Sung J F, Blumenthal D S, Coates R J, Williams J E, Alema-Mensah E, Liff J M
Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Morehouse College, Atlanta, Georgia, USA.
Am J Prev Med. 1997 Jan-Feb;13(1):51-7.
We conducted a randomized controlled trial to determine if an in-home educational intervention conducted by lay health workers (LHWs) could increase adherence among low-income, inner-city, African-American women to breast and cervical cancer screening schedules.
We recruited 321 African-American women from diverse inner-city sources. After baseline interviews, they were randomly assigned to either the intervention (n = 163) or the control (n = 158) group. Those in the intervention group were visited in their homes up to three times by LHWs who provided a culturally sensitive educational program that emphasized the need for screening.
Ninety-three (93) women in the intervention group and 102 in the control group completed the postintervention interview. For Pap smears, the increase in screening was similar in both groups. For clinical breast exams (CBEs), however, there was a modest increase in the intervention group. The improvement was greatest for mammography, for which there was a 10% to 12% increase. Among women who were not on recommended schedules at baseline, the improvement was substantial and greater in the intervention group.
LHWs' intervention appeared to improve the rate at which inner-city women obtained CBEs and mammograms, but had no effect on Pap smears. A high attrition rate weakened our ability to make conclusive statements about the exact impact of the intervention.
我们进行了一项随机对照试验，以确定由非专业卫生工作者（LHWs）开展的家庭健康教育干预措施能否提高低收入、市中心区的非裔美国女性对乳腺癌和宫颈癌筛查计划的依从性。
我们从市中心区的不同渠道招募了321名非裔美国女性。在进行基线访谈后，她们被随机分配到干预组（n = 163）或对照组（n = 158）。干预组的女性接受LHWs上门家访多达三次，LHWs提供了一个注重文化敏感性的教育项目，强调筛查的必要性。
干预组有93名女性和对照组有102名女性完成了干预后的访谈。对于巴氏涂片检查，两组的筛查率增加情况相似。然而，对于临床乳腺检查（CBEs），干预组有适度增加。乳腺X线摄影检查的改善最为明显，增加了10%至12%。在基线时未按推荐计划进行筛查的女性中，干预组的改善幅度很大且更为显著。
LHWs的干预似乎提高了市中心区女性接受CBEs和乳腺X线摄影检查的比例，但对巴氏涂片检查没有影响。高失访率削弱了我们就干预的确切影响做出确定性陈述的能力。
