• K L Margolis, N Lurie, P G McGovern, M Tyrrell, and J S Slater.
• Hennepin County Medical Center, University of Minnesota, Minneapolis 55404, USA.
• J Gen Intern Med. 1998 Aug 1; 13 (8): 515521515-21.

ObjectiveTo determine if women would have higher breast and cervical cancer screening rates if lay health advisers recommended screening and offered a convenient screening opportunity.DesignControlled trial.SettingUrban county teaching hospital.ParticipantsWomen aged 40 years and over attending appointments in several non-primary-care outpatient clinics.InterventionsLay health advisers assessed the participants' breast and cervical cancer screening status and offered women in the intervention group who were due for screening an appointment with a female nurse practitioner.Measurements And Main ResultsScreening rates at baseline and at follow-up 1 year after the intervention were determined. At follow-up, the mammography rate was 69% in the intervention group versus 63% in the usual care group (p = .009), and the Pap smear rate was 70% in the intervention group versus 63% in the usual care group (p = .02). In women who were due for screening at baseline, the mammography rate was 60% in the intervention group versus 50% in the usual care group (p = .006), and the Pap smear rate was 63% in the intervention group versus 50% in the usual care group (p = .002). The intervention was effective across age and insurance payer strata, and was particularly effective in Native American women.ConclusionsBreast and cervical cancer screening rates were improved in women attending non-primary-care outpatient clinics by using lay health advisers and a nurse practitioner to perform screening. The effect was strongest in women in greatest need of screening.

30 keywords...

hide…