Campbell H, MacDonald S, McKiernan M
Department of Public Health Medicine, University of Edinburgh.
J Public Health Med. 1996 Mar;18(1):94-7. doi: 10.1093/oxfordjournals.pubmed.a024468.
It is important that if cervical screening programmes are to be successful coverage rates of the target population of women are high. In the context of a well-organized programme in Fife a project was carried out to assess the impact of health visitors following up women who had repeatedly failed to attend for screening.
Ten health visitors in Fife were randomly selected and were each asked to approach 20 women registered with the general practice to which they were attached who met the study criteria. Women were asked for their reasons for non-attendance. Subsequent attendance for cervical screening was identified through the on-line cervical cytology database.
Two health visitors declined to participate in the project. One hundred and sixty-two women were offered a visit by a health visitor to discuss their reasons for non-attendance. Forty-two (28 per cent) of the women approached attended for a smear in the following three months. Of those visited by a health visitor 37 per cent attended for a smear.
In Fife, local beliefs and attitudes about cervical screening together with lack of knowledge of existing clinics with female staff operating outside working hours constitute the major reasons for non-attendance. In this situation, a personal approach based on providing information and individual counselling appears to be successful in encouraging non-attenders to reconsider their decision and participate in the cervical screening programme.
若宫颈筛查项目想要成功，目标女性人群的覆盖率必须很高。在法夫郡一个组织完善的项目背景下，开展了一项评估健康访视员跟进多次未参加筛查女性的影响的项目。
随机选择法夫郡的10名健康访视员，要求每人联系20名符合研究标准且在其所属全科诊所登记的女性。询问这些女性不参加筛查的原因。通过在线宫颈细胞学数据库确定后续宫颈筛查的参与情况。
两名健康访视员拒绝参与该项目。162名女性被提供由健康访视员上门拜访以讨论其不参加筛查的原因。被联系的女性中有42名（28%）在接下来的三个月内参加了涂片检查。在接受健康访视员拜访的女性中，37%参加了涂片检查。
在法夫郡，当地对宫颈筛查的观念和态度以及对有女性工作人员在非工作时间营业的现有诊所缺乏了解，是不参加筛查的主要原因。在这种情况下，基于提供信息和个人咨询的个性化方法似乎能成功鼓励未参加者重新考虑其决定并参与宫颈筛查项目。
