***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: OBJECTIVES We conducted a trial to evaluate the effectiveness of a cervical cancer control intervention for Vietnamese American women that used lay health workers . METHODS The study group included 234 women who had not received a Papanicolaou ( Pap ) test in the last 3 years . Experimental group participants received a lay health worker home visit . Our trial endpoint was Pap test receipt within 6 months of r and omization . Pap testing completion was ascertained through women 's self-reports and medical record review s. We examined intervention effects among women who had ever received a Pap test ( prior to r and omization ) and women who had never received a Pap test . RESULTS Three quarters of the women in the experimental group completed a home visit . Ever-screened experimental group women were significantly more likely to report Pap testing ( P < .02 ) and to have records verifying Pap testing ( P < .04 ) than were ever-screened control group women . There were no significant differences between the trial arms for women who had never been screened . CONCLUSIONS Our findings indicate that lay health worker-based interventions for Vietnamese American women are feasible to implement and can increase levels of Pap testing use among ever-screened women but not among never-screened women INTRODUCTION Southeast Asian women have low levels of Papanicolaou ( Pap ) testing participation  . We conducted a group-r and omized controlled trial to evaluate a cervical cancer screening intervention program targeting Seattle 's Cambodian refugee community . METHODS Women who completed a baseline , community-based survey were eligible for the trial . Neighborhoods were the unit of r and omization . Three hundred and seventy survey participants living in 17 neighborhoods were r and omized to intervention or control status .  Intervention group women received home visits by outreach workers and were invited to group meetings in neighborhood setting s. The primary outcome measure was self-reported Pap testing in the year prior to completing a follow-up survey . RESULTS The proportion of women in the intervention group reporting recent cervical cancer screening increased from 44 % at baseline to 61 % at follow-up ( + 17 % ) . The corresponding proportions among the control group were 51 and 62 % ( + 11 % ) . These temporal increases were statistically significant in both the intervention ( P < 0.001 ) and control ( P = 0.027 ) groups . DISCUSSION This study was unable to document an increase in Pap testing use specifically in the neighborhood-based outreach intervention group ; rather , we found an increase in both intervention and control groups . A general awareness of the project among women and their health care providers as well as other ongoing cervical cancer screening promotional efforts may all have contributed to increases in Pap testing rates Background : Low-income African American women face numerous barriers to mammography screening . We tested the efficacy of a combined interactive computer program and lay health advisor intervention to increase mammography screening . Methods : In this r and omized , single blind study , participants were 181 African American female health center patients of ages 41 to 75 years , at ≤250 % of poverty level , with no breast cancer history , and with no screening mammogram in the past 15 months . They were assigned to either ( a ) a low-dose comparison group consisting of a culturally appropriate mammography screening pamphlet or ( b ) interactive , tailored computer instruction at baseline and four monthly lay health advisor counseling sessions . Self-reported screening data were collected at baseline and 6 months and verified by medical record . Results : For intent-to-treat analysis of primary outcome ( medical record – verified mammography screening , available on all but two participants ) , the intervention group had increased screening to 51 % ( 45 of 89 ) compared with 18 % ( 16 of 90 ) for the comparison group at 6 months . When adjusted for employment status , disability , first-degree relatives with breast cancer , health insurance , and previous breast biopsies , the intervention group was three times more likely ( adjusted relative risk , 2.7 ; 95 % confidence interval , 1.8 - 3.7 ; P < 0.0001 ) to get screened than the low-dose comparison group . Similar results were found for self-reported mammography stage of screening adoption . Conclusions : The combined intervention was efficacious in improving mammography screening  in low-income African American women , with an unadjusted effect size ( relative risk , 2.84 ) significantly higher ( P < 0.05 ) than that in previous studies of each intervention alone . Cancer Epidemiol Biomarkers Prev ; 19(1 ) ; INTRODUCTION Chinese Americans have low colorectal cancer ( CRC ) screening rates . Evidence -based interventions to increase CRC screening in this population are lacking . This study aims to compare the efficacy of two interventions in increasing  CRC screening  among Chinese Americans . DESIGN Cluster r and omized comparative trial . SETTING / PARTICIPANTS From 2010 to 2014 , a community-academic team conducted this study in San Francisco , CA with Chinese Americans aged 50 - 75 years who spoke English , Cantonese , or M and arin . INTERVENTION Lay health worker ( LHW ) intervention plus in- language brochure ( LHW+Print ) versus brochure ( Print ) . LHWs in the LHW+Print arm were trained to teach participants about CRC in two small group sessions and two telephone calls . MAIN OUTCOME MEASURES Change in self-reports of ever having had CRC screening and being up to date for CRC screening from baseline to 6 months post-intervention . Statistical analysis was performed from 2014 to 2015 . RESULTS This study recruited 58 LHWs , who in turn recruited 725 participants . The average age of the participants was 62.2 years , with 81.1 % women and 99.4 % foreign born .  Knowledge increase was significant ( p<0.002 ) for nine measures in the LHW+Print group and six in the Print group . Both groups had increases in having ever been screened for CRC ( LHW+Print , 73.9%-88.3 % , p<0.0001 ; Print , 72.3%-79.5 % , p=0.0003 ) and being up to date for CRC screening ( LHW+Print , 60.0%-78.1 % , p<0.0001 ; Print , 58.1%-64.1 % , p=0.0003 ) . In multivariable analyses , the intervention OR for LHW+Print versus Print was 1.94 ( 95 % CI=1.34 , 2.79 ) for ever screening and 2.02 ( 95 % CI=1.40 , 2.90 ) for being up to date . CONCLUSIONS Both in- language print material s and LHW outreach plus print material s increased CRC screening  among Chinese Americans . The combination of LHW+Print was more effective than Print alone . These findings can guide clinicians and policymakers in choosing appropriate interventions to increase CRC screening among Chinese American immigrants . TRIAL REGISTRATION This study is registered at www . clinical trials.gov NCT00947206 Objectives To test a community health worker (CHW)-led health literacy intervention on mammogram and Papanicolaou test screening among Korean American women . Methods We conducted a cluster-r and omized trial at 23 ethnic churches in the Baltimore , Maryl and -Washington , DC , metropolitan area between 2010 and 2014 . Trained CHWs enrolled 560 women . The intervention group received an individually tailored cancer-screening brochure followed by CHW-led health literacy training and monthly telephone counseling with navigation assistance . Study outcomes included receipt of an age-appropriate cancer screening test , health literacy , cancer knowledge , and perceptions about cancer screening at 6 months . Results The odds of having received a mammogram were 18.5 ( 95 % confidence interval [ CI ] = 9.2 , 37.4 ) times higher in the intervention than in the control group , adjusting for covariates . The odds of receiving a Papanicolaou test were 13.3 ( 95 % CI = 7.9 , 22.3 ) times higher ; the odds of receiving both tests were 17.4 ( 95 % CI = 7.5 , 40.3 ) times higher . Intervention effects also included increases in health literacy and positive perceptions about cancer screening . Conclusions A health literacy-focused CHW intervention successfully promoted cancer-screening behaviors and related cognitive and attitudinal outcomes in Korean American women Background : Cervical cancer is a significant health disparity among women in Ohio Appalachia . The goal of this study was to evaluate the efficacy of a lay health advisor ( LHA ) intervention for improving Papanicolaou ( Pap ) testing rates , to reduce cervical cancer , among women in need of screening . Methods : Women from 14 Ohio Appalachian clinics in need of a Pap test were r and omized to receive either usual care or an LHA intervention over a 10-month period . The intervention consisted of two in-person visits with an LHA , two phone calls , and four postcards . Both self-report and medical record review ( MRR ) data ( primary outcome ) were analyzed . Results : Of the 286 women , 145 and 141 were r and omized to intervention and usual care arms , respectively . According to MRR , more women in the LHA arm had a Pap test by the end of the study compared with those r and omized to usual care ( 51.1 % vs. 42.0 % ; OR = 1.44 , 95 % CI : 0.89–2.33 ; P = 0.135 ) . Results of self-report were more pronounced ( 71.3 % vs. 54.2 % ; OR = 2.10 , 95 % CI : 1.22–3.61 ; P = 0.008 ) . Conclusions : An LHA intervention showed some improvement in the receipt of Pap tests among Ohio Appalachian women in need of screening . Although biases inherent in using self-reports of screening are well known , this study also identified biases in using MRR data in clinics located in underserved areas . Impact : LHA interventions show promise for improving screening behaviors among nonadherent women from underserved population s. Cancer Epidemiol Biomarkers Prev ; 20(5 ) ; 835–43 . © 2011 AACR Background . The American Cancer Society ( ACS ) is interested in facilitating colorectal cancer screening ( CRCS ) in primary care . Methods . Similar clinics were assigned r and omly to 1 of 3 CRCS arms : ( 1 ) usual care , ( 2 ) exam-room posters design ed by the ACS ; and ( 3 ) posters plus patient reminder calls from an ACS volunteer . Results . Compared to patients due for screening in Arm 1 , the odds ratio for getting CRCS in Arm 2 was 1.04 ( 95 % confidence interval [ CI ] , 0.81–1.34 ) , P value not significant ; in Arm 3 , it was 1.49 ( 95 % CI , 1.16–1.90 ) , P value < .001 . Conclusions . Exam-room posters plus patient reminder calls from the ACS can increase CRCS in primary care OBJECTIVES This study assessed the effectiveness of telephone counseling in a church-based mammography promotion intervention trial . METHODS Thirty churches were r and omized to telephone counseling and control conditions ; telephone interview data were used in assessing intervention effects on mammography adherence . Separate analyses were conducted for baseline-adherent participants ( maintaining adherence ) and baseline-nonadherent participants ( conversion to adherence ) . RESULTS Year 1 follow-up data indicated that the telephone counseling intervention  maintained mammography adherence among baseline-adherent participants and reduced the nonadherence rate from 23 % to 16 % . CONCLUSIONS Partnerships between the public health and faith communities are potentially effective conduits to promote maintenance of widely endorsed health behaviors such as regular cancer screening Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Background In the US , Hispanic women have a higher incidence of , and mortality from , cervical cancer than non-Hispanic white women . The reason for this disparity may be attributable to both low rates of screening and poor adherence to recommended diagnostic follow-up after an abnormal Pap test . The ' Cervical Cancer Screening and Adherence to Follow-up Among Hispanic Women ' study is a collaboration between a research institution and community partners made up of members from community based organizations , the Yakima Valley Farm Workers Clinic and the Breast , Cervical , and Colon Health Program of the Yakima District . The study will assess the efficacy of two culturally-appropriate , tailored educational programs design ed to increase cervical cancer screening among Hispanic women , based in the Yakima Valley , Washington , US . Methods / design A parallel r and omized-controlled trial of 600 Hispanic women aged 21–64 , who are non-compliant with Papanicolau ( Pap ) test screening guidelines . Participants will be r and omized using block r and omization to ( 1 ) a control arm ( usual care ) ; ( 2 ) a low-intensity information program , consisting of a Spanish- language video that educates women on the importance of cervical cancer screening ; or ( 3 ) a high-intensity program consisting of the video plus a ‘ promotora ’ or lay-community health educator-led , home based intervention to encourage cervical cancer screening . Participants who 
    Output:
    
Larger effect sizes were observed in participants previously non-adherent with recommended schedules of cancer screening .
Community-based health worker interventions are an effective re source for increasing uptake of all 3 types of cancer screening in ethnic minority groups .
Those previously non-adherent with recommended schedules of cancer screening benefitted the most from the CBHW approach .
Further research is needed to ascertain whether CBHWs can help promote symptom recognition and help-seeking behaviour to facilitate early diagnosis of cancer