title: Interventions for increasing uptake in screening programmes.
abstract: BACKGROUND
  Opportunities for the early detection of disease are not sufficiently being taken advantage of. Specific interventions could increase the uptake of prevention programmes. A comprehensive analysis of effectiveness and cost-effectiveness of these interventions with reference to Germany is still needed.
  
  
  OBJECTIVE
  This report aimed to describe and assess interventions to increase uptake in primary and secondary prevention and to explore the assessment of their cost-effectiveness.
  
  
  METHODS
  29 scientific databases were systematically searched in a wide strategy. Additional references were located from bibliographies. All published systematic reviews and primary studies were assessed for inclusion without language restrictions. Teams of two reviewers identified the literature, extracted data and assessed the quality of the publications independently.
  
  
  RESULTS
  Four HTA reports and 22 systematic reviews were identified for the medical evaluation covering a variety of interventions. The economic evaluation was based on two HTA-reports, one meta-analysis and 15 studies. The evidence was consistent for the effectiveness of invitations and reminders aimed at users, and for prompts aimed at health care professionals. These interventions were the most commonly analysed. (Financial) Incentives for users and professionals were identified in a small number of studies. Limited evidence was available for cost-effectiveness showing incremental costs for follow-up reminders and invitations by telephone. Evidence for ethical, social and legal aspects pointed to needs in vulnerable populations.
  
  
  CONCLUSIONS
  The material was heterogeneous regarding interventions used, study populations and settings. The majority of references originated from the United States and focused on secondary prevention. Approaching all target groups by invitations and reminders was recommended to increase uptake in prevention programmes in general.
  
  
  CONCLUSIONS
  Further research should aim to focus on primary prevention. Future research should also focus on specific interventions aiming to include vulnerable target groups and individuals, who have not previously made use of opportunities for prevention.
authors.affiliation: Medizinische Hochschule Hannover, Abteilung Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Hannover, Deutschland.
authors.forename: Ulla
authors.initials: U
authors.lastname: Walter
authors.forename: Christian
authors.initials: C
authors.lastname: Krauth
authors.forename: Matthias
authors.initials: M
authors.lastname: Wienold
authors.forename: Maren
authors.initials: M
authors.lastname: Dreier
authors.forename: Susanne
authors.initials: S
authors.lastname: Bantel
authors.forename: Sigrid
authors.initials: S
authors.lastname: Droste