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1.
Yutaka Ueda Tomotaka Sobue Akiko Morimoto Tomomi Egawa-Takata Chie Hashizume Hisayo Kishida Satomi Okamoto Kiyoshi Yoshino Masami Fujita Takayuki Enomoto Yoshimi Tomine Jun Fukuyoshi Tadashi Kimura 《Journal of epidemiology / Japan Epidemiological Association》2015,25(1):50-56
Background
Finding ways to improve the cervical cancer screening rates among young women has been seen as a critical national health problem in many countries, including Japan. The aim of the present study was to evaluate the effects of a free-coupon program for cervical cancer screening conducted by a local government under financial support from the Japanese national government.Methods
The personal cervical cancer screening information was analyzed for all female residents of Toyonaka City, including any past screening history and clinical results since the year 2009, when a free-coupon program for screening was started. These results were compared to results from 2008, prior to implementation of the free-coupon screening program.Results
The screening rates of women eligible for the free-coupon peaked dramatically compared to women of similar age who paid for their screening; however, the rates for the ineligible-age population also increased significantly in parallel to those in the free-coupon program, possibly by indirect peer and publicity effects. In women aged 20 to 25 years, the consecutive screening rate after a free-coupon screening was significantly lower than for those women who received a regular residential screening. After a free-coupon screening, the rate for participating in consecutive screenings depended significantly on the institution where the participant received her first screening test.Conclusions
These results suggest that, for a generation of young women 20–25 years of age, a free-coupon program for cervical cancer screening was effective in increasing the first-time participation rate for screening; however, the increase in first-time participation did not lead to the expected increase in consecutive screenings.Key words: cervical cancer screening, free-coupon, screening rate, consecutive screening 相似文献2.
Karen Patricia Williams Athur Mabiso David Todem Adnan Hammad Hiam Hamade Yolanda Hill-Ashford Murlisa Robinson-Lockett Gloria Palamisono Ruth E. Zambrana 《Preventing chronic disease》2011,8(1)
Introduction
We examined differences in knowledge and socioeconomic factors associated with 3 types of breast cancer screening (breast self-examination, clinical breast examination, and mammogram) among African American, Arab, and Latina women.Methods
Community health workers used a community-based intervention to recruit 341 women (112 Arab, 113 Latina, and 116 African American) in southeastern Michigan to participate in a breast cancer prevention intervention from August through October 2006. Before and after the intervention, women responded to a previously validated 5-item multiple-choice test on breast cancer screening (possible score range: 0 to 5) in their language of preference (English, Spanish, or Arabic). We used generalized estimating equations to analyze data and to account for family-level and individual correlations.Results
Although African American women knew more about breast cancer screening at the baseline (pretest median scores were 4 for African American, 3 for Arab and 3 for Latina women), all groups significantly increased their knowledge after participating in the breast cancer prevention intervention (posttest median scores were 5 for African American and 4 for Arab and Latina women). Generalized estimating equations models show that Arab and Latina women made the most significant gains in posttest scores (P < .001).Conclusion
Racial/ethnic differences in knowledge of breast cancer screening highlight the need for tailored information on breast cancer screening for African American, Arab, and Latina women to promote adherence to breast cancer screening guidelines. 相似文献3.
Bircan Erbas Muhammed Akram Dorota M Gertig Dallas English John L. Hopper Anne M Kavanagh Rob Hyndman 《Journal of epidemiology / Japan Epidemiological Association》2010,20(2):159-165
Background
Mortality/incidence predictions are used for allocating public health resources and should accurately reflect age-related changes through time. We present a new forecasting model for estimating future trends in age-related breast cancer mortality for the United States and England–Wales.Methods
We used functional data analysis techniques both to model breast cancer mortality-age relationships in the United States from 1950 through 2001 and England–Wales from 1950 through 2003 and to estimate 20-year predictions using a new forecasting method.Results
In the United States, trends for women aged 45 to 54 years have continued to decline since 1980. In contrast, trends in women aged 60 to 84 years increased in the 1980s and declined in the 1990s. For England–Wales, trends for women aged 45 to 74 years slightly increased before 1980, but declined thereafter. The greatest age-related changes for both regions were during the 1990s. For both the United States and England–Wales, trends are expected to decline and then stabilize, with the greatest decline in women aged 60 to 70 years. Forecasts suggest relatively stable trends for women older than 75 years.Conclusions
Prediction of age-related changes in mortality/incidence can be used for planning and targeting programs for specific age groups. Currently, these models are being extended to incorporate other variables that may influence age-related changes in mortality/incidence trends. In their current form, these models will be most useful for modeling and projecting future trends of diseases for which there has been very little advancement in treatment and minimal cohort effects (eg. lethal cancers).Key words: breast cancer, forecasting, functional-data-analysis models, mortality trends 相似文献4.
PURPOSE
Cancer screening programs have the potential of intended beneficial effects, but they also inevitably have unintended harmful effects. In the case of screening mammography, the most frequent harm is a false-positive result. Prior efforts to measure their psychosocial consequences have been limited by short-term follow-up, the use of generic survey instruments, and the lack of a relevant benchmark—women with breast cancer.METHODS
In this cohort study with a 3-year follow-up, we recruited 454 women with abnormal findings in screening mammography over a 1-year period. For each woman with an abnormal finding on a screening mammogram (false and true positives), we recruited another 2 women with normal screening results who were screened the same day at the same clinic. These participants were asked to complete the Consequences of Screening in Breast Cancer—a validated questionnaire encompassing 12 psychosocial outcomes—at baseline, 1, 6, 18, and 36 months.RESULTS
Six months after final diagnosis, women with false-positive findings reported changes in existential values and inner calmness as great as those reported by women with a diagnosis of breast cancer (Δ = 1.15; P = .015; and Δ = 0.13; P = .423, respectively). Three years after being declared free of cancer, women with false-positive results consistently reported greater negative psychosocial consequences compared with women who had normal findings in all 12 psychosocial outcomes (Δ >0 for 12 of 12 outcomes; P <.01 for 4 of 12 outcomes).CONCLUSION
False-positive findings on screening mammography causes long-term psychosocial harm: 3 years after a false-positive finding, women experience psychosocial consequences that range between those experienced by women with a normal mammogram and those with a diagnosis of breast cancer.Key words: mass screening, breast cancer, false-positive reactions/adverse effects 相似文献5.
Steve S. Coughlin Robert J. Uhler H. Irene Hall Peter A. Briss 《Preventing chronic disease》2004,1(1)
Background
Several preventive practices that reduce chronic disease risk have been associated with breast and cervical cancer screening, including maintenance of normal weight and avoidance of cigarette smoking. A history of certain chronic illnesses such as diabetes and cardiovascular disease has also been related to cancer screening. Nevertheless, studies that have attempted to identify women who are less likely to have had a recent breast or cervical cancer screening test have infrequently examined the associations of breast and cervical cancer screening with multiple health factors that influence chronic disease risk.Methods
To clarify relationships between cancer screening and health behaviors and other factors that influence chronic disease risk, we examined the self-reported breast and cervical cancer screening practices of women in the United States by using data from the 1999 Behavioral Risk Factor Surveillance System. The women were described according to their recent use of mammography and the Papanicolaou test, physician visits within the past year, health insurance coverage, and preventive practices that reduce chronic disease risk.Results
Overall, 74.5% (95% CI, 73.9%-75.1%) of the women in this sample aged 40 years or older (n = 56,528) had received a mammogram within the past 2 years. The percentage of women who had been screened for breast cancer, however, varied widely by factors associated with reducing the risk of chronic disease (e.g., cholesterol check in the past 2 years, blood pressure check in the past 2 years, normal weight, avoidance of cigarette smoking) and having access to health care (e.g., health insurance coverage, recent physician visit). Similarly, 84.4% (95% CI, 83.9%-84.9%) of all women aged 18 years or older who had not undergone a hysterectomy (n = 69,113) had received a Papanicolaou test in the past 3 years, and factors associated with reduced chronic disease risk and health care access were related to having had a recent Papanicolaou test.Conclusion
The results of this study suggest that underscreened women who are at risk for breast and cervical cancer are likely to benefit from programs that identify and address coexisting prevention needs. The identification of coexisting prevention needs might assist in developing interventions that address multiple risks for chronic disease among women and might subsequently help improve the efficiency and effectiveness of prevention programs. 相似文献6.
Flávio Xavier Silva Leila Katz Alex Sandro Rolland Souza Melania Maria Ramos Amorim 《Revista de saúde pública》2014,48(6):931-939
OBJECTIVE
To assess findings of mammography of and interventions resulting from breast cancer screening in women aged 40-49 years with no increased risk (typical risk) of breast cancer.METHODS
This cross-sectional study evaluated women aged 40-49 years who underwent mammography screening in a mastology reference center in Recife, PE, Northeastern Brazil, between January 2010 and October 2011. Women with breast-related complaints, positive findings in the physical examination, or high risk of breast cancer were excluded.RESULTS
The 1,000 mammograms performed were classified into the following Breast Imaging-Reporting and Data System (BI-RADS) categories BI-RADS 0, 232; BI-RADS 1, 294; BI-RADS 2, 294; BI-RADS 3, 16; BI-RADS 4A, 2; BI-RADS 5, 1. There was one case of grade II invasive ductal carcinoma and various interventions, including 469 ultrasound scans, 53 referrals to mastologists, 11 cytological examinations, and 8 biopsies.CONCLUSIONS
Mammography screening in women aged 40-49 years with typical risk of breast cancer led to the performance of other interventions. However, it also resulted in increased costs without demonstrable efficacy in decreasing mortality. 相似文献7.
Doyin Oluwole John Kraemer for Pink Ribbon Red Ribbon 《Bulletin of the World Health Organization》2013,91(9):691-696
Problem
In low- and middle-income countries, breast and cervical cancer have a poor prognosis, partly owing to barriers to treatment. To redress this situation, health systems must be strengthened.Approach
Pink Ribbon Red Ribbon (PRRR) is an innovative partnership designed to leverage public and private investments in global health and to build on the successful United States President’s Emergency Plan for AIDS Relief (PEPFAR) platform to combat cancers of the breast and cervix in sub-Saharan Africa and Latin America. By supporting a comprehensive set of country-owned and country-driven interventions, PRRR seeks to reduce deaths from cervical cancer among women screened and treated through the programme and to reduce deaths from breast cancer by promoting early detection.Local setting
In its initial phase, PRRR is supporting the governments of Botswana, Zambia and other countries in expanding cervical cancer prevention, screening and treatment coverage – especially to high-risk women with human immunodeficiency virus infection – and in strengthening breast cancer education and control services.Relevant changes
PRRR has introduced a diagonal strategy based on the life course and continuum of care approaches to cancer control. Its work has resulted in the delivery of the human papillomavirus vaccine to young girls in several settings and in the strengthening of prevention, screening and treatment delivery systems from the community to the tertiary level.Lessons learnt
This paper outlines the approach PRRR has taken as a country-aligned public–private partnership and the preliminary lessons learnt, including the need for flexible implementation, effective country coordination mechanism and regular communication with all stakeholders. 相似文献8.
Ana P. Ortiz Sarah Hebl Ruby Serrano María E. Fernandez Erick Suárez Guillermo Tortolero-Luna 《Preventing chronic disease》2010,7(3)
Introduction
Racial/ethnic disparities in cervical cancer screening exist in the United States; rates are lowest among women who live in Puerto Rico. We identified factors associated with cervical cancer screening among women aged 18 years or older living in Puerto Rico.Methods
We included women who participated in the Puerto Rico Behavioral Risk Factor Surveillance System in 2006 who had not had a hysterectomy (n = 2,206). We calculated the weighted population prevalence estimates of Papanicolaou (Pap) test screening in the past 3 years and used logistic regression models to assess factors associated with screening.Results
Most participants (71.9% [95% confidence interval (CI)Most participants (71.9% [95% confidence interval (CI) = 69.4%-74.4%]) reported having had a Pap test in the preceding 3 years. Factors associated with screening in multivariate analysis included routine checkup in the past year and leisure-time physical activity. Compared with women with a household income less than $15,000, those with higher incomes were more likely to have had a Pap test. Similarly, divorced or separated women were more likely to have been screened (odds ratio [OR] = 1.13; 95% CI = 1.12-1.15) than those who were married/living together. We did not find associations between screening behavior and education, health care coverage, body mass index, or smoking status.Conclusion
The prevalence of cervical cancer screening in Puerto Rico is below the 90% recommendation established by Healthy People 2010. Our findings regarding factors associated with Pap screening behavior identified population subgroups who are underscreened and who may benefit from targeted interventions and screening programs. 相似文献9.
10.
Introduction
Marital status may be a predisposing factor related to preventive health screenings, which may in part explain the "healthy marriage" effect. This study investigates differences in the likelihood of being screened for cholesterol by marital status for men and women.Methods
Medical Expenditure Panel Surveys from 2003 through 2005 were used to calculate the likelihood of self-reported cholesterol screening in the past year by marital status and sex. Several rounds of interviews during a 2-year period resulted in a sample of 36,594 US adults.Results
Most married, widowed, and divorced/separated people reported cholesterol screening in the past year. The highest percentages of people being screened for cholesterol were widowed men (75%) and women (81%). By contrast, 26% of single men and 38% of single women reported cholesterol screening. In multivariate models, being unmarried was associated with lower odds of cholesterol screening among men and women. The lowest likelihood of screening was associated with widowed status for both men (odds ratio, 0.56) and women (odds ratio, 0.53).Conclusion
Marital status is a predisposing factor for cholesterol screening. Public health interventions aimed at improving preventive screening should focus on social networks, especially family members. 相似文献11.
Shizuha Arai Naoki Nakaya Masako Kakizaki Kaori Ohmori-Matsuda Taichi Shimazu Shinichi Kuriyama Akira Fukao Ichiro Tsuji 《Journal of epidemiology / Japan Epidemiological Association》2009,19(1):34-40
Objective
To determine the associations between personality subscales and attendance at gastric cancer screenings in Japan.Methods
A total of 21,911 residents in rural Japan who completed a short form of the Eysenck Personality Questionnaire-Revised (EPQ-R) and a questionnaire on various health habits including the number of gastric cancer screenings attended were included in the primary analysis. We defined gastric cancer screening compliance as attendance at gastric cancer screening every year for the previous 5 years; all other patterns of attendance were defined as non-compliance. We defined gastric cancer screening visiting as attendance at 1 or more screenings during the previous 5 years; lack of attendance was defined as non-visiting. We used logistic regression to estimate the odds ratios (ORs) of gastric cancer screening compliance and visiting according to 4 score levels that corresponded to the 4 EPQ-R subscales (extraversion, neuroticism, psychoticism, and lie).Result
Extraversion had a significant linear, positive association with both compliance and visiting (trend, P < 0.001 for both). Neuroticism had a significant linear, inverse association with compliance (trend, P = 0.047), but not with visiting (trend, P = 0.21). Psychoticism had a significant linear, inverse association with both compliance and visiting (trend, P < 0.001 for both). Lie had no association with either compliance or visiting.Conclusion
The personality traits of extraversion, neuroticism, and psychoticism were significantly associated with gastric cancer screening attendance. A better understanding of the association between personality and attendance could lead to the establishment of effective campaigns to motivate people to attend cancer screenings.Key words: attendance, cross-sectional study, gastric cancer screening, Japanese, personality 相似文献12.
Philippe Autier Mathieu Boniol Michel Smans Richard Sullivan Peter Boyle 《Journal of the Royal Society of Medicine》2015,108(11):440-450
Objectives
We compared calculations of relative risks of cancer death in Swedish mammography trials and in other cancer screening trials.Participants
Men and women from 30 to 74 years of age.Setting
Randomised trials on cancer screening.Design
For each trial, we identified the intervention period, when screening was offered to screening groups and not to control groups, and the post-intervention period, when screening (or absence of screening) was the same in screening and control groups. We then examined which cancer deaths had been used for the computation of relative risk of cancer death.Main outcome measures
Relative risk of cancer death.Results
In 17 non-breast screening trials, deaths due to cancers diagnosed during the intervention and post-intervention periods were used for relative risk calculations. In the five Swedish trials, relative risk calculations used deaths due to breast cancers found during intervention periods, but deaths due to breast cancer found at first screening of control groups were added to these groups. After reallocation of the added breast cancer deaths to post-intervention periods of control groups, relative risks of 0.86 (0.76; 0.97) were obtained for cancers found during intervention periods and 0.83 (0.71; 0.97) for cancers found during post-intervention periods, indicating constant reduction in the risk of breast cancer death during follow-up, irrespective of screening.Conclusions
The use of unconventional statistical methods in Swedish trials has led to overestimation of risk reduction in breast cancer death attributable to mammography screening. The constant risk reduction observed in screening groups was probably due to the trial design that optimised awareness and medical management of women allocated to screening groups. 相似文献13.
Diana Redwood Larry Holman Sharon Zandman-Zeman Tom Hunt Leah Besh Wanda Katinszky 《Preventing chronic disease》2011,8(3)
Background
Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. CRC screening allows for prevention through the removal of precancerous lesions and early detection of cancer.Community Context
Ride for Life Alaska (RFL), a nonprofit organization that raises funds to fight cancer, and the Anchorage Neighborhood Health Center (ANHC), which is Alaska''s largest community health center, joined efforts to provide CRC screening and outreach to an ethnically diverse group of low-income underinsured or uninsured patients residing in and around Anchorage, Alaska.Methods
RFL and ANHC worked with gastroenterologists, medical practices, and pathology services to contribute pro bono and reduced-fee services for CRC screening. Information to patients was distributed through signs in the clinic, flyers, and the ANHC website.Outcomes
CRC screening was increased in this population. During 2007-2009, there were 2,561 immunochemical fecal occult blood tests given to patients, and 1,558 were completed (61%); 24% were positive. Sixteen gastroenterologists, 4 medical practices, and 2 laboratories provided 111 follow-up colonoscopies and pathology services to patients identified through the CRC screening program who did not have other funding resources available for follow-up care.Interpretation
This program provides a model for leveraging scarce screening resources by drawing on multiple partners to increase CRC screening. Recommendations for those seeking to initiate similar programs are to have memoranda of agreement in place and a clear scope of work for all participating people and organizations to avoid delays in program implementation; hire a screening care coordinator to manage patient care and collaborate with medical practices; and identify program champions who have the energy and persistence to craft such partnerships. 相似文献14.
15.
Peer Reviewed: Evidence-Based Interventions and Screening Recommendations for Colorectal Cancer in Comprehensive Cancer Control Plans: A Content Analysis 下载免费PDF全文
Julie S. Townsend Lisa C Richardson C. Brooke Steele Dana E White 《Preventing chronic disease》2009,6(4)
Introduction
Colorectal cancer is the third most commonly diagnosed cancer and third leading cause of cancer death in the United States. The extent to which Comprehensive Cancer Control (CCC) programs in states, tribal governments and organizations, territories, and Pacific Island jurisdictions address evidence-based recommendations and interventions for colorectal cancer in their CCC plans is largely unknown.Methods
We downloaded CCC plans posted on the Cancer Control PLANET Web site for review. We searched the plans for key terms, identifying potential evidence-based content surrounding colorectal cancer prevention and early detection. Content was abstracted for further review and classification.Results
Of 55 plans reviewed, 54 (98%) referred to evidence-based recommendations or interventions for colorectal cancer or indicated they intended to refer to the evidence base when developing programs. More than 57% (n = 31) of programs referred to the American Cancer Society guidelines, 41% (n = 22) referred to the United States Preventive Services Task Force, and 11% (n = 6) referred to the Guide to Community Preventive Services. Few programs mentioned Research Tested Intervention Programs (n = 1), National Cancer Institute''s Physician Data Query (n = 4), Cochrane Reviews (n = 2), or Put Prevention Into Practice (n = 2) in reference to evidence-based interventions for colorectal cancer prevention.Conclusion
Most CCC programs discussed either evidence-based screening guidelines or interventions in their cancer plans, although many mentioned this information exclusively as background information. We recommend that program planners be trained to locate evidence-based interventions and use consistent common language to describe them in their plans. CCC program planners should be encouraged to conduct and publish intervention studies. 相似文献16.
Context
This article compares cervical cancer screening intensity and cervical cancer mortality trends in the United States and the Netherlands to illustrate the potential of cross-national comparative studies. We discuss the lessons that can be learned from the comparison as well as the challenges in each country to effective and efficient screening.Methods
We used nationally representative data sources in the United States and the Netherlands to estimate the number of Pap smears and the cervical cancer mortality rate since 1950. The following questions are addressed: How do differences in intensity of Pap smear use between the countries translate into differences in mortality trends? Can population coverage rates (the proportion of eligible women who had a Pap smear within a specified period) explain the mortality trends better than the total intensity of Pap smear use?Findings
Even though three to four times more Pap smears per woman were conducted in the United States than in the Netherlands over a period of three decades, the two countries’ mortality trends were quite similar. The five-year coverage rates for women aged thirty to sixty-four were quite comparable at 80 to 90 percent. Because screening in the Netherlands was limited to ages thirty to sixty, screening rates for women under thirty and over sixty were much higher in the United States. These differences had consequences for age-specific mortality trends. The relatively good coverage rate in the Netherlands can be traced back to a nationwide invitation system based on municipal population registries. While both countries followed a “policy cycle” involving evidence review, surveillance of screening practices and outcomes, clinical guidelines, and reimbursement policies, the components of this cycle were more systematically linked and implemented nationwide in the Netherlands than in the United States. To a large extent, this was facilitated by a public health model of screening in the Netherlands, rather than a medical services model.Conclusions
Cross-country studies like ours are natural experiments that can produce insights not easily obtained from other types of study. The cervical cancer screening system in the Netherlands seems to have been as effective as the U.S. system but used much less screening. Adequate coverage of the female population at risk seems to be of central importance. 相似文献17.
Peer Reviewed: Church-Based Breast Cancer Screening Education: Impact of Two Approaches on Latinas Enrolled in Public and Private Health Insurance Plans 下载免费PDF全文
Angela Sauaia Sung-joon Min Tim Byers David Lack Cecilia Apodaca Diego Osuna Angela Stowe Gretchen F McGinnis Lisa M Latts 《Preventing chronic disease》2007,4(4)
Introduction
The Tepeyac Project is a church-based health promotion project that was conducted from 1999 through 2005 to increase breast cancer screening rates among Latinas in Colorado. Previous reports evaluated the project among Medicare and Medicaid enrollees in the state. In this report, we evaluate the program among enrollees in the state''s five major insurance plans.Methods
We compared the Tepeyac Project''s two interventions: the Printed Intervention and the Promotora Intervention. In the first, we mailed culturally tailored education packages to 209 Colorado Catholic churches for their use. In the second, promotoras (peer counselors) in four Catholic churches delivered breast-health education messages personally. We compared biennial mammogram claims from the five insurance plans in the analysis at baseline (1998–1999) and during follow-up (2000–2001) for Latinas who had received the interventions. We used generalized estimating equations (GEE) analysis to adjust rates for confounders.Results
The mammogram rate for Latinas in the Printed Intervention remained the same from baseline to follow-up (58% [2979/5130] vs 58% [3338/5708]). In the Promotora Intervention, the rate was 59% (316/536) at baseline and 61% (359/590) at follow-up. Rates increased modestly over time and varied widely by insurance type. After adjusting for age, income, urban versus rural location, disability, and insurance type, we found that women exposed to the Promotora Intervention had a significantly higher increase in biennial mammograms than did women exposed to the Printed Intervention (GEE parameter estimate = .24 [±.11], P = .03).Conclusion
For insured Latinas, personally delivering church-based education through peer counselors appears to be a better breast-health promotion method than mailing printed educational materials to churches. 相似文献18.
Karen Yeary Eric Flowers Gemessia Ford Desiree Burroughs Chara Stewart Paulette Mehta Paul Greene Ronda Henry-Tillman Jackie Burton Delores Woods 《Preventing chronic disease》2011,8(2)
Background
The death rate from colorectal cancer is high and affects poor and medically underserved populations disproportionately. In the United States, health disparities are particularly acute in the Lower Mississippi River Delta region. Because many in the region have limited access to basic health care resources, they are not screened for cancer, even though screening is one of the most effective strategies to prevent colorectal cancer. Community-based participatory research is a promising approach to prevent colorectal cancer in this population.Community Context
The Empowering Communities for Life program was implemented in 2 underserved counties in the Arkansas Lower Mississippi River Delta. The program arose from a 9-year partnership between the University of Arkansas for Medical Sciences and 9 cancer councils across Arkansas.Methods
Empowering Communities for Life is a community-based participatory intervention designed to increase colorectal cancer screening in rural, underserved communities through fecal occult blood testing. Community and academic partners collaborated to develop research infrastructure, intervention materials and methods, and the assessment instrument.Outcome
Project outcomes were strengthened community-academic partnerships, certification of community partners in conducting human subjects research, development of a randomized controlled design to test the intervention''s efficacy, an interactive PowerPoint presentation, an informational pamphlet, the certification of 6 lay health advisors and 22 role models to provide the intervention, and an assessment tool using an audience response system.Interpretation
Lessons learned in working collaboratively with diverse groups include the importance of meeting face to face and listening. 相似文献19.
Tara Kiran Andrew S. Wilton Rahim Moineddin Lawrence Paszat Richard H. Glazier 《Annals of family medicine》2014,12(4):317-323
PURPOSE
There is limited evidence for the effectiveness of pay for performance despite its widespread use. We assessed whether the introduction of a pay-for-performance scheme for primary care physicians in Ontario, Canada, was associated with increased cancer screening rates and determined the amounts paid to physicians as part of the program.METHODS
We performed a longitudinal analysis using administrative data to determine cancer screening rates and incentive costs in each fiscal year from 1999/2000 to 2009/2010. We used a segmented linear regression analysis to assess whether there was a step change or change in screening rate trends after incentives were introduced in 2006/2007. We included all Ontarians eligible for cervical, breast, and colorectal cancer screening.RESULTS
We found no significant step change in the screening rate for any of the 3 cancers the year after incentives were introduced. Colon cancer screening was increasing at a rate of 3.0% (95% CI, 2.3% to 3.7%) per year before the incentives were introduced and 4.7% (95% CI, 3.7% to 5.7%) per year after. The cervical and breast cancer screening rates did not change significantly from year to year before or after the incentives were introduced. Between 2006/2007 and 2009/2010, $28.3 million, $31.3 million, and $50.0 million were spent on financial incentives for cervical, breast, and colorectal cancer screening, respectively.CONCLUSIONS
The pay-for-performance scheme was associated with little or no improvement in screening rates despite substantial expenditure. Policy makers should consider other strategies for improving rates of cancer screening. 相似文献20.
Lin Y Kikuchi S Tamakoshi K Wakai K Kondo T Niwa Y Yatsuya H Nishio K Suzuki S Tokudome S Yamamoto A Toyoshima H Mori M Tamakoshi A;Japan Collaborative Cohort Study Group for Evaluation of Cancer Risk 《Journal of epidemiology / Japan Epidemiological Association》2008,18(2):77-83