Health Education Research Advance Access originally published online on May 20, 2004
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Health Education Research, Vol. 19, No. 4, 457-468,
August 2004
© 2004 Oxford University Press
Media interventions to increase cervical screening uptake in South Africa: an evaluation study of effectiveness
1 Lewisham VTS, SLOVTS, Gassiot House, St Thomas's Hospital, London SE1 7EH, UK, 2 Health Services Research Department, Institute of Psychiatry, London SE5 8AF, UK, 3 London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK, 4 Department of Sexually Transmitted Diseases, London WC1E 6AU, UK, 5 Khayelitsha Cervical Screening Project, Cancer Association, PO Box 13330, Mowbray 7705, South Africa, 6 EngenderHealth, New York, NY 10001, USA and 7 Department Obstetrics and Gynaecology, Groote Schuur, Cape Town 7937, South Africa
8 Correspondence to: J. Bindman; E-mail: j.bindman{at}iop.kcl.ac.uk
Successful cervical cancer prevention depends on reaching, screening and treating women with pre-invasive disease. We aimed to evaluate the effectiveness of two media interventions—a photo-comic and a radio-drama—in increasing cervical screening uptake. A randomized controlled trial compared a photo-comic on cervical cancer screening with a placebo comic. One month after the comics were distributed a radio-drama paralleling the photo-comic was broadcast on the community radio station and a retrospective evaluation was carried out. The trial was set in Khayelitsha, a peri-urban squatter community near Cape Town, South Africa. A random sample consisted of 658 women between the ages of 35 and 65 years, from a stratified sample of census areas. The main outcome measure was self-reported cervical screening uptake 6 months after distribution of the comics. Seven percent (18 of 269) of women who received the intervention photo-comic reported cervical screening during the 6 months follow-up, compared with 6% (25 of 389) of controls (P = 0.89). Women who recalled hearing the radio-drama were more likely to report attending screening (nine of 53, 17%) than those who did not (19 of 429, 4%; P < 0.001). We conclude that the photo-comic was ineffective in increasing cervical screening uptake in this population. The radio-drama may have had more impact, but only a minority of women recalled being exposed to it. Future research must concentrate not only on achieving high level of exposure to health messages, but also on investigating the links between exposure and action.