Improving uptake of breast screening in multiethnic populations: a randomised controlled trial using practice reception staff to contact non-attenders

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Abstract
Objectives: To determine whether a two hour training programme for general practice reception staff could improve uptake in patients who had failed to attend for breast screening, and whether women from different ethnic groups benefited equally. Design: Controlled trial, randomised by general practice. Setting: Inner London borough of Newham. Subjects: 2064 women aged 50–64 years who had failed to attend for breast screening. Women came from 26 of 37 eligible practices. 31% were white, 17% were Indian, 10% Pakistani, 14% black, 6% Bangladeshi, 1% Chinese, 4% were from other ethnic groups, and in 16% the ethnic group was not reported. Main outcome measures: Attendance for breast screening in relation to ethnic group in women who had not taken up their original invitation. Results: Attendance in the intervention group was significantly better than in the control group (9% v 4%). The response was best in Indian women—it was 19% in the intervention group and 5% in the control group. Conclusions: This simple, low cost intervention improved breast screening rates modestly. Improvement was greatest in Indian women—probably because many practice staff shared their cultural and linguistic background. This intervention could be effective as part of a multifaceted strategy to improve uptake in areas with low rates. The uptake of breast screening is inadequate and inequitable in some deprived areas—often those with large minority ethnic populations Training general practice receptionists to contact women who had not responded to an initial invitation for breast screening made a small but important improvement in attendance Improvement was most pronounced among Indian women—perhaps because most practices employed staff who spoke an Indian language Resources of local general practices could be used as part of multifaceted programmes to increase screening rates in areas of low uptake.