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Randomized Controlled Trial
. 2005 Sep-Oct;41(3-4):741-8.
doi: 10.1016/j.ypmed.2005.06.003.

The effectiveness of a community outreach intervention to improve follow-up among underserved women at highest risk for cervical cancer

Linda P Engelstad  1 , Susan Stewart, Regina Otero-Sabogal, May S Leung, Patricia I Davis, Rena J Pasick
Affiliations
Randomized Controlled Trial

The effectiveness of a community outreach intervention to improve follow-up among underserved women at highest risk for cervical cancer

Linda P Engelstad et al. Prev Med. 2005 Sep-Oct.

Abstract

Background: A disproportionate number of women diagnosed with cervical cancer are from low-income and/or ethnically diverse groups. This study was designed to evaluate the effectiveness of an outreach and counseling intervention at improving the rate of follow-up of abnormal Pap smears among women at Alameda County Medical Center, Oakland, CA.

Methods: Between September 1, 1999 and August 31, 2001, 348 women with abnormal Pap test results were randomly assigned to intervention or usual care. The main outcome was rate of follow-up.

Results: The intervention produced a significant increase in the rate of follow-up visits within 6 months. Women in the intervention group were much more likely to obtain timely follow-up at Highland Hospital than were those in the control group (61% vs. 32%, P = 0.001). The intervention was equally effective when delivered to women in the control group who had no follow-up by 6 months. Overall, we were able to contact 90% of women in the intervention group.

Conclusions: An outreach intervention is highly effective at increasing follow-up of abnormal Pap smears in a public hospital setting. Institutions offering cervical cancer screening to low-income, high-risk women should consider the use of outreach workers to reduce loss to follow-up.

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