Fernandez M E, DeBor M, Candreia M J, Wagner A K, Stewart K R
University of Texas-Houston School of Public Health, Center for Health Promotion Research and Development 77030-9960, USA.
Am J Prev Med. 1999 Apr;16(3 Suppl):35-49. doi: 10.1016/s0749-3797(98)00145-7.
Minority women and women with low income levels are significantly less likely to practice appropriate mammography and Pap test screening. ENCOREplus is a health promotion program that provides outreach, education, referral, and other service that facilitate breast and cervical cancer screening for medically underserved women. The program is delivered through a network of community-based nonprofit organizations (YWCA of the U.S.A). The purpose of this study was to assess the effectiveness of ENCOREplus in promoting mammography and Pap test screening among women who were nonadherent to screening guidelines.
Baseline data were collected from women participating in the program. Follow-up occurred within six months of baseline to assess whether or not enrollees received recommended screenings. Screening-completion rates were compared to rates from other published intervention studies.
Data from the program's second implementation year show that 27,494 women participated in the ENCOREplus program. Over half the women were racial/ethnic minorities, over 75% reported annual incomes under $15,000, and 49% reported no insurance. Among women 40 and over, 69.7% were nonadherent to ACS mammography screening guidelines at baseline. Among participants 18 and older, 68.9% were nonadherent to Pap test screening guidelines. Of nonadherent participants, 57.8% received mammograms and 36.5% received Pap tests. Both mammography and Pap test screening-completion rates compared favorably with other programs.
This study demonstrates that programs implemented through community-based organizations can be successful in increasing mammography and Pap test screening among low-income and minority women.
少数族裔女性和低收入女性进行适当的乳房X光检查和巴氏试验筛查的可能性显著较低。ENCOREplus是一项健康促进计划，提供外展、教育、转诊及其他服务，以促进医疗服务不足的女性进行乳腺癌和宫颈癌筛查。该计划通过一个基于社区的非营利组织网络（美国基督教女青年会）实施。本研究的目的是评估ENCOREplus在促进未遵守筛查指南的女性进行乳房X光检查和巴氏试验筛查方面的有效性。
从参与该计划的女性中收集基线数据。在基线后的六个月内进行随访，以评估参与者是否接受了推荐的筛查。将筛查完成率与其他已发表的干预研究的比率进行比较。
该计划第二个实施年度的数据显示，有27494名女性参与了ENCOREplus计划。超过一半的女性是少数族裔，超过75%的女性报告年收入低于15000美元，49%的女性报告没有保险。在40岁及以上的女性中，69.7%在基线时未遵守美国癌症协会的乳房X光检查筛查指南。在18岁及以上的参与者中，68.9%未遵守巴氏试验筛查指南。在未遵守指南的参与者中，57.8%接受了乳房X光检查，36.5%接受了巴氏试验。乳房X光检查和巴氏试验的筛查完成率与其他计划相比都很有利。
本研究表明，通过社区组织实施的计划可以成功提高低收入和少数族裔女性的乳房X光检查和巴氏试验筛查率。
