Stead M J, Wallis M G, Wheaton M E
Warwickshire, Solihull and Coventry Breast Screening Unit, Coventry and Warwickshire Hospital, UK.
J Med Screen. 1998;5(2):69-72. doi: 10.1136/jms.5.2.69.
To find the most cost and time effective way of increasing uptake by re-invitation of non-attenders after an initial invitation.
Women from the Warwickshire, Solihull, and Coventry breast screening programme who failed to attend their initial invitation.
Between October 1996 and February 1997, 2229 women who had failed to attend and had not declined their first invitation to screening were split into two groups according to their Sx number (a number allocated to all women when they are called for screening). Women with an odd number received a "open" invitation asking them to telephone the screening unit for another appointment and women with an even number were given a second "fixed" appointment time. The response of both groups of women was monitored.
There was a significant difference (p < 0.001) in response to a second invitation between the open invitation and fixed appointment letter (12.3% v 22.8%). The greatest disparities were between those who had attended screening in both preceding rounds and those who had failed to attend either round. Socioeconomic status measured by Townsend scores did not seem to affect the response to second appointments.
Second appointments are an important way of increasing screening uptake and thus reducing mortality, which should not be dismissed. The type of invitation is important, with fixed appointments being more effective, and the best predictor of attendance being attendance in the previous screening rounds. This information can be used to allocate resources efficiently to achieve an increased uptake.
All women should receive a second invitation, ideally as a timed appointment. However, if this appointment strategy prevents an individual screening programme maintaining a three year cycle, we have identified a group of women for whom a simple reminder letter would maintain increased uptake while allowing savings in appointment scheduling.
寻找通过再次邀请初次邀请时未参加者来提高参与率的最具成本效益和时间效益的方法。
来自沃里克郡、索利赫尔和考文垂乳腺癌筛查项目且初次邀请时未参加的女性。
在1996年10月至1997年2月期间，2229名未参加且未拒绝初次筛查邀请的女性根据其Sx编号（女性被邀请进行筛查时分配的编号）分为两组。编号为奇数的女性收到一封“开放式”邀请，要求她们致电筛查单位预约另一个时间，编号为偶数的女性则获得第二个“固定”预约时间。对两组女性的回应进行了监测。
开放式邀请和固定预约信在对第二次邀请的回应上存在显著差异（p<0.001）（12.3%对22.8%）。最大的差异存在于前两轮都参加筛查的人和两轮都未参加的人之间。用汤森得分衡量的社会经济地位似乎不影响对第二次预约的回应。
第二次预约是提高筛查参与率从而降低死亡率的重要方式，不应被忽视。邀请类型很重要，固定预约更有效，而参与前一轮筛查是参与情况的最佳预测指标。这些信息可用于有效分配资源以提高参与率。
所有女性都应收到第二次邀请，理想情况下是定时预约。然而，如果这种预约策略妨碍个别筛查项目维持三年周期，我们已确定一组女性，对她们来说，一封简单的提醒信既能维持参与率提高，又能节省预约安排成本。
