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Remote outreach boosts screening adherence six-fold for women in rural areas

by John R. Fischer, Senior Reporter | May 08, 2023
Women's Health
Remote outreach for women in rural areas increases cancer screening adherence nearly six times.
In the U.S., cancer treatment costs $150,000 on average per patient. While evidence-based screenings have been proved to increase early detection, which, in turn, typically lowers the amount spent on treatment, adherence is low, especially in rural areas and among minorities and people of lower education and income.

In a recent study, researchers at the Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, and the Indiana University Melvin and Bren Simon Comprehensive Cancer Center evaluated the impact that remote outreach could potentially have on adherence among women in rural areas who were due for breast, cervical and colorectal screenings, and if it could create a more holistic approach for identifying cancer early.

Their study, which is the first large-scale assessment of the impact of remote intervention for multiple screenings, showed that supplying women with DVDs, plus follow-up calls with patient navigators, caused breast, cervical and colorectal screenings among rural women to jump six-fold.
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"We have technology available to overcome previous barriers such as rurality and access to care. This holistic approach to cancer prevention and screening could be adapted to other behaviors that would also serve to reduce our national cancer burden,” said Victoria Champion, Regenstrief Institute affiliated scientist and Indiana University School of Nursing distinguished professor of nursing, in a statement.

From 98 rural counties in Ohio and Indiana, Champion and her colleagues divided 983 women between 50 and 74, who had no previous cancer diagnosis and were not up-to-date on one or more evidence-based cancer screenings recommended by the U.S. Preventive Services Task Force, into three groups: the usual care group, which received study newsletters, a second that were mailed interactive DVDs about screening tests and booking appointments, and a third that received the DVD, plus follow-up support calls from patient navigators to answer questions, discuss issues preventing patients from being screened, and to assist with scheduling appointments.

The second group saw adherence double, while the third saw it increase almost six times for all three screenings, compared to the usual care arm.

While limited to mostly white, highly educated patients, the authors say further exploration of more diverse patient populations is possible, as well as for online education tools as internet access increases in rural communities.

The findings were published in JAMA Network Open.

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