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Effect of culturally tailored education on attendance at mammography and the Papanicolaou test.

ABSTRACT: OBJECTIVES:To determine the effectiveness of culturally tailored education on attendance at breast and cervical cancer screening among ethnic minority women. DATA SOURCES:Systematic database searches in Ovid MEDLINE, ProQuest, PubMed, PsycINFO, and Cochrane CENTRAL. STUDY DESIGN:Randomized controlled trials (RCTs) of culturally tailored educational interventions to ethnic minority women in Western countries were investigated for a meta-analysis. RCTs that assessed attendance at mammography or the Papanicolaou test (Pap test) were eligible for inclusion. DATA COLLECTION METHODS:Study characteristics and results were extracted separately. Independent raters assessed risk of bias by using Cochrane Collaboration's tool. PRINCIPAL FINDINGS:Seven RCTs (n = 4246) were included in the meta-analysis of mammography attendance, and four RCTs (n = 1750) were included in the meta-analysis of Pap test attendance. The effect of culturally tailored educational interventions on attendance at mammography was an increase of 18 percent (RR = 1.18, 95% CI, 1.09-1.28, P < .001), with low heterogeneity (I2 = 30.0, P = .237), and a 54 percent increase at the Pap test (RR = 1.54, 95% CI, 1.14-2.09, P = .005), with substantial heterogeneity (I2 = 75.9%, P = .001). CONCLUSIONS:Interpreted within the limitations set by the low number of studies and substantial heterogeneity for the Pap test, findings from the current meta-analyses indicate that culturally tailored educational interventions may increase attendance of ethnic minority women at breast and cervical cancer screenings. There is a need for more studies, in particular RCTs conducted outside the United States, to determine if such findings are similar in other countries.

SUBMITTER: Brevik TB

PROVIDER: S-EPMC7240773 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Project description:ImportanceBlack individuals and Hispanic individuals are less likely to recognize stroke and call 911 (stroke preparedness), contributing to racial/ethnic disparities in intravenous tissue plasminogen activator use.ObjectiveTo evaluate the effect of culturally tailored 12-minute stroke films on stroke preparedness vs the usual care practice of distributing stroke education pamphlets.Design, setting, and participantsCluster randomized clinical trial between July 26, 2013, and August 16, 2018, with randomization of 13 black and Hispanic churches located in urban neighborhoods to intervention or usual care. In total, 883 congregants were approached, 503 expressed interest, 375 completed eligibility screening, and 312 were randomized. Sixty-three individuals were ineligible (younger than 34 years and/or did not have at least 1 traditional stroke risk factor).InterventionsTwo 12-minute stroke films on stroke preparedness for black and Hispanic audiences.Main outcomes and measuresThe primary outcome was the Stroke Action Test (STAT), assessed at baseline, 6 months, and 12 months.ResultsIn total, 261 of 312 individuals completed the study (83.7% retention rate). Most participants were female (79.1%). The mean (SD) age of participants was 58.57 (11.66) years; 51.1% (n = 159) were non-Hispanic black, 48.9% (n = 152) were Hispanic, and 31.7% (n = 99) had low levels of education. There were no significant end-point differences for the STAT at follow-up periods. The mean (SD) baseline STAT scores were 59.05% (29.12%) correct for intervention and 58.35% (28.83%) correct for usual care. At 12 months, the mean (SD) STAT scores were 64.38% (26.39%) correct for intervention and 61.58% (28.01%) correct for usual care. Adjusted by education, a post hoc subgroup analysis revealed a mean (SE) intervention effect of 1.03% (0.44%) (P = .02) increase per month in the low-education subgroup (about a 10% increase in 12 months). In the high-education subgroup, the mean (SE) intervention effect was -0.05% (0.30%) (P = .86). Regarding percentage correct, the low-education intervention subgroup improved from 52.4% (7 of 21) to 66.7% (14 of 21) compared with the other subgroups.Conclusions and relevanceNo difference was observed in stroke preparedness at 12 months in response to culturally tailored 12-minute stroke films or conventional stroke education pamphlets. Additional studies are required to confirm findings from a post hoc subgroup analysis that suggested a significant education effect.Trial registrationClinicalTrials.gov identifier: NCT01909271.

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Effect of culturally tailored education on attendance at mammography and the Papanicolaou test.

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