Study: Low-tech interventions increase cancer screenings among rural women

Using low-tech interventions like a DVD and patient navigation services delivered by phone increases the odds of obtaining cancer screenings among rural women, a new study has found.

The study, published in JAMA Network Open, recruited nearly a thousand women from rural Indiana and Ohio who weren’t up-to-date on any or all recommended screenings for breast, cervical and colorectal cancer.

Some of the participants were given an interactive DVD that included tailored messages specific to the user’s age and family history as well as information about barriers to screenings and how to schedule and complete appointments. Another group received the DVD plus patient navigation services, while a third cohort received usual care. 

Researchers found the DVD group had nearly twice the odds of receiving all needed screenings compared with the usual care group. But the odds were nearly six times greater for the DVD and patient navigation cohort compared with usual care. 

The DVD alone was not significantly more effective than usual care, though the DVD plus patient navigation was. 

“In this randomized clinical trial of rural women who were not up to date with at least 1 of the recommended cancer screenings (breast, cervical or colorectal), an intervention designed to simultaneously increase adherence to any or all of the 3 cancer screening tests was more effective than usual care, available at relatively modest costs and able to be remotely delivered, demonstrating great potential for implementing an evidence-based intervention in remote areas of the midwestern U.S.,” the study’s authors wrote. 


Women who live in rural areas have lower rates of breast, cervical and colorectal cancer compared with their urban counterparts. The researchers argued the DVD and patient navigation services could be a cost-effective way to ensure they access these screenings, catching cancer earlier.

However, they did note some limitations. The study group was largely white and nearly half had a college education, so the results may not translate to other groups. 

They noted the DVD was completely narrated, so it could still be accessible regardless of educational background. Still, using a DVD for patient education could still pose a problem going forward. 

“We found that all participants had the requisite technology necessary to use the interactive DVD, although this technology is rapidly becoming obsolete, creating the necessity to translate the intervention to an online tool that can be accessed via a computer, tablet, or smartphone,” the researchers wrote. “This intervention was delivered to rural women who, at the time of the study, had limited internet access; therefore, remote delivery was best suited to DVD technology.”



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