Method: Small randomised trial of reminder letter vs phone call/ SMS for routine cervical screening testing, in an Aboriginal Community Controlled Medical Service in NSW.
Results: 256 women aged between 25 and 74 who were current patients and had current reminders due for cervical screening were included, and were randomised to either receive a reminder letter (and up to two further letters if they did not respond) or phone call (followed by up to two SMS) to attend for screening. 24 women (17.6%) attended for CST within 3 months after a phone call or SMS reminder, compared to 15 women (12.5%) following a letter, although this difference was not significant (p=0.252). The time spent on phone calls/ SMS vs letters by staff was similar, although costs for letter printing and mailing was more than the cost of phone call or SMS.
Discussion: Overall, the response to reminders was lower than expected. Choice of reminder type should be left to service preference. Automated SMS appeared to be the most cost-efficient recall and likely to be the most time efficient. Manual reminder systems were time consuming for staff. A number of women were not contactable due to lack of up to date address or phone number. Women who did not respond to three reminders were not likely to respond to further reminder attempts.
Implications for practice: Opportunistic care should be used to remind women about the benefits of cervical screening. While there was no significant difference in effectiveness in letter vs phone call / SMS for cervical screening recalls, reminder systems can still play a role in encouraging women to participate in screening programs, in conjunction with national screening registers and reminder systems.