International Festival of Public Health

LT 5 - Prevention and Screening

Cervical cancer screening service utilization: The relative contribution of health insurance coverage and socioeconomic status of Namibian women

Presenter: Dr. Olatunde Aremu, Birmingham City University

Other author(s): None

Abstract Text: Background :Cervical cancer is a huge global health burden among women worldwide and remains a leading cause of deaths in low-and-middle income nations. Papanicolaou (Pap) smear is an efficacious screening modality, and has found a useful application as a cervical cancer preventive strategy. The Pap is able to detect premalignant cervical changes and help reduce cervical cancer mortality. Despite its benefit, uptake of Pap smear has been marked with several inequities. Namibia is one of the earlier adopter of Pap smear screen tool in the SSA. However, as the case with most low income countries, disparities in incidence of cervical cancer across socioeconomic groups are rising in Namibia. It is unclear whether economic difficulties usually experienced when accessing also influences cervical cancer screening practices. Therefore, looking at the relationship between economic status, mode of healthcare access and cervical screening practices is of importance.

Aims:To investigates the influence of health insurance coverage and wealth status on cervical cancer screening use among Namibian women.

Methods:A multilevel regression model was developed using the data of 5,951 women aged 18-49 years from 538 censor codes who participated in the most recent Namibia DHS.

Results: In all, almost 60% of Namibia women have not undergone a Pap smear screening in the recent years. Lack of, health insurance coverage, education, occupation and being poor as well as living in economically deprived neighbourhoods were associated with lack of Pap smear screening uptake.

Conclusion: Pap screening in Namibia is strongly influenced by health insurance status and several socioeconomic variables.

Evaluation of a secondary school violence prevention workshop

Presenter: Madeleine Cochrane, Centre for Public Health, Liverpool John Moores University

Other Author(s): Ellie McCoy, Dr Hannah Timpson, Jim McVeigh

Abstract Text:

Introduction: UK-based evidence on the effectiveness of school-based violence prevention education programmes is limited, in particular evidence on the use of films is insufficient. The charity Stand Against Violence (SAV) delivers a one-hour workshop with the aim of encouraging young people to think about the consequences of violence. The workshop includes a: short 11 minute film, group perspective-taking activity, questions and answers session.

Aim: To evaluate the impact of the SAV workshop on 12-15 year olds' attitudes and behaviour towards violence and to report on pupils' and teachers' satisfaction with the workshop. Design: Data was captured at three time points (pre, post and follow-up) using an attitude and behaviour questionnaire (n=386, schools 1&2). Data from post workshop feedback questionnaires (n= 204, schools 3-5), teacher interviews (n=8, school 1), observations (n=4, school 6) and school incidents data (school 3) were also collected.

Setting: A convenience sample of six secondary schools across the South-West of England took part in the study from March-September 2014.

Results: Both pupils and teachers reported being satisfied with the workshop. A comparison of the attitude and behaviour questionnaires using ANOVA indicated pupils' attitudes and behaviour towards violence improved significantly following the workshop, although this improvement declined slightly after six to eight weeks.

Conclusions: The SAV workshop is easy and suitable to implement in secondary schools with the potential to change young people's attitudes and behaviour towards violence. The long term impact of the workshop on pupils' attitudes and behaviour should be explored.

Annual asthma reviews in adults: Are patients attending them on time?

Presenter: Sargam Vohra, University of Manchester (University Hospital of South Manchester)

Other author(s): None

Abstract Text:

Background:Asthma reviews are helpful in managing patient symptoms and increasing patient quality of life. According to current NICE guidelines, reviews should be carried out at least annually.The high numbers of non-attendance in Sorrell Group Practice need to be improved.

Aim:This audit aims to identify reasons for non-attendance as well as to suggest improvements to increase attendance.

Methods:50 adult patients were randomly selected from a list of 326 asthmatics who had not attended a review in the past 12 months. A telephone consultation was held to identify reasons for non-attendance. Additionally, a questionnaire was created which included the Asthma Control Test to assess asthma status.

Results:The main reasons for non-attendance were absence of invitations by the GP practice(28%) and lack of motivation due to controlled symptoms(20%). This was followed by patients forgetting to book appointments(12%). Some were uninformed that reviews should be done annually (8%). Few were unaware of 'out of work hours' service(6%) as well and home visits(6%). 8% of patients were on a clinical trial and had already undergone a review.

Conclusion:Increasing patient participation and education, personalised asthma action plans and integrated pathways will hopefully increase attendance rates in the future.

Creativity and the co-production of health services: using Ketso as a hands-on tool to gather the views of several hundred service users, providers and carers

Presenter: Joanne Tippett, University of Manchester and Ketso

Other author(s): None