Effect of a community action intervention on cervical cancer screening rates in rural Australian towns: The CART project

Background. The effect of community action on cervical cancer screening rat es was explored in 20 rural Australian towns. Methods. Town quarterly Pap test counts, from the Australian Health Insuran ce Commission, were converted to town rates using Census populations. Pap t est rates for 12 quarters before and after mobilization were examined. Results. Wilcoxon-Mann-Whitney tests demonstrated significantly higher per capita Pap test rates pre- to postmobilization for intervention towns compa red to matched control towns for women whose last Pap test was more than 2 years ago (P = 0.008). Maximum efficiency robust tests examining the equali ty of mean differences (intervention-control) of per capita rates between p re- and post-mobilization periods also found significant differences for Pa p tests where last procedure was between I and 2 years ago (R = 13.9, P = 0 .039) and near significance for Pap tests where last procedure was less tha n one year ago (R = 10.6, P = 0.087). Conclusions. It appeared that underscreened women were more likely and over screened women were less likely to have a Pap test in response to the inter vention. The results indicate that a community action program can positivel y impact cervical cancer screening rates. (C) 2000 American Health Foundati on and Academic Press.