Effect of culturally tailored education on attendance at mammography and the Papanicolaou test

Health Serv Res. 2020 Jun;55(3):457-468. doi: 10.1111/1475-6773.13271. Epub 2020 Jan 28.

Abstract

Objectives: To determine the effectiveness of culturally tailored education on attendance at breast and cervical cancer screening among ethnic minority women.

Data sources: Systematic database searches in Ovid MEDLINE, ProQuest, PubMed, PsycINFO, and Cochrane CENTRAL.

Study design: Randomized controlled trials (RCTs) of culturally tailored educational interventions to ethnic minority women in Western countries were investigated for a meta-analysis. RCTs that assessed attendance at mammography or the Papanicolaou test (Pap test) were eligible for inclusion.

Data collection methods: Study characteristics and results were extracted separately. Independent raters assessed risk of bias by using Cochrane Collaboration's tool.

Principal findings: Seven RCTs (n = 4246) were included in the meta-analysis of mammography attendance, and four RCTs (n = 1750) were included in the meta-analysis of Pap test attendance. The effect of culturally tailored educational interventions on attendance at mammography was an increase of 18 percent (RR = 1.18, 95% CI, 1.09-1.28, P < .001), with low heterogeneity (I2 = 30.0, P = .237), and a 54 percent increase at the Pap test (RR = 1.54, 95% CI, 1.14-2.09, P = .005), with substantial heterogeneity (I2 = 75.9%, P = .001).

Conclusions: Interpreted within the limitations set by the low number of studies and substantial heterogeneity for the Pap test, findings from the current meta-analyses indicate that culturally tailored educational interventions may increase attendance of ethnic minority women at breast and cervical cancer screenings. There is a need for more studies, in particular RCTs conducted outside the United States, to determine if such findings are similar in other countries.

Keywords: Papanicolaou test; ethnic groups; health education; mammography; meta-analysis.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cultural Competency*
  • Early Detection of Cancer
  • Ethnicity / education*
  • Female
  • Global Health
  • Health Education / organization & administration*
  • Health Education / standards
  • Humans
  • Mammography / statistics & numerical data*
  • Minority Groups / education*
  • Papanicolaou Test / statistics & numerical data*
  • Randomized Controlled Trials as Topic