title: A randomized controlled trial of interventions to promote cervical cancer screening among Chinese women in North America.
abstract: BACKGROUND
  North American Chinese women have lower levels of Papanicolaou (Pap) testing than other population subgroups. We conducted a randomized controlled trial to evaluate the effectiveness of two alternative cervical cancer screening interventions for Chinese women living in North America.
  
  
  METHODS
  Four hundred and eighty-two Pap testing underutilizers were identified from community-based surveys of Chinese women conducted in Seattle, Washington, and Vancouver, British Columbia. These women were randomly assigned to one of two experimental arms or control status. Several Chinese-language materials were used in both experimental arms: an education-entertainment video, a motivational pamphlet, an educational brochure, and a fact sheet. Women in the first experimental group (outreach worker intervention) received the materials, as well as tailored counseling and logistic assistance, during home visits by trilingual, bicultural outreach workers. Those in the second experimental group (direct mail intervention) received the materials by mail. The control group received usual care. Follow-up surveys were completed 6 months after randomization to ascertain participants' Pap testing behavior. All statistical tests were two-sided.
  
  
  RESULTS
  A total of 402 women responded to the follow-up survey (83% response rate). Of these women, 50 (39%) of the 129 women in the outreach group, 35 (25%) of the 139 women in the direct mail group, and 20 (15%) of the 134 women in the control group reported Pap testing in the interval between randomization and follow-up data collection (P<.001 for outreach worker versus control, P =.03 for direct mail versus control, and P =.02 for outreach worker versus direct mail). Intervention effects were greater in Vancouver than in Seattle.
  
  
  CONCLUSIONS
  Culturally and linguistically appropriate interventions may improve Pap testing levels among Chinese women in North America.
authors: Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98105, USA. vtaylor@fhcrc.org
authors: Victoria M
authors: VM
authors: Taylor
authors: T Gregory
authors: TG
authors: Hislop
authors: J Carey
authors: JC
authors: Jackson
authors: Shin-Ping
authors: SP
authors: Tu
authors: Yutaka
authors: Y
authors: Yasui
authors: Stephen M
authors: SM
authors: Schwartz
authors: Chong
authors: C
authors: Teh
authors: Alan
authors: A
authors: Kuniyuki
authors: Elizabeth
authors: E
authors: Acorda
authors: Ann
authors: A
authors: Marchand
authors: Beti
authors: B
authors: Thompson
mesh_terms: D000328:Adult; D000368:Aged; D001213:Asian / Q000193:education*; D002681:China / Q000208:ethnology; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D065006:Papanicolaou Test; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000208:ethnology; D014626:Vaginal Smears / Q000706:statistics & numerical data*