AADR (24.8% vs 20.5%, RR 1.21; 95%CI 1.02-1.43) and APC (0.94 vs. 0.77, p=0.001) were higher in the EV arm. WT and AE were similar between arms. Conclusion EV increased ADR in a FIT-based screening program, supporting a complete exploration of colonic mucosa. Its utility was highest among endoscopists with a low ADR. ClinicalTrial.gov NCT03612674

scholarly journals P63 Improving cervical smear uptake through an Automated Voice Messages Reminder

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Francesca Bladt ◽  
Felyx Wong ◽  
Francesca Bladt
Keyword(s):  
Cervical Cancer ◽  
Low Cost ◽  
Cervical Screening ◽  
Telephone Triage ◽  
Cervical Smear ◽  
Screening Programs ◽  
Smear Test ◽  
Voice Message ◽  
The Uk ◽  
Busy Schedule

Abstract National cervical screening programs have played a pivotal role in the prevention of cervical cancer. However, practices across the UK have reached an all-time low in cervical screening uptake. This study aimed to assess the efficacy of implementing an automated voice message reminder within the local general practice (GP) telephone triage system and explore the reasons which deter eligible patients away from cervical screening. A 20-second voice-message reminder in the telephone queue was played, addressing key risk factors along with a message from a child who lost his mother to cervical cancer. From the anonymised GP database, weekly new smear test bookings were monitored from 4 weeks prior until 2 weeks after the intervention was implemented. To qualitatively assess factors which deter patients away from screening, female patients were randomly sampled to fill in an anonymous questionnaire. The use of a low-cost 20 second voice message in the telephone queue across UK GP practices could be an effective method to increase cervical smear test coverage towards the national target of 80%. 35 questionnaire responses were received, main themes reported for not attending screening include embarrassment(37%), busy schedule(32%) and cultural differences(24%). In the week following the intervention, cervical smear tests increased more than 2-fold, from an average of 12 to 26 smears per week. This could be partly due to the convenient timing of voice recording, reminding them to book both appointments simultaneously and the child’s emotive message.

scholarly journals Stigma mastery in people living with HIV: gender similarities and theory

2021 ◽  
Author(s):  
Charles Patrick Namisi ◽  
John C. Munene ◽  
Rhoda K. Wanyenze ◽  
Anne R. Katahoire ◽  
Rosalinda M. Parkes-Ratanshi ◽  
...  
Keyword(s):  
Older Women ◽  
Social Exclusion ◽  
Theoretical Framework ◽  
People Living With Hiv ◽  
Negative Effects ◽  
Hiv Diagnosis ◽  
Cross Sectional ◽  
Age Related ◽  
Related Stigma ◽  
Living With Hiv

Abstract Aims This study aimed to determine the prevalence of, factors associated with, and to build a theoretical framework for understanding Internalsed HIV-related Stigma Mastery (IHSM). Methods A cross-sectional study nested within a 2014 Stigma Reduction Cohort in Uganda was used. The PLHIV Stigma Index version 2008, was used to collect data from a random sample of 666 people living with HIV (PLHIV) stratified by gender and age. SPSS24 with Amos27 softwares were used to build a sequential-mediation model. Results The majority of participants were women (65%), aged ≥ 40 years (57%). Overall, IHSM was 45.5% among PLHIV, that increased with age. Specifically, higher IHSM correlated with men and older women “masculine identities” self-disclosure of HIV-diagnosis to family, sharing experiences with peers. However, lower IHSM correlated with feminine gender, the experience of social exclusion stress, fear of future rejection, and fear of social intimacy. Thus, IHSM social exclusion with its negative effects and age-related cognition are integrated into a multidimensional IHSM theoretical framework with a good model-to-data fit. Conclusion Internalised HIV-related Stigma Mastery is common among men and older women. Specificially, “masculine identities” self-disclose their own HIV-positive diagnosis to their family, share experiences with peers to create good relationships for actualising or empowerment in stigma mastery. However, social exclusion exacerbates series of negative effects that finally undermine stigma mastery by young feminine identities. Thus, stigma mastery is best explained by an integrated empowerment framework, that has implications for future practice, policy, and stigma-related research that we discuss.

scholarly journals Implementing genomic screening in diverse populations

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Noura S. Abul-Husn ◽  
Emily R. Soper ◽  
Giovanna T. Braganza ◽  
Jessica E. Rodriguez ◽  
Natasha Zeid ◽  
...  
Keyword(s):  
Screening Program ◽  
African Ancestry ◽  
Genomic Medicine ◽  
European Ancestry ◽  
Transthyretin Amyloidosis ◽  
Medicine Research ◽  
Screening Programs ◽  
Genomic Screening ◽  
Genomic Results ◽  
To Receive

Abstract Background Population-based genomic screening has the predicted ability to reduce morbidity and mortality associated with medically actionable conditions. However, much research is needed to develop standards for genomic screening and to understand the perspectives of people offered this new testing modality. This is particularly true for non-European ancestry populations who are vastly underrepresented in genomic medicine research. Therefore, we implemented a pilot genomic screening program in the BioMe Biobank in New York City, where the majority of participants are of non-European ancestry. Methods We initiated genomic screening for well-established genes associated with hereditary breast and ovarian cancer syndrome (HBOC), Lynch syndrome (LS), and familial hypercholesterolemia (FH). We evaluated and included an additional gene (TTR) associated with hereditary transthyretin amyloidosis (hATTR), which has a common founder variant in African ancestry populations. We evaluated the characteristics of 74 participants who received results associated with these conditions. We also assessed the preferences of 7461 newly enrolled BioMe participants to receive genomic results. Results In the pilot genomic screening program, 74 consented participants received results related to HBOC (N = 26), LS (N = 6), FH (N = 8), and hATTR (N = 34). Thirty-three of 34 (97.1%) participants who received a result related to hATTR were self-reported African American/African (AA) or Hispanic/Latinx (HL), compared to 14 of 40 (35.0%) participants who received a result related to HBOC, LS, or FH. Among the 7461 participants enrolled after the BioMe protocol modification to allow the return of genomic results, 93.4% indicated that they would want to receive results. Younger participants, women, and HL participants were more likely to opt to receive results. Conclusions The addition of TTR to a pilot genomic screening program meant that we returned results to a higher proportion of AA and HL participants, in comparison with genes traditionally included in genomic screening programs in the USA. We found that the majority of participants in a multi-ethnic biobank are interested in receiving genomic results for medically actionable conditions. These findings increase knowledge about the perspectives of diverse research participants on receiving genomic results and inform the broader implementation of genomic medicine in underrepresented patient populations.

scholarly journals Smartphone-Enhanced Training, QA, Monitoring, and Evaluation of a Platform for Secondary Prevention of Cervical Cancer: Opportunities and Challenges to Implementation in Tanzania

2020 ◽  
pp. 1114-1123
Author(s):  
Karen Yeates ◽  
Erica Erwin ◽  
Zac Mtema ◽  
Frank Magoti ◽  
Simoni Nkumbugwa ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Visual Inspection ◽  
Screening Program ◽  
Cervical Screening ◽  
Monitoring And Evaluation ◽  
Visual Assessment ◽  
Cervical Cancer Prevention ◽  
Supportive Supervision ◽  
Health Providers

PURPOSE Until human papillomavirus (HPV)–based cervical screening is more affordable and widely available, visual inspection with acetic acid (VIA) is recommended by the WHO for screening in lower-resource settings. Visual inspection will still be required to assess the cervix for women whose screening is positive for high-risk HPV. However, the quality of VIA can vary widely, and it is difficult to maintain a well-trained cadre of providers. We developed a smartphone-enhanced VIA platform (SEVIA) for real-time secure sharing of cervical images for remote supportive supervision, data monitoring, and evaluation. METHODS We assessed programmatic outcomes so that findings could be translated into routine care in the Tanzania National Cervical Cancer Prevention Program. We compared VIA positivity rates (for HIV-positive and HIV-negative women) before and after implementation. We collected demographic, diagnostic, treatment, and loss-to-follow-up data. RESULTS From July 2016 to June 2017, 10,545 women were screened using SEVIA at 24 health facilities across 5 regions of Tanzania. In the first 6 months of implementation, screening quality increased significantly from the baseline rate in the prior year, with a well-trained cadre of more than 50 health providers who “graduated” from the supportive-supervision training model. However, losses to follow-up for women referred for further evaluation or to a higher level of care were considerable. CONCLUSION The SEVIA platform is a feasible, quality improvement, mobile health intervention that can be integrated into a national cervical screening program. Our model demonstrates potential for scalability. As HPV screening becomes more affordable, the platform can be used for visual assessment of the cervix to determine amenability for same-day ablative therapy and/or as a secondary triage step, if needed.

Sign in / Sign up

Export Citation Format

Share Document