title: Comparison of a community outreach service with opportunity screening for cervical cancer using Pap smears.
abstract: We sought to compare the take-up of cervical screening with Pap smears in a new outreach and pre-existing hospital-based setting (1) to assess the extent to which the two means of provision would overlap; (2) to establish how the utilization rate is influenced by demographic features and geographical distance from the point of provision; and (3) to access whether an outreach service would lead to increased utilization. We used a pre-test-post-test design and used multiple linear regression to assess the effect an outreach service has on utilization after adjusting for participants age, education and martial status. We found that the outreach service independently provided screening to 89% of eligible women and that coverage was inversely associated with distance from the pre-existing hospital provision. After controlling for age, education and martial status, there was a statistically significant increase (53%; 95% CI: 25, 80%) in utilization. There was little overlap between the outreach and hospital-based cervical screening services so that overall accessibility was enhanced, particularly for the elderly, widowed and less well educated. The outreach service also reduced inequalities due to geography.
authors: Department of Health Care Management, Chang-Gung University, Taoyuan, Taiwan.
authors: Huan-Cheng
authors: HC
authors: Chang
authors: Hui-Yin
authors: HY
authors: Hsiung
authors: Shu-I
authors: SI
authors: Chen
authors: Amy Ming-Fang
authors: AM
authors: Yen
authors: Tony Hsiu-Hsi
authors: TH
authors: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003159:Community-Institutional Relations; D005260:Female; D006761:Hospitals; D006801:Humans; D008403:Mass Screening / Q000379:methods / Q000458:organization & administration; D008875:Middle Aged; D065006:Papanicolaou Test; D011314:Preventive Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000517:prevention & control*; D014626:Vaginal Smears / Q000191:economics / Q000706:statistics & numerical data*