Program spending to increase adherence: South African cervical cancer screening

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dc.contributor.authorGoldhaber-Fiebert, Jeremy Den_ZA
dc.contributor.authorDenny, Lynette Aen_ZA
dc.contributor.authorDe Souza, Michelleen_ZA
dc.contributor.authorKuhn, Louiseen_ZA
dc.contributor.authorGoldie, Sue Jen_ZA
dc.date.accessioned2016-01-11T06:53:14Z
dc.date.available2016-01-11T06:53:14Z
dc.date.issued2009en_ZA
dc.description.abstractBackground: Adherence is crucial for public health program effectiveness, though the benefits of increasing adherence must ultimately be weighed against the associated costs. We sought to determine the relationship between investment in community health worker (CHW) home visits and increased attendance at cervical cancer screening appointments in Cape Town, South Africa. M ethodology/Principal Findings: We conducted an observational study of 5,258 CHW home visits made in 2003-4 as part of a community-based screening program. We estimated the functional relationship between spending on these visits and increased appointment attendance (adherence). Increased adherence was noted after each subsequent CHW visit. The costs of making the CHW visits was based on resource use including both personnel time and vehicle-related expenses valued in 2004 Rand. The CHW program cost R194,018, with 1,576 additional appointments attended. Adherence increased from 74% to 90%; 55% to 87%; 48% to 77%; and 56% to 80% for 6-, 12-, 24-, and 36-month appointments. Average per-woman costs increased by R14-R47. The majority of this increase occurred with the first 2 CHW visits (90%, 83%, 74%, and 77%; additional cost: R12-R26). Conclusions/Significance: We found that study data can be used for program planning, identifying spending levels that achieve adherence targets given budgetary constraints. The results, derived from a single disease program, are retrospective, and should be prospectively replicated.en_ZA
dc.identifier.apacitationGoldhaber-Fiebert, J. D., Denny, L. A., De Souza, M., Kuhn, L., & Goldie, S. J. (2009). Program spending to increase adherence: South African cervical cancer screening. <i>PLoS One</i>, http://hdl.handle.net/11427/16266en_ZA
dc.identifier.chicagocitationGoldhaber-Fiebert, Jeremy D, Lynette A Denny, Michelle De Souza, Louise Kuhn, and Sue J Goldie "Program spending to increase adherence: South African cervical cancer screening." <i>PLoS One</i> (2009) http://hdl.handle.net/11427/16266en_ZA
dc.identifier.citationGoldhaber-Fiebert, J. D., Denny, L. A., De Souza, M., Kuhn, L., & Goldie, S. J. (2009). Program spending to increase adherence: South African cervical cancer screening. PloS one, 4(5), e5691. doi:10.1371/journal.pone.0005691en_ZA
dc.identifier.ris TY - Journal Article AU - Goldhaber-Fiebert, Jeremy D AU - Denny, Lynette A AU - De Souza, Michelle AU - Kuhn, Louise AU - Goldie, Sue J AB - Background: Adherence is crucial for public health program effectiveness, though the benefits of increasing adherence must ultimately be weighed against the associated costs. We sought to determine the relationship between investment in community health worker (CHW) home visits and increased attendance at cervical cancer screening appointments in Cape Town, South Africa. M ethodology/Principal Findings: We conducted an observational study of 5,258 CHW home visits made in 2003-4 as part of a community-based screening program. We estimated the functional relationship between spending on these visits and increased appointment attendance (adherence). Increased adherence was noted after each subsequent CHW visit. The costs of making the CHW visits was based on resource use including both personnel time and vehicle-related expenses valued in 2004 Rand. The CHW program cost R194,018, with 1,576 additional appointments attended. Adherence increased from 74% to 90%; 55% to 87%; 48% to 77%; and 56% to 80% for 6-, 12-, 24-, and 36-month appointments. Average per-woman costs increased by R14-R47. The majority of this increase occurred with the first 2 CHW visits (90%, 83%, 74%, and 77%; additional cost: R12-R26). Conclusions/Significance: We found that study data can be used for program planning, identifying spending levels that achieve adherence targets given budgetary constraints. The results, derived from a single disease program, are retrospective, and should be prospectively replicated. DA - 2009 DB - OpenUCT DO - 10.1371/journal.pone.0005691 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2009 T1 - Program spending to increase adherence: South African cervical cancer screening TI - Program spending to increase adherence: South African cervical cancer screening UR - http://hdl.handle.net/11427/16266 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/16266
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0005691
dc.identifier.vancouvercitationGoldhaber-Fiebert JD, Denny LA, De Souza M, Kuhn L, Goldie SJ. Program spending to increase adherence: South African cervical cancer screening. PLoS One. 2009; http://hdl.handle.net/11427/16266.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentInstitute of Infectious Disease and Molecular Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2009 Goldhaber-Fiebert et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherCervical canceren_ZA
dc.subject.otherCancer screeningen_ZA
dc.subject.otherHealth screeningen_ZA
dc.subject.otherSouth Africaen_ZA
dc.subject.otherCell phonesen_ZA
dc.subject.otherFuelsen_ZA
dc.subject.otherScreening guidelinesen_ZA
dc.subject.otherPublic and occupational healthen_ZA
dc.titleProgram spending to increase adherence: South African cervical cancer screeningen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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