Effectiveness of two direct-mail strategies to encourage women to have cervical (Pap) smears

The aim of this study was to assess the acceptability, utilisazion and differential effectiveness of two direct-mail strategies for increasing community Papanicolaou (Pap) smear rates. The two strategies were: a personally addressed letter containing simple information about Pap smears and a personally addressed letter combined with a series of targeted behavioural prompts designed to address a number of aspects of screening which previous research had shown to be associated with poor screening rates. The two strategies were assessed in two geo graphically separated postal regions in Australia. Each region represented approximately 10 women aged 18–70 wars. Outcome data on the change in regional Pap smear rates were obtained from government health insurance claims for cervical screening and from pathology service records. Both interventions resulted in statistically significant increases in attendances for screening over the post-intervention period. 42.2% in the region receiving the simple prompt and 39.6% in the region receiving the multi-faceted approach There was no sigrujicant difference between the two intervention regions. The results indicate that direct-mail strategies can be effective in prompting attendance for cervical cancer screening. Further, nore, it would appear that a simple informational strategy can be at least as effective as a more elaborate package. Both interventions resulted in similar increases in attendances of around 40%.