Motivational interviewing-based training vs traditional training on the uptake of cervical screening: a quasi-experimental study

The Effect of Face-to-Face and Phone Call Motivational Interviewing on Cervical Cancer Screening

BACKGROUND

Having regular screening tests largely depends on motivational factors. Motivational interviewing (MI) facilitates the movement through the stages of the transtheoretical model of change.

OBJECTIVE

The aim of this study was to compare the effect of face-to-face and phone call MI on cervical cancer screening.

METHODS

This experimental study was conducted on 150 eligible women referred to health centers in Tabriz, Iran. The women were assigned into 3 groups (face-to-face MI, phone MI, or control) using blocked randomization. The face-to-face MI group participated in 3 weekly group counseling sessions, and the motivational phone call group received 3 weekly phone calls. The participants completed the demographic and obstetric questionnaire and stages of change checklist. Adherence to Pap smear was checked, according to the health profile, 6 months after the intervention. The data were analyzed using SPSS 24 software. Chi-square, homogeneity test, and sequential logistic regression by the generalized estimating equations were used.

RESULTS

After the intervention, about 32% women from the face-to-face MI group, 22% from the motivational phone call group, and 4% from the control group underwent Pap smear screening ( P = .002). There was no significant difference between the 2 interventional groups in Pap smear frequency ( P = .36).

CONCLUSION

The study results indicated that both face-to-face and phone call MI are effective in motivating women to have a Pap smear. Further studies are recommended to consider long-term follow-up (3-5 years).

IMPLICATIONS FOR PRACTICE

It is recommended that healthcare providers use motivational phone call to encourage cancer screening behaviors.

Steps towards implementing evidence-based screening in family medicine in Ukraine: SWOT-analysis of an approach of multidimensional empowerment

Background

The purpose of this study is to forward the implementation of an operational evidence-based state screening program of common diseases in Ukraine, where currently no state-based and evidence-based screening (EBS) exists. EBS should be performed by Family Doctors in a primary care setting and concern prevalent diseases in adults, such as: obesity (BMI), hypertension (BP measurement), diabetes (glycaemia), dyslipidemia (cholesterol/lipids), colon cancer (FOBT/colonoscopy), breast cancer (mammography), STIs (chlamydia, syphilis), HIV, HBV, HCV (i.e. serology or other rapid tests), HPV (swabs), cervical cancer (test Pap). depression (i.e., PHQ-9), and smoking (i.e., Fagerstrom).

Methods

Four needs-based research actions were led among citizens and healthcare professionals, based on multidimensional empowerment. Internal Strengths and Weaknesses of the ongoing implementation process were identified through these studies, whereas external Opportunities and Threats were determined by the present socio-cultural and political context. This SWOT analysis is likely to guide future state-based initiatives to accomplish EBS implementation in Ukraine.

Results

Internal Strengths are the bottom-up multidimensional empowerment approach, teaching of EBS and the development of an internet-based platform “Screening adviser” to assist shared decision making for person-centred EBS programs. Internal Weaknesses identified for the Family Doctors are a heterogeneous screening and the risk of decreasing motivation to screen. External Opportunities include the ongoing PHC reform, the existent WONCA and WHO support, and the existence of EBS programs in Europe. External Threats are the lack of national guidelines, not fully introduced gate keeping system, the vulnerable socio-economic situation, the war situation in the East of Ukraine and the Covid-19 pandemic.

Conclusions

We started EBS implementation through research actions, based on a multidimensional empowerment of citizens, HCP and in EBS pathways involved stakeholder teams, to foster a sustainable operational human resource to get involved in that new EBS pathway to implement. The presented SWOT-analysis of this ongoing implementation process allows to plan and optimize future steps towards a state based and supports EBS program in Ukraine.

The Outcome of a Self-Efficacy Enhancement Program for Cervical Cancer Screening among Women in Phrasaeng District, Suratthani Province, Thailand

Objective:

The purpose of this research was to examine the effect of a self-efficacy enhancement program on perceived self-efficacy and cervical cancer screening among women.

Methods:

This research was quasi-experimental research, using the subjects consisted of 130 samples; each of the experimental and control group consisted of 65 samples. The experimental group received a self-efficacy enhancement program. The control group received knowledge and usual care by health personnel in the health promoting hospital. The duration of the research was 8 weeks. The self-efficacy was testing the reliability equal to 0.90. Data were analyzed using descriptive statistics, Chi-square, and t-test.

Results:

The mean scores of perceived self-efficacy between the experimental and control group before using the program (M=2.18, S.D.=0.40; M=2.22, S.D.=0.39), there was no significantly different (p> 0.05). The mean scores of perceived self-efficacy between the experimental and control group after using the program (M=4.11, S.D.=0.44; M=2.28, S.D.=0.42), there was a significantly different (p< 0.001). The mean scores of perceived self-efficacy of the experimental group before and after using the program were higher, (M=2.18, S.D.=0.40; M=4.11, S.D.=0.44), there was a significantly different (p< 0.001). The experimental group came to screening 64 people (98.5 %), and the control group came to screening eight people (12.3 %), calculated ratio as 8:1 and compared the cervical cancer screening in the experimental and control group had differences significantly (p< 0.001).

Conclusion:

The self-efficacy enhancement program, resulting in increased screening rates and screened after the first week by having most screening tests in the community. Therefore, the program should be applied, and proactive services should be provided for women to have access in community and a health service place.