Effectiveness of two direct-mail strategies to encourage women to have cervical (Pap) smears

The aim of this study was to assess the acceptability, utilisazionand differential effectiveness of two direct-mail strategiesfor increasing community Papanicolaou (Pap) smear rates. Thetwo strategies were: a personally addressed letter containingsimple information about Pap smears and a personally addressedletter combined with a series of targeted behavioural promptsdesigned to address a number of aspects of screening which previousresearch had shown to be associated with poor screening rates.The two strategies were assessed in two geo graphically separatedpostal regions in Australia. Each region represented approximately10 women aged 18–70 wars. Outcome data on the change inregional Pap smear rates were obtained from government healthinsurance claims for cervical screening and from pathology servicerecords. Both interventions resulted in statistically significantincreases in attendances for screening over the post-interventionperiod. 42.2% in the region receiving the simple prompt and39.6% in the region receiving the multi-faceted approach Therewas no sigrujicant difference between the two intervention regions.The results indicate that direct-mail strategies can be effectivein prompting attendance for cervical cancer screening. Further,nore, it would appear that a simple informational strategy canbe at least as effective as a more elaborate package. Both interventionsresulted in similar increases in attendances of around 40%.