ASPO Abstracts
Comparative Effectiveness of Interventions to Improve Screening for Three Cancers among Rural Women: A Randomized Trial.
Category: Cancer Health Disparities
Conference Year: 2022
Abstract Body:
Purpose: This study tested the comparative effectiveness of tailored messaging delivered via a mailed DVD vs. mailed DVD + telephone-based patient navigation (PN) vs. usual care to increase the proportion of rural women up to date (UTD) with breast, cervical and colorectal cancer screening. Methods: A total of 963 rural women 50 to 75 years of age and not UTD with guideline-based screening recommendations for at least one cancer (breast, cervical and colorectal) were randomized to usual care, a mailed DVD or a DVD + PN group. Women were recruited through purchased contact lists, community recruitment and Facebook. The DVD was developed to interactively provide messages related to health beliefs that included perceived risks of cancer, benefits, and barriers to screening, and perceived self-efficacy for obtaining needed screening tests (not UTD at baseline). The PN group included counseling women on barriers to obtaining needed screenings. The intervention was developed to simultaneously support obtaining screening for all or any cancer screening tests that were outside of guidelines at baseline. Results: The mean age of women was 58.6 years, 97% were non-Hispanic white and 77% were married. At 12-month post intervention, 15% of women in the DVD intervention had received all needed tests compared to 9% in usual care (OR = 1.90, p = 0.035). The addition of PN to DVD increased the percentage of women receiving all needed screenings (49%) compared to usual care with an odds ratio of 5.77 (p < 0.001). For any needed screening, the combination (DVD + PN) intervention (but not DVD alone) was significantly more effective than usual care (OR = 3.81). Women who needed only mammography were more likely to become UTD with all screening tests (OR = 21.0) or any needed test (OR =1.58). Conclusions: The addition of PN to a DVD greatly increased the percentage of women receiving all or any of the needed cancer screening tests (not UTD at baseline) after adjusting for other prognostic covariates. An intervention designed to simultaneously increase cancer screening for three cancers among rural women was efficacious and these interventions can be remotely delivered, demonstrating potential for implementing this evidence-based intervention in rural areas.
Keywords: Cancer screening, Intervention, Rural women