Telephone interventions in adherence to receiving the Pap test report: a randomized clinical trial

Abstract

Objective:to test the efficacy of the behavioral and educational interventions undertaken by telephone, for women’s attendance at the consultation to receive the Pap test report. Method:a randomized clinical trial, with a sample randomized in three groups: telephone call - educational (n=171), telephone call - reminder (n=171) and comparison (n=169). The inclusion criteria were to be of legal age, to have become sexually active, to undertake the preventive examination during the study and to have a mobile or fixed telephone. The educational group received a telephone call involving a script based in the motivational interview and in the Brazilian guidelines. The behavioral group received a telephone call involving a reminder about the consultation. The comparison group received a card with details of when to return for a consultation regarding the results. Results:the women who received one of the interventions had a non-return rate of 7.3% and an increase of 39% (RR CI95%: 1.24-1.55) in the protection against this outcome. In the individual analysis of the interventions, it was evidenced that both are efficacious, as the telephone call - reminder reduces the woman’s failure to return to the service by 40% (RR CI95%: 1.25-1.57), while the telephone call - educational does so by 37% (RR CI95%: 1.22-1.54). The rates of non-return were of 6.5% and 8.2%, respectively, as against 33.1% in the comparison group. Conclusion:the interventions tested showed greater efficacy in the educational and behavioral contexts, in relation to the normal attendance, as they motivated the women to return to the service to receive the Pap test report. Clinical trial register: RBR-w3vnc.

Conhecimento e adesão ao Papanicolau de mulheres de uma rede de Atenção Primária à Saúde

“…Mesmo com o conhecimento pré-existente das mulheres do presente estudo sobre a finalidade do exame de Papanicolau, é necessário trabalhar constantemente a educação popular em saúde para prevenir o câncer do colo uterino, seja pela disseminação da informação de que o diagnóstico precoce de lesões aumenta as chances de cura ou pela conscientização de vacinar adolescentes contra o HPV [24,27,28]. Nicolau et al [29] relataram que o contato telefônico, tanto para fins educativos quanto para lembrar o retorno à UBS, com mulheres que realizaram esse exame, aumentou em 39% a taxa de adesão ao recebimento do resultado. Assim, essa intervenção se mostrou importante para motivar a população em relação ao cuidado contínuo com a saúde.…”

Moving towards a strategy to accelerate cervical cancer elimination in a high-burden city—Lessons learned from the Amazon city of Manaus, Brazil

“…Strategies to improve compliance must address the educational and social challenges women experience through personalized attention by the health system. Other health systems in Brazil have shown that nursing teams, family health teams and community health workers can improve women's commitment with her own health and follow-up through intensive patient education and communication efforts [36][37][38]. In Manaus and other challenged areas of Brazil, screening programs would greatly benefit from removal of the many steps and delays that create obstacles, and thereby regain women's trust in and compliance with the screening program.…”

Mobile Technologies and Cervical Cancer Screening in Low- and Middle-Income Countries: A Systematic Review

“…Of the 17 articles selected from title and abstract screening, 6 were excluded because of unmatched exposure or intervention of interest, 1 was excluded because of duplicate sample use, and 2 were excluded for unmatched study design. This yielded a total of 8 studies [19][20][21][22][23][24][25][26] included in the systematic review.…”