Supplementing factual information with patient narratives in the cancer screening context: a qualitative study of acceptability and preferences

Objective To explore people's responses to narrative information in the context of colorectal cancer screening. Design nineteen in-depth interviews were conducted with men and women (aged 45–59). Participants were given two types of colorectal screening information to read: factual and narrative. Participants gave their views on both types of information. Data were analysed using Framework Analysis. Results The most frequent responses to the narrative information were that they were reassuring, made colorectal screening more vivid, participants could relate to the people in the stories and they liked the range of narratives presented. Despite the narrative information being seen as more persuasive by some, this was not regarded as manipulative or negative. Both types of information were seen as equally credible. Participants felt a combination of facts and narratives would be useful when considering an offer of colorectal cancer screening. Conclusion Overall, participants were positive about the addition of narrative information to the currently provided factual information about colorectal cancer screening. Supplementing existing factual information with narrative information may provide participants with a more complete understanding of participation in colorectal cancer screening when considering an offer to be screened

Evaluation of a multifaceted social marketing campaign to increase awareness of and screening for oral cancer in African Americans

Jedele JM, Ismail AI. Evaluation of a multifaceted social marketing campaign to increase awareness of and screening for oral cancer in African Americans. Community Dent Oral Epidemiol 2010; 38: 371–382. © 2010 John Wiley & Sons A/SA 2-year social marketing media campaign and community education activities were organized to promote screening for oral cancer in a high-risk population in Detroit/Wayne County, Michigan. Long-term goals of the campaign were to reduce the oral cancer death rate, increase the proportion of oral cancers detected at an early stage, and increase the proportion of adults who report having been screened. The intermediate goals of the campaign were to increase awareness of oral cancer and of oral cancer screening. This article presents outcomes related to the intermediate goals of the campaign.The intermediate goals of the campaign were assessed by the number of calls to a toll-free hotline, which media venues led to calls, number of screenings conducted by the free screening clinic, number of precancers and cancers detected, and the number of sessions conducted, organizations involved, and persons participating in the community education program. The costs per screened case and cancers detected were also evaluated. The media campaign promoted screening using billboards, radio and newspaper ads, and a toll-free hotline. Culturally relevant messages were developed collaboratively with focus groups representing the target audience. Billboards were placed in highly visible locations around Detroit, Michigan. Sixty-second messages on the impact of oral cancer and that screening is ‘painless and free’ were aired on radio stations popular with the target audience. Ads displaying the hotline were placed in two local newspapers. Callers to the hotline were scheduled for a free screening with a clinic operated by the project. Referral to an oral surgeon was scheduled if a suspicious lesion was found. Free education sessions were also conducted with community-based organizations. Costs associated with the campaign and hotline were totaled, and the cost per screening and cancer detected were calculated.During the campaign, 1327 radio spots aired; 42 billboards were displayed; two newspaper ads were printed; and 242 education sessions were conducted. The hotline received 1783 calls. The majority of callers reported that their call was prompted by a radio ad (57%). The clinic screened 1020 adults and referred 78 for further examination. Three cancers, two precancers, and 12 benign tumors were detected. The total cost associated with the campaign and toll-free hotline was $795,898.A multifaceted social marketing campaign including radio ads, billboards, and education sessions can effectively target a high-risk population and that given an outlet could result in a significant number of people getting screened at a relatively low cost.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79227/1/j.1600-0528.2010.00545.x.pd

‘Much Clearer with Pictures’: Using Community-Based Participatory Research to Design and Test a Picture Option Grid for Underserved Patients with Breast Cancer

Women of low socioeconomic status (SES) diagnosed with early stage breast cancer experience decision-making, treatment and outcome disparities. Evidence suggests that decision aids can benefit underserved patients, when tailored to their needs. Our aim was to develop and test the usability, acceptability and accessibility of a pictorial encounter decision aid targeted at women of low SES diagnosed with early stage breast cancer

Peer navigation improves diagnostic follow-up after breast cancer screening among Korean American women: results of a randomized trial

To test an intervention to increase adherence to diagnostic follow-up tests among Asian American women. Korean American women who were referred for a diagnostic follow-up test (mainly diagnostic mammograms) and who had missed their follow-up appointment were eligible to participate in the study. Women from two clinics (n = 176) were randomly allocated to a usual care control arm or a peer navigator intervention arm. A 20-min telephone survey was administered to women in both study arms six months after they were identified to assess demographic and socio-economic characteristics and the primary outcome, self-reported completion of the recommended follow-up exam. Among women who completed the survey at six-month follow-up, self-reported completion of follow-up procedures was 97% in the intervention arm and 67% in the control arm (p < 0.001). Based on an intent-to-treat analysis of all women who were randomized and an assumption of no completion of follow-up exam for women with missing outcome data, self-reported completion of follow-up was 61% in the intervention arm and 46% in the usual care control arm (p < 0.069). Our results suggest that a peer navigator intervention to assist Korean American women to obtain follow-up diagnostic tests after an abnormal breast cancer screening test is efficacious

Estimation of Pap-test coverage in an area with an organised screening program: challenges for survey methods

BACKGROUND: The cytological screening programme of Viterbo has completed the second round of invitations to the entire target population (age 25–64). From a public health perspective, it is important to know the Pap-test coverage rate and the use of opportunistic screening. The most commonly used study design is the survey, but the validity of self-reports and the assumptions made about non respondents are often questioned. METHODS: From the target population, 940 women were sampled, and responded to a telephone interview about Pap-test utilisation. The answers were compared with the screening program registry; comparing the dates of Pap-tests reported by both sources. Sensitivity analyses were performed for coverage over a 36-month period, according to various assumptions regarding non respondents. RESULTS: The response rate was 68%. The coverage over 36 months was 86.4% if we assume that non respondents had the same coverage as respondents, 66% if we assume they were not covered at all, and 74.6% if we adjust for screening compliance in the non respondents. The sensitivity and specificity of the question, "have you ever had a Pap test with the screening programme" were 84.5% and 82.2% respectively. The test dates reported in the interview tended to be more recent than those reported in the registry, but 68% were within 12 months of each other. CONCLUSION: Surveys are useful tools to understand the effectiveness of a screening programme and women's self-report was sufficiently reliable in our setting, but the coverage estimates were strongly influenced by the assumptions we made regarding non respondents

The Relevance of Fatalism in the Study of Latinas’ Cancer Screening Behavior: A Systematic Review of the Literature

# The Author(s) 2010. This article is published with open access at Springerlink.com Background Fatalism has been identified as a dominant belief among Latinos and is believed to act as a barrier to cancer prevention. However, controversy exists over the utility of the construct in explaining health disparities experienced by disadvantaged populations above the influence of structural barriers such as low socioeconomic status (SES) and limited access to health care. Purpose This paper reviews the empirical research on fatalism and Latinas ’ participation in cancer screening in an attempt to determine whether fatalism predicts participation in cancer screening after accounting for structural barriers