Effect of culturally tailored education on attendance at mammography and the Papanicolaou test

Objectives To determine the effectiveness of culturally tailored education on attendance at breast and cervical cancer screening among ethnic minority women. Data Sources Systematic database searches in Ovid MEDLINE, ProQuest, PubMed, PsycINFO, and Cochrane CENTRAL. Study Design Randomized controlled trials (RCTs) of culturally tailored educational interventions to ethnic minority women in Western countries were investigated for a meta-analysis. RCTs that assessed attendance at mammography or the Papanicolaou test (Pap test) were eligible for inclusion. Data Collection Methods Study characteristics and results were extracted separately. Independent raters assessed risk of bias by using Cochrane Collaboration's tool. Principal Findings Seven RCTs (n = 4246) were included in the meta-analysis of mammography attendance, and four RCTs (n = 1750) were included in the meta-analysis of Pap test attendance. The effect of culturally tailored educational interventions on attendance at mammography was an increase of 18 percent (RR = 1.18, 95% CI, 1.09-1.28, P < .001), with low heterogeneity (I-2 = 30.0, P = .237), and a 54 percent increase at the Pap test (RR = 1.54, 95% CI, 1.14-2.09, P = .005), with substantial heterogeneity (I-2 = 75.9%, P = .001). Conclusions Interpreted within the limitations set by the low number of studies and substantial heterogeneity for the Pap test, findings from the current meta-analyses indicate that culturally tailored educational interventions may increase attendance of ethnic minority women at breast and cervical cancer screenings. There is a need for more studies, in particular RCTs conducted outside the United States, to determine if such findings are similar in other countries.