Impact of a Breast Cancer Screening Community Intervention

Zapka, Jane G.; Costanza, Mary E.; Harris, D.R.; Hosmer, David W.; Stoddard, Anne M.; Barth, Robin S.; Gaw, Victoria P.

doi:10.1006/pmed.1993.1003

Cited by 38 publications

(15 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other researchers have reported similar challenges. [10][11][12]29 There were several limitations of this study, including self-reported screening practices, a low response rate at some study sites, and differential response rates among some demographic groups between baseline and follow-up. In addition, this study was conducted with women employed in unionized state agencies and health care settings.…”

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Promoting breast and cervical cancer screening at the workplace: results from the Woman to Woman Study

Allen

Stoddard²,

Mays³

et al. 2001

Am J Public Health

View full text Add to dashboard Cite

A B S T R A C TObjectives. This article reports findings from a peer-delivered intervention designed to increase use of breast and cervical cancer screening.Methods. Twenty-six worksites were randomly assigned to the intervention or comparison group. The 16-month intervention consisted of group discussions, outreach, and educational campaigns. Data were collected from a random sample of women employees stratified by age (baseline n=2943; final n = 2747). Cross-sectional analyses were conducted to evaluate the impact of the intervention on screening behaviors.Results. Relative to comparison worksites, the intervention group experienced greater increases in the percentage of women who reported a recent mammogram (7.2% vs 5.6%), clinical breast examination (5.8% vs 2.1%), and Papanicolaou (Pap) test (4.7% vs 1.9%). After worksite cluster and age strata were controlled for, the observed increase in Pap tests was significantly greater in the intervention group (odds ratio [OR]=1.28; 95% confidence interval [CI]=1.01, 1.62); however, differences in mammography screening rates (OR=1.14; 95% CI=0.90, 1.44) and clinical breast examination (OR=1.19; 95% CI=0.96, 1.49) were not statistically significant.Conclusions. Intervention activities produced a modest increase in cervical cancer screening, but they did not accelerate breast cancer screening rates above the observed secular trend. (Am J Public Health. 2001;91:584-590) In 1998, an estimated 43900 women died from breast cancer and 4900 died from cervical cancer in the United States.1 For both diseases, effective early detection methods have been identified. Regular mammography screening among women 50 years and older has been shown to reduce breast cancer mortality by as much as 30%.2 Regular screening with the Papanicolaou (Pap) test may reduce cervical cancer mortality by as much as 98%.

show abstract

Section: Discussionmentioning

confidence: 98%

“…9 In recent years, numerous efforts have been undertaken to promote screening participation. These initiatives have primarily been based in community settings [10][11][12] or conducted in health facilities. [13][14][15][16] Few studies have investigated the efficacy of breast and cervical cancer education programs based in worksites.…”

mentioning

confidence: 99%

Promoting breast and cervical cancer screening at the workplace: results from the Woman to Woman Study

Allen

Stoddard²,

Mays³

et al. 2001

Am J Public Health

View full text Add to dashboard Cite

show abstract

“…43,44 Other studies reporting primary outcomes more than 12 months after intervention implementation were not as successful. [45][46][47][48][49][50][51] In conclusion, the Cancer SOS intervention had persistent, although modest, effects on screening at 24 months' follow-up. Effectiveness of the intervention strategy had clearly diminished from results reported at 12 months' follow-up, most likely because of diminished compliance with the system.…”

Section: Discussionmentioning

confidence: 99%

Long-term Results From a Randomized Controlled Trial to Increase Cancer Screening Among Attendees of Community Health Centers

Roetzheim¹

2005

The Annals of Family Medicine

View full text Add to dashboard Cite

PURPOSEWe assessed whether increased cancer screening rates that were observed with Cancer Screening Offi ce Systems (Cancer SOS) could be maintained at 24 months' follow-up, a period in which clinics were expected to be largely self-suffi cient in maintaining the intervention. METHODSEight primary care clinics serving disadvantaged populations in Hillsborough County, Fla, agreed to take part in a cluster-randomized experimental trial. Charts of independent samples of established patients aged 50 to 75 years were abstracted, with data collected at baseline (n = 1,196) and at 24 months' follow-up (n = 1,296). Papanicolaou (Pap) smears, mammography, and fecal occult blood testing were assessed.RESULTS At 24 months of follow-up, intervention patients had received a greater number of cancer screening tests (mean 1.17 tests vs 0.94 tests, t test = 4.42, P <.0001). In multivariate analysis that controlled for baseline screening rates, secular trends, and other patient and clinic characteristics, the intervention increased the odds of mammograms slightly (odds ratio [OR]) = 1.26; 95% confi dence interval [CI], 1.02-1.55; P = .03) but had no effect on fecal occult blood tests (OR = 1.17; 95% CI, 0.92-1.48; P =0.19) or Pap smears (OR = 0.88; 95% CI, 0.0.68-1.15; P = .34).CONCLUSIONS The Cancer SOS intervention had persistent, although modest, effects on screening at 24 months' follow-up, an effect that had clearly diminished from results reported at 12 months' follow-up. Further study is needed to develop successful intervention strategies that are either self-sustaining or that are able to produce long-term changes in screening behavior.

show abstract

“…A few investigators have designed community intervention trials in which exactly one cluster has been assigned to the intervention group and one to the control group, either with or without the beneÿt of randomization [26][27][28][29][30][31][32]. Such trials invariably result in interpretation di culties arising from the total confounding of two sources of variation: (i) variation in response due to the e ect of intervention and (ii) the natural variation that exists between the two clusters even in the absence of an intervention e ect.…”

Section: Difficulties In Estimating Design Effects From Individual Trmentioning

confidence: 99%

Issues in the meta‐analysis of cluster randomized trials

Donner

Klar

2002

Statistics in Medicine

710

137

View full text Add to dashboard Cite

Meta-analyses involving the synthesis of evidence from cluster randomization trials are being increasingly reported. These analyses raise challenging methodologic issues beyond those raised by meta-analyses which include only individually randomized trials. In this paper we review and comment on a selected number of these issues, including problems of study heterogeneity, difficulties in estimating design effects from individual trials and the choice of statistical methods.

show abstract

Impact of a Breast Cancer Screening Community Intervention

Cited by 38 publications

References 0 publications

Promoting breast and cervical cancer screening at the workplace: results from the Woman to Woman Study

Promoting breast and cervical cancer screening at the workplace: results from the Woman to Woman Study

Long-term Results From a Randomized Controlled Trial to Increase Cancer Screening Among Attendees of Community Health Centers

Issues in the meta‐analysis of cluster randomized trials

Contact Info

Product

Resources

About