Simple and Inexpensive Interventions Can Save Women’s Lives in Rural America

Researchers from Indiana University and Ohio State University conducted a random clinical trial to determine if particular interventions were effective in convincing women in rural areas to undergo routine recommended breast, cervical, and colorectal cancer screenings. The lead author was Victoria L. Chapman, who holds the Edward W. and Sarah Stam Cullipher Chair at the Indiana University School of Nursing.

The researchers recruited and followed up with women from rural Indiana and Ohio who were not up to date on any or all recommended cancer screenings. One third of the women were mailed a DVD information disc because many women in these rural areas do not have access to broadband internet access. The DVD interactively assessed and provided messages for health beliefs, including risk of developing the targeted cancers and barriers, benefits, and self-efficacy for obtaining the needed screenings.

A second group also was mailed the DVD. These women were telephoned by a patient navigator who counseled women on overcoming the barriers to obtaining screenings. A third group did not receive the DVD or counseling.

The results showed that women who got the DVD were twice as likely as women who did not receive the DVD to obtain the recommended screenings. Women who got the DVD and then were telephoned by counselors were six times as likely to get the recommended screenings.

The authors stated that “compared with treating cancer, the costs of each intervention to bring women up to date with screening were relatively modest, as on average, cancer treatment costs $150 000 per patient in the United States and costs of the intervention would be lower per person at a larger scale. Thus, the additional costs required for the addition of patient navigators to improve screening may result in cost savings by avoiding cancer deaths or treatment at more advanced stages.”

The full study, “Comparative Effectiveness of 2 Interventions to Increase Breast, Cervical, and Colorectal Cancer Screening Among Women in the Rural US: A Randomized Clinical Trial,” was published on JAMA Open Network. It may be accessed here.