***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A nurse-administered , protocol -driven model ( NP ) for preventive services delivery was compared with a traditional physician reminder ( PR ) model with nursing back-up among 473 patients attending Internal Medicine and Family Medicine clinics . A total of 240 patients were r and omized to the NP group and 233 to the PR group . Demographic characteristics including gender [ 71 % female ( NP ) and 71 % female ( PR ) ] , race ( 78 % and 75 % African American , respectively ) and age ( numbers of persons aged 18 - 54 , 55 - 64 and 65 + years ) were similar in each group . In the NP group 244/244 screening tests for breast , cervical and colon cancers and alcohol abuse were initiated or completed by nurses , while in the PR group 110/215 ( 51 % ) were initiated or completed by physicians . The NP group received 552/552  counseling services from nurses for tobacco , alcohol , nutrition , exercise and prostate screening , while in the PR group , physicians delivered 10 % of the needed services ( 56/560 ) . Aside from counseling for prostate cancer screening , which was 100 % in both the NP and PR groups , all other between-group differences for each service were significant at the level of p<0.001 . Results show the feasibility of a nursing protocol for initiating equitable cancer prevention services in a primary care setting Our objective was to assess the efficiency of a home-visit invitation aim ed to increase uptake of cervical cancer screening in women between 35 and 60 years of age . From May , 2006 , we conducted a quasi-r and omized trial to determine if an in-home education and invitation intervention would increase uptake of cervical cancer screening . We r and omly recruited 304 women from the Samliem inner-city community , Khon Kaen , Northeast Thail and , and assigned participants to either the intervention or control zone . Baseline screening coverage interviews were then performed : 58 of 158 women in the intervention zone and 46 of 146 in the control zone were excluded from the study because of having had a Pap smear within 5 years , but these were included in the final analysis . First , 100 women in the intervention group were visited in their homes by one of the research ers , who provided culturally-sensitive health education that emphasized the need for screening . Four months later , post-intervention ,  screening-coverage interviews were again performed in both groups , in combination with the same health education for 100 women in the control group for a comparison . There was no difference in the baseline Pap smear screening-coverage rate in the intervention vs. control zones ( 36.7 vs. 31.5 % , p=0.339 ) . One hundred women in the intervention group completed the intervention interviews and after four months , 100 women in the intervention group and 100 in the control group also completed the post-intervention interviews . The increased screening-coverage rate in the intervention zone was similar to that of the control zone ( 43.6 vs. 34.9 % , p=0.119 ) ; however , there was a borderline significant increase in the intervention zone compared with baseline ( 36.7 to 43.6 % , p=0.070 ) . Therefore , home visit education and invitation intervention produced only a nominal effect on increasing Pap smear coverage within a 4-month study period Objectives : To assess the knowledge , attitude , and practice regarding  cervical cancer screening among Kuwaiti women . Subjects and Methods : A total of 300 married Kuwaiti women were r and omly selected from those who visited the clinics irrespective of reason(s ) for the visit . A structured question naire covering sociodemographic characteristics , knowledge , attitude , and practice related to cervical cancer screening was administered . Results : Of the 300 women , complete information was collected from 281 ( 93.7 % ) , the knowledge about the test was adequate in 147 ( 52.3 % ) women , while 86 ( 30.6 % ) had adequate attitude towards the test and only 67 ( 23.8 % ) had an adequate practice . The main reason given for not having had a Papanicolaou smear was that it was not suggested by the doctor . Among all the respondents 220 ( 78.7 % ) would prefer a female doctor to conduct the test . The level of education was the only significant factor independently associated with inadequate knowledge and attitude towards Papanicolaou smear test ( p = 0.006 and p = 0.001 , respectively ) when adjusted for the effect of other factors in multivariate logistic regression analysis . However , age ( p < 0.001 ) , level of education ( p = 0.028 ) , and number of years since last visit with a gynaecologist ( p = 0.005 ) were significant factors independently associated with inadequate practice of the test . Conclusion : Our findings showed that a well- design ed health education programme on cervical cancer and benefits of screening would increase the awareness among Kuwaiti women BACKGROUND The North Carolina Native American Cervical Cancer Prevention Project was a 5-year , National Cancer Institute-funded trial of health education design ed to increase screening for cervical cancer among Native-American women in North Carolina . PURPOSE This study was conducted to evaluate the effectiveness of this education program in the Eastern-B and Cherokee target population . METHODS Cherokee tribal l and s were mapped and all households ( N = 2223 ) were listed to ensure maximum coverage of the eligible population ( women , aged 18 years and older , who were enrolled tribal members ) . Eligible women were identified by the use of a brief question naire administered to an adult member of the household . Of the 1279 households with eligible women , 1020 ( 79.8 % ) agreed to participate . The intervention was an individualized health education program delivered by female Cherokee lay health educators . The participants were r and omly assigned to receive or not to receive the intervention ( i.e. , to program and control groups , respectively ) by use of the Solomon Four-Group design . Data were collected in face-to-face interviews conducted in the participant 's home . Of the 996 women who were ultimately enrolled , 540 were r and omly assigned to receive a pretest ( preintervention ) interview that involved administration of a 96-item question naire design ed to collect data on knowledge , intentions , and behaviors related to cervical cancer ; of these 540 women , 263 were r and omly assigned to receive the education program . The remaining 456 women did not receive the pretest , but 218 were r and omly assigned to receive the education program . Six months after receiving the education program , the women in all four groups were administered a post-test that was identical to the pretest . Logistic regression was used to assess the effects of the pretest and the educational program . All P values result ed from two-sided statistical tests . RESULTS Eight hundred and fifteen ( 81.8 % ) of the 996 participants completed the post-test interview . The remaining 181 women who were lost to follow-up were evenly distributed among the four study groups . At the post-test , 282 ( 73.2 % ) of the 385 women who received the education program reported having had a Pap smear following the intervention , compared with 275 ( 64 % ) of the 430 control subjects . Women who received the education program were more likely to answer all knowledge items correctly on the post-test ( odds ratio [ OR ] = 2.18 , 95 % confidence interval [ CI ] = 1.08 - 4.39 ) and to report having obtained a Pap smear in the past year ( OR = 2.06 , 95 % CI = 1.14 - 3.72 ) than women in the control groups . CONCLUSION Women who received the education program exhibited a greater knowledge about cervical cancer prevention and were more likely to have reported having had a Pap smear within the past year than women who did not receive the program Study objectives : To assess whether providing women with additional information on the pros and cons of screening , compared with information currently offered by the NHS , affects their intention to attend for screening . Design : R and omised controlled trial . Participants were r and omly assigned to receive either the control , ( based on an NHS Cervical Screening Programme leaflet currently used ) , or the intervention leaflet ( containing additional information on risks and uncertainties ) . Setting : Three general practice s in Birmingham . Participants : 300 women aged 20 to 64 attending the practice s during a one month period . Main outcome measures : Intention to attend for screening . Main results : 283 women ( 94.3 % ) completed the study . Fewer women in the intervention ( 79 % ) than the control group ( 88 % ) expressed intention to have screening after reading the information leaflet ( difference between groups 9.2 % , 95 % confidence intervals ( CI ) 3.2 % to 21.7 % ) . The crude odds ratio ( OR ) and 95 % CI was 0.50 ( 0.26 to 0.97 ) . After adjusting for other factors , the trend persisted ( OR 0.60 , 95 % CI 0.28 to 1.29 ) . Having a previous Pap smear was the only significant predictor of intention to have screening ( adjusted OR 2.54 , 95 % CI 1.03 to 6.21 ) . Subgroup analysis showed no intervention effect in intended uptake between women at higher and lower risk of cervical cancer ( p=0.59 ) . Conclusions : Providing women with evidence based information on the risks , uncertainties , and the benefits of screening , is likely to deter some , but not differentially those at higher risk Objective To assess and compare rates of adherence to follow-up in women undergoing video or regular colposcopy .  MethodS ixty patients with abnormal Pap smears were r and omized to undergo video or regular colposcopy .  All participants were given the same instructions and a follow-up appointment . If a patient did not keep her appointment and did not reschedule , this was considered a failure . Multivariate logistic regression was used for assessment of predictors of follow-up . Results The follow-up rate was significantly higher in the video colposcopy group compared to the regular colposcopy group ( 80 vs. 50 % , p=0.014 ) . After adjusting for results of previous and referral Pap smears , and previous treatment , multivariate analyses indicated that women undergoing video colposcopy were almost five times more likely to return for follow-up than women undergoing regular colposcopy ( odds ratio=4.9 , 95 % confidence interval=[1.24 , 19.39 ] ) . Conclusion Colposcopy clinics with patient population similar to ours may consider the use of video colposcope BACKGROUND To promote prevention and early detection of cancer , the authors conducted a three-year intervention targeting Vietnamese physicians in solo practice in California . METHODS Twenty subjects who had received their medical training in Vietnam were recruited into a r and omized controlled trial . The intervention included computerized or manual cancer screening reminders , continuing medical education seminars , Vietnamese- language health education material s , newsletters , and oncology data -query programs . Evaluation included chart audits for eight targeted activities pre- and post-intervention . RESULTS Before the intervention , annual physician performance rates were low for all eight activities : routine checkups ( 65.6 % ) , Pap testing ( 13.8 % ) , pelvic examinations ( 19.8 % ) , clinical breast examinations ( 13.3 % ) , mammography ( 6.4 % ) , hepatitis B serologies ( 21.9 % ) , hepatitis B immunizations ( 12.8 % ) , and smoking cessation counseling ( 1.6 % ) . After the intervention , performance rates increased significantly for smoking cessation counseling ( p = 0.02 ) , Pap testing ( p = 0.004 ) , and pelvic examinations ( p = 0.01 ) . CONCLUSIONS The results demonstrate the efficacy of an intervention targeting Vietnamese primary care physicians in promoting smoking cessation counseling , Pap testing , and pelvic examinations , but not other cancer prevention activities OBJECTIVE --To discover whether systematic methods of call and recall are more effective than a non- systematic method and to see which of the two systematic methods was more effective . DESIGN -- Prospect i ve r and omised controlled trial over a year . SETTING --One group general practice . PATIENTS --416 Women over 35 eligible for a smear test who had never had a cervical smear test or in whom a smear test was overdue ( previous test more than five years before ) . INTERVENTIONS --One group received written invitations to have a smear taken . The second group had their notes tagged so that the doctor would remind them ( when they attended for another reason ) to have a smear test . No special intervention was made in the third group . MAIN OUTCOME MEASURE -- Performance of a cervical smear test during the year of the study . RESULTS --32 % ( 45/140 ) of the screened group , 27 % ( 39/142 ) of the tagged group , and 15 % ( 20/134 ) of the control group had a smear test during the year . The percentage of women having a smear test in the screened group was not significantly different from that in the tagged group , but the percentages in the two groups were significantly different from that in the control group . Whether a woman had had a previous smear test significantly affected the uptake of the invitation to have a smear test independently of the method of invitation . CONCLUSIONS --The systematic methods of call and recall were more effective than a non- systematic method . There was no significant difference between the two systematic methods ( sending letters or tagging the notes ) at one year In a r 
    Output:
    
Overall , however , invitations appear to be effective methods of increasing uptake .
There is evidence to support the use of invitation letters to increase the uptake of cervical screening .
There is limited evidence to support educational interventions but it is unclear what format is most effective .