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Cancer > Cancer Screening > One-on-one education
Client-oriented Cancer Screening Interventions:
One-on-One Education
On behalf of the Task Force on Community Preventive Services, a team of subject matter specialists and other scientists conducted a systematic review of published studies evaluating the effectiveness of client reminders in increasing screening for breast, cervical and colorectal cancer.
The Task Force recommends interventions that include one-on-one education based on evidence of its effectiveness in increasing:
- breast cancer screening by mammography, and
- cervical cancer screening by Pap test.
The Task Force concluded there was insufficient evidence to determine the effectiveness of one-on-one education to increase:
- colorectal cancer screening by fecal occult blood testing (FOBT), flexible sigmoidoscopy, colonoscopy, or double contrast barium enema.
- One-on-one education is defined as communication of information to individual clients by telephone or through face-to-face encounters, conducted by a healthcare or allied health professional (e.g., health educator) or by a lay health advisor or volunteer.
- Clients receive the information in clinical settings, homes, or local gathering places.
- One-on-one education can be supplemented by the use of:
- brochures
- informational letters, or
- reminders (printed or telephone).
- The education content can:
- address a general target population (untailored messages), or
- address unique circumstances and characteristics of specific individuals that are identified through individual assessments (tailored messages).
Breast Cancer: One-on-One Education is Recommended to Increase Screening
Findings from the Systematic Review
- Twenty-five studies qualified for the systematic review and evaluated 31 different interventions.
- There was a median increase of 9.3 percentage points in the proportion of study participants who completed breast cancer screening by mammography.
- Both tailored interventions (10.6 percentage point median increase) and untailored interventions (9.3 percentage point median increase) were effective in increasing screening rates.
- Reviewed studies were conducted in rural and urban communities and among different ethnic and socioeconomic groups.
Cervical Cancer: One-on-One Education is Recommended to Increase Screening
Findings from the Systematic Review
- From five studies (tailored and untailored) that qualified for the systematic review, eight outcome measures demonstrated an 8.1 percentage point median increase in completed cervical cancer screening by Pap test.
- Reviewed studies were conducted in rural and urban communities and among different ethnic and socioeconomic groups.
Colorectal Cancer: More Evidence is Needed to Determine the Effectiveness of One-on-One Education to Increase Screening
Findings from the Systematic Review
- Only two studies (providing three effect measures) qualified for the systematic review.
- Although the studies reported a median 12.9 percentage point increase in colorectal cancer screening by FOBT, both had limitations in the quality of their execution.
- Therefore the studies provided insufficient evidence to determine the effectiveness of one-on-one education in increasing colorectal cancer screening because of too few qualifying studies.
Prior to and during the literature review and data analysis, the review team and the Task Force on Community Preventive Services attempt to address the key questions of what interventions work, for whom, under what conditions, and at what cost. Lack of sufficient information often leaves one or more of these questions unanswered. The Community Guide refers to these as “research gaps". Research gaps are pulled together in the form of a basic set of questions to inform a research agenda for those in the field. Each completed Community Guide review includes a section on research gaps (or issues) and this is included in final evidence review publications.
Cancer is a major public health problem in the United States. For more information on the scope of this problem, visit Background on Screening for Breast, Cervical and Colorectal Cancers.
Evidence Review:
Baron RC, Rimer BK, Breslow RA, et al.
Client-directed interventions to increase community
demand for breast, cervical, and colorectal cancer
screening: a systematic review.
Am J Prev Med 2008;35(1S):34-55.
Recommendations:
Task Force on Community Preventive
Services. Recommendations for client- and
provider-directed interventions to increase
breast, cervical, and colorectal cancer screening
Am J Prev Med 2008;35(1S):21-5.
The findings and conclusions in this report are those of the authors and the Task Force on Community Preventive Services and do not necessarily represent the official position of the CDC.
The content of publications of the Guide to Community Preventive Services is in the public domain. Citation as to source, however, is appreciated. Sample citation: Guide to Community Preventive Services. Client-oriented cancer screening interventions: one-on-one education.
www.thecommunityguide.org/cancer/screening/one-on-one-education.htm.
Last Updated on: MM/DD/YYYY.
Review completed: July 2008
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