title: A telephone reminder intervention to improve breast screening information and access.
abstract: OBJECTIVE
  In the UK, women aged 50-70 are offered breast cancer screening every three years. Screening participation rates in London have been particularly low. Low rates have been associated with low socio-economic status, and some ethnic groups have been observed to be underserved by cancer screening. This paper reports on a telephone reminder intervention in London Newham, an area of high deprivation and ethnic diversity.
  
  
  METHODS
  Observational study of planned intervention.
  
  
  METHODS
  Women invited for breast screening were telephoned to confirm receipt of the invitation letter, remind invitees of their upcoming appointment, and to provide further information. Aggregate data at general practice level on invitation to and attendance at breast screening and on numbers reached by telephone were analysed by logistic regression.
  
  
  RESULTS
  For the 29 participating GP practices (10,928 invitees) overall uptake in 2010 was higher compared to the previous screening round in 2007 (67% vs. 51%; p < 0.001). On average 59% of invitees were reached by the reminder calls. A 10% increase in women reached resulted in an 8% increase in the odds of women attending their screening appointment (95% CI: 5%-11%), after adjusting for 2007 attendance rates. Practices with a higher proportion of South Asian women were associated with a larger uptake adjusted for 2007 uptake and population reached by the telephone intervention, (4% increase in odds of attendance per 10% increase in South Asian population, CI 1%-7%, p = 0.003) while practices with a higher proportion of black women were associated with a smaller uptake similarly adjusted. (11% decrease in odds of attendance per 10% increase in black population, CI 9%-16%, p < 0.001).
  
  
  CONCLUSIONS
  A language- and culture-sensitive programme of reminder calls substantially improved breast cancer screening uptake.
authors.affiliation: Centre for Cancer Prevention, Queen Mary, University of London, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK.
authors.forename: J
authors.initials: J
authors.lastname: Offman
authors.affiliation: Centre for Cancer Prevention, Queen Mary, University of London, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK. Electronic address: j.myles@qmul.ac.uk.
authors.forename: J
authors.initials: J
authors.lastname: Myles
authors.affiliation: NHS England Southside, 105 Victoria Street, London SW1E 6QT, UK.
authors.forename: S
authors.initials: S
authors.lastname: Ariyanayagam
authors.affiliation: Community Links, 105 Barking Road, Canning Town, London E16 4HQ, UK.
authors.forename: Z
authors.initials: Z
authors.lastname: Colorado
authors.affiliation: Centre for Primary Care & Public Health, Blizard Institute, Yvonne Carter Building, 58 Turner Street, London E1 2AB, UK.
authors.forename: M
authors.initials: M
authors.lastname: Sharp
authors.affiliation: NHS Commissioning Board London, 4th Floor, Drummond Street Wing, Stephenson House, 75 Hampstead Road, London NW1 2PL, UK.
authors.forename: M
authors.initials: M
authors.lastname: Cruice
authors.affiliation: Centre for Cancer Prevention, Queen Mary, University of London, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK.
authors.forename: B V
authors.initials: BV
authors.lastname: North
authors.affiliation: Central and East London Breast Screening Service, 3rd Floor, West Wing, St Bartholomew's Hospital, London EC1A 7BE, UK.
authors.forename: S
authors.initials: S
authors.lastname: Shiel
authors.affiliation: Contracting and Quality Directorate, North and East London Commissioning Support Unit, Clifton House, 75-77 Worship Street, London EC2A 2DU, UK.
authors.forename: T
authors.initials: T
authors.lastname: Baker
authors.affiliation: North and East London Commissioning Support Unit, Clifton House, 75-77 Worship Street, London EC2A 2DU, UK.
authors.forename: R
authors.initials: R
authors.lastname: Jefferies
authors.affiliation: Quality Assurance Reference Centre, Barts and the London NHS Trust, 1st Floor, 51/53 Bartholomew Close, West Smithfield, London EC1A 7BE, UK.
authors.forename: K
authors.initials: K
authors.lastname: Binysh
authors.affiliation: Centre for Cancer Prevention, Queen Mary, University of London, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK.
authors.forename: S W
authors.initials: SW
authors.lastname: Duffy
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000517:prevention & control*; D018864:Cultural Diversity; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D033181:Information Dissemination / Q000379:methods*; D008131:London; D008875:Middle Aged; D015397:Program Evaluation; D017010:Reminder Systems; D012959:Socioeconomic Factors; D013222:State Medicine; D013689:Telephone
keywords: Breast screening; Community intervention; Telephone reminder