title: Evaluation of a service intervention to improve awareness and uptake of bowel cancer screening in ethnically-diverse areas.
abstract: BACKGROUND
  Uptake of bowel cancer screening is lowest in London, in populations of lower socio-economic status, and in particular ethnic or religious groups.
  
  
  METHODS
  We report on the evaluation of two interventions to improve uptake in an area including populations of low socio-economic status and considerable ethnic diversity. The interventions were face-to-face health promotion on bowel cancer screening at invitees' general practice and health promotion delivered by telephone only. Nine large general practices in East London were chosen at random to offer face-to-face health promotion, and nine other large practices to offer telephone health promotion, with 24 practices of similar size as comparators. Data at practice level were analysed by Mann-Whitney-Wilcoxon tests and grouped-logistic regression.
  
  
  RESULTS
  There were 2034 invitees in the telephone intervention practices, 1852 in the face-to-face intervention practices and 5227 in the comparison practices. Median gFOBt kit uptake in the target population (aged 59-70) was 46.7% in the telephone practices, 43.8% in the face-to-face practices and 39.1% in the comparison practices. Significant improvements in the odds of uptake were observed following telephone intervention in both males (OR=1.39, 95% CI=1.20-1.61, P<0.001) and females (OR=1.49, 95% CI=1.29-1.73, P<0.001), while the face-to-face intervention mainly impacted uptake in males (OR=1.23, 95% CI=1.10-1.36), P<0.001) but did not lead to a significant increase in females (OR=1.12, 95% CI=0.96-1.29, P=0.2).
  
  
  CONCLUSIONS
  Personally delivered health promotion improved uptake of bowel cancer screening in areas of low socio-economic status and high ethnic diversity. The intervention by telephone appears to be the most effective method.
authors.affiliation: Public Health, London Borough of Tower Hamlets, 4th Floor Mulberry Place, 5 Clove Crescent, London E14 1BY, UK.
authors.forename: J
authors.initials: J
authors.lastname: Shankleman
authors.affiliation: Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London EC1M 6BQ, UK.
authors.forename: N J
authors.initials: NJ
authors.lastname: Massat
authors.affiliation: NHS Bowel Cancer Screening Programme Newham, Tower Hamlets and City & Hackney Strategic Commissioning and Community Public Health Partnerships, 4th Floor Westside, Newham Dockside, 1000 Dockside Road, London E16 2QU, UK.
authors.forename: L
authors.initials: L
authors.lastname: Khagram
authors.affiliation: NHS England, London Region, Southside, 105 Victoria Street, London SW1E 6QT, UK.
authors.forename: S
authors.initials: S
authors.lastname: Ariyanayagam
authors.affiliation: NHS City & Hackney Clinical Commissioning Group, Lawson practice, Nuttal Street, London N1 5HZ, UK.
authors.forename: A
authors.initials: A
authors.lastname: Garner
authors.affiliation: NHS Newham Clinical Commissioning Group, Warehouse K, 2 Western Gateway, London E16 1DR, UK.
authors.forename: S
authors.initials: S
authors.lastname: Khatoon
authors.affiliation: Bowel Cancer Screening Programme London Hub, North West London Hospitals NHS Trust, Watford Road, Harrow HA1 3UJ, UK.
authors.forename: S
authors.initials: S
authors.lastname: Rainbow
authors.affiliation: North East London Bowel Cancer Screening Programme, Homerton University Hospital Trust, Homerton Row, London E9 6SR, UK.
authors.forename: S
authors.initials: S
authors.lastname: Rangrez
authors.affiliation: Community Links Trust, 105 Barking Road, London E16 4HQ, UK.
authors.forename: Z
authors.initials: Z
authors.lastname: Colorado
authors.affiliation: Community Links Trust, 105 Barking Road, London E16 4HQ, UK.
authors.forename: W
authors.initials: W
authors.lastname: Hu
authors.affiliation: Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London EC1M 6BQ, UK.
authors.forename: D
authors.initials: D
authors.lastname: Parmar
authors.affiliation: Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London EC1M 6BQ, UK.
authors.forename: S W
authors.initials: SW
authors.lastname: Duffy
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033181:Information Dissemination / Q000379:methods; D008131:London; D008297:Male; D008875:Middle Aged; D011204:Poverty Areas; D013689:Telephone