Interventions to reach underscreened populations: a narrative review for planning cancer screening initiatives

Abstract

The authors conclude with a summary the types and a decision tool designed to help KT and implementation teams select interventions which could be adapted to their own context.

Cervical and Breast Cancer Screening After CARES: A Community Program for Immigrant and Marginalized Women

“…Previous community interventions to improve cancer screening among under-screened populations have shown variable success. 4,[25][26][27][28][29][30][31] In systematic reviews effect sizes averaged 16% for Pap screening and 7.8% for mammography, 26,27 similar to CARES' effect size of 14% for Pap screening, but significantly lower than the 20% for mammography. Notably, most studies have relied on self-report to measure screening or used intention to screen to assess impact.…”

“…This study adds to the literature that peer leaders or "lay health educators" can be effective in overcoming language and cultural barriers to preventive care experienced by immigrant and minority populations. 30,31,39,40 Greatest effects have been noted when lay educators were racially or ethnically similar to the target group, as was the case for CARES peer leaders. 40 CARES peer leaders also supported system navigation, linking women interested in screening with services, and providing linguistic support and accompaniment to group screening sessions.…”

‘This is the beginning of the new me’: process evaluation of a group fitness intervention to promote wellbeing in formerly homeless individuals

“…Participants expressed concerns about the lack of participation in the intervention from the other supportive housing tenants, and some of their comments implied that the intervention did not reach some of those in need. One of the common and key issues in any public health intervention and research is how to reach those who are most difficult to reach [44–46]. For example, interventions that target youth are commonly implemented in schools and fail to reach those with attendance issues who are often the ones who need the intervention the most [47, 48].…”

Access to health for refugees in Greece: lessons in inequalities

“…However, the rapid changes in the epidemiology of multiple conditions that are seen in countries with high immigration rates, like Greece, demand more pragmatic solutions. For example, following a simple decision-making tool at point of care could increase participation in screening in communities known to have disproportionately high populations of immigrants or refugees who may have a language barrier [ 7 ]. Refugees can be a target audience for which just the best available knowledge can be used.…”