Can a Home-Visit Invitation Increase Pap Smear Screening in Samliem, Khon Kaen , Thailand ?

Abstract

Our objective was to assess the efficiency of a home-visit invitation aimed to increase uptake of cervical cancerscreening in women between 35 and 60 years of age. From May, 2006, we conducted a quasi-randomized trial todetermine if an in-home education and invitation intervention would increase uptake of cervical cancerscreening. We randomly recruited 304 women from the Samliem inner-city community, Khon Kaen, NortheastThailand, and assigned participants to either the intervention or control zone. Baseline screening coverageinterviews were then performed: 58 of 158 women in the intervention zone and 46 of 146 in the control zone wereexcluded from the study because of having had a Pap smear within 5 years, but these were included in the finalanalysis. First, 100 women in the intervention group were visited in their homes by one of the researchers, whoprovided culturally-sensitive health education that emphasized the need for screening. Four months later, postintervention,screening-coverage interviews were again performed in both groups, in combination with the samehealth education for 100 women in the control group for a comparison. There was no difference in the baselinePap smear screening-coverage rate in the intervention vs. control zones (36.7 vs. 31.5%, p=0.339). One hundredwomen in the intervention group completed the intervention interviews and after four months, 100 women in theintervention group and 100 in the control group also completed the post-intervention interviews. The increasedscreening-coverage rate in the intervention zone was similar to that of the control zone (43.6 vs. 34.9%, p=0.119);however, there was a borderline significant increase in the intervention zone compared with baseline (36.7 to43.6%, p=0.070). Therefore, home visit education and invitation intervention produced only a nominal effect onincreasing Pap smear coverage within a 4-month study period.