Effects of a Community Health Worker-Led Multimedia Intervention on the Uptake of Cervical Cancer Screening among South Asian Women: A Pilot Randomized Controlled Trial.

Wong Wong,Law Law,Chan Chan,Choi Choi,So So

doi:10.3390/ijerph16173072

Abstract

The utilization rate of cervical cancer screening services among South Asian women is low. Multimedia interventions conducted by community health workers (CHWs) could potentially enhance the cervical cancer screening uptake among these individuals. This study aimed to investigate the feasibility and preliminary effects of a CHW-led multimedia intervention on cervical cancer screening uptake among this underprivileged group. This pilot study utilized a randomized wait-list controlled trial design. Forty-two South Asian women were recruited at six ethnic minority associations. Randomization of each organization into either the intervention arm or wait-list control arm was then performed. The intervention was conducted by the CHWs from the associations where the participants were recruited. Outcome measures were assessed and compared at baseline and immediately post-intervention. We demonstrated that the intervention was feasible as evidenced by the high consent rate and low withdrawal and attrition rates. The intervention arm showed a statistically significant improvement in perceived benefits (p = 0.001) and perceived barriers (p = 0.02). However, no significant difference was noted in screening uptake and screening intention between arms. Our findings support the feasibility of CHW-led multimedia intervention and provide preliminary evidence of its effectiveness on enhancing the cervical cancer screening beliefs among South Asian women.

Highlights

Cervical cancer is the fourth most common cancer among women worldwide; about 570,000 new cases were reported in 2018, with an age-standardized rate of mortality of 6.9 per 100,000 [1].To address the high worldwide prevalence of cervical cancer, strategies need to be implemented to achieve effective prevention of this disease
To assess the preliminary effects of a community health workers (CHWs)-led intervention for South Asian women compared with the controls on the (1) uptake rate of cervical cancer screening; (2) readiness to undergo cervical cancer screening; and (3) beliefs regarding cervical cancer screening immediately post-intervention
17 failed to meet the inclusion criteria, mainly because they had received a Pap test within five years or had been exposed to another cervical cancer educational program last year

Summary

Introduction

Cervical cancer is the fourth most common cancer among women worldwide; about 570,000 new cases were reported in 2018, with an age-standardized rate of mortality of 6.9 per 100,000 [1]. To address the high worldwide prevalence of cervical cancer, strategies need to be implemented to achieve effective prevention of this disease. Detection of cancer via cancer screening is suggested to be an effective preventive strategy, as it enables earlier commencement of treatment, increasing the chance of successful treatment. The Papanicolaou test (Pap test) is one of the most common and effective forms of cervical cancer screening [3]. The Department of Health of Hong Kong recommends that women aged between 25 and 64 years old who have had a sexual experience undertake the Pap test every three years [4]

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