Improving uptake of breast screening in multiethnic populations: a randomised controlled trial using practice reception staff to contact non-attenders

Objectives: To determine whether a two hour training programme for general practice reception staff could improve uptake in patients who had failed to attend for breast screening, and whether women from different ethnic groups benefited equally. Design: Controlled trial, randomised by general practice. Setting: Inner London borough of Newham. Subjects: 2064 women aged 50-64 years who had failed to attend for breast screening. Women came from 26 of 37 eligible practices. 31% were white, 17% were Indian, 10% Pakistani, 14% black, 6% Bangladeshi, 1% Chinese, 4% were from other ethnic groups, and in 16% the ethnic group was not reported. Main outcome measures: Attendance for breast screening in relation to ethnic group in women who had not taken up their original invitation. Results: Attendance in the intervention group was significantly better than in the control group (9% v 4%). The response was best in Indian women-it was 19% in the intervention group and 5% in the control gorup. Conclusions: This simple, low cost intervention improved breast screening rates modestly. Improvement was greatest in Indian women-probably because many practice staff shared their cultural and linguistic background. This intervention could be effective as part of a multifaceted strategy to improve uptake in areas with low rates.