EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n. °135, 4050-600 Porto, Portugal; Unidade de Saúde Pública, ACeS Porto Ocidental, Rua da Vila Nova s/n, 4100-503 Porto, Portugal.
EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n. °135, 4050-600 Porto, Portugal.
Prev Med. 2018 Sep;114:123-133. doi: 10.1016/j.ypmed.2018.06.004. Epub 2018 Jun 9.
The aim of this study was to test the effectiveness of invitation to cervical cancer screening through a very low-cost strategy based on automated and customized text messages, phone calls and reminders. A randomized (1:1) controlled trial was conducted among 13 Portuguese primary care units, recruiting women aged 25 to 49 years, eligible for cervical cancer screening, with an available mobile phone number. In the intervention group, participants were invited for cervical cancer screening through automated/customized text messages and phone calls, followed by text message reminders. Participants in the control group were invited through a written letter (standard of care). The primary outcome was the proportion of women adherent to screening up to 45 days after invitation and the secondary outcome was defined as the adherence proportion after invitation based only on text messages and reminders. A total of 1220 women were randomized, 605 to intervention and 615 to control group. The adherence to cervical cancer was significantly higher among women assigned to intervention (39.0% vs. 25.7%, p < 0.001); this corresponds to a difference of 13.3% (95% CI 8.1 to 18.5). The difference in adherence between an invitation strategy based only on text messages and reminders and the standard of care was -0.4%, 95% CI -5.3 to 4.5. In conclusion, an invitation to cervical cancer screening using automated text messages/phone calls and reminders increases the adherence to cervical cancer screening. Such a low-cost and operator-independent strategy of invitation may contribute to the sustainability of organized screening programs.
NCT03122275.
目的：本研究旨在测试一种基于自动化和定制化短信、电话和提醒的非常低成本策略，通过邀请女性进行宫颈癌筛查的有效性。
方法：这是一项在 13 个葡萄牙初级保健单位进行的随机（1:1）对照试验，纳入年龄在 25 至 49 岁、有宫颈癌筛查资格且有可用手机号码的女性。干预组通过自动化/定制短信和电话邀请女性进行宫颈癌筛查，随后发送短信提醒。对照组通过书面信函（标准护理）进行邀请。主要结局是在邀请后 45 天内接受筛查的女性比例，次要结局定义为仅通过短信和提醒邀请后的依从率。
结果：共纳入 1220 名女性，605 名被分配到干预组，615 名被分配到对照组。与对照组相比，分配到干预组的女性接受宫颈癌筛查的比例明显更高（39.0% vs. 25.7%，p<0.001）；这相当于 13.3%的差异（95%CI 8.1-18.5）。仅基于短信和提醒的邀请策略与标准护理之间的依从率差异为-0.4%，95%CI-5.3 至 4.5。
结论：使用自动化短信/电话和提醒邀请女性进行宫颈癌筛查可提高宫颈癌筛查的依从性。这种低成本且不依赖操作人员的邀请策略可能有助于有组织的筛查计划的可持续性。
临床试验注册号：NCT03122275。
