EFFECTIVENESS OF 2 DIRECT-MAIL STRATEGIES TO ENCOURAGE WOMEN TO HAVE CERVICAL (PAP) SMEARS

The aim of this study was to assess the acceptability, utilisation and differential effectiveness of two direct-mail strategies for increasi ng community Papanicolaou (Pap) smear rates. The two strategies were: a personally addressed letter containing simple information about Pap smears and a personally addressed letter combined with a series of tar geted behavioural prompts designed to address a number of aspects of s creening which previous research had shown to be associated with poor screening rates. The two strategies were assessed in two geographicall y separated postal regions in Australia. Each region represented appro ximately 1000 women aged 18-70 years. Outcome data on the change in re gional Pap smear rates were obtained from government health insurance claims for cervical screening and from pathology service records. Both interventions resulted in statistically significant increases in atte ndances for screening over the post-intervention period: 42.2% in the region receiving the simple prompt and 39.6% in the region receiving t he multi-faceted approach. There was no significant difference between the two intervention regions. The results indicate that direct-mail s trategies can be effective in prompting attendance for cervical cancer screening. Furthermore, it would appear that a simple informational s trategy can be at least as effective as a more elaborate package. Both interventions resulted in similar increases in attendances of around 40%.