Introducing Saturday appointments for Papanicolaou (Pap) tests reduced the number of eligible patients affiliated with Mayo Clinic Community Internal Medicine (CIM) who were overdue for testing, according to research presented at the American Academy of Physician Associates (AAPA) national conference held May 20 to 24, 2023, in Nashville, Tennessee.
The study authors identified 4 main barriers to accessing Pap tests for CIM patients: appointment availability, fear or anxiety, provider demographics, and lack of time.
Prior to the intervention, there were 5239 patients aged 21 to 61 years at CIM who were overdue for a Pap test. By offering Saturday appointments, researchers hoped to address the barriers to appointment availability and lack of time for patients and reduce the number of overdue patients by 1%, bringing the total number of overdue patients down to 5187.
To reach patients in the intervention population, the study authors implemented public and private recruitment strategies including portal messages, social media posts, advertisements, and email blasts.
During the intervention, clinicians completed 62 Pap tests out of 102 initially scheduled appointments. In doing so, the researchers exceeded their goal, as the intervention reduced the number of overdue patients by 1.2% for a total of 5177 patients.
Of the 62 patients, 77.4% who received a Pap test were white, 9.7% identified as African American, 8.1% were of Asian descent, and 4.8% were of other races. Nearly half of patients (48.4%) were aged 51 to 65 years.
Of the 5239 patients in the intervention population, 37.1% had a male primary care provider. Patient concern regarding having a male provider is 1 of the 4 main barriers to Pap test access.
This intervention was successful in working toward the ultimate goal of conducting Pap tests: detecting cervical cancer as early as possible; 3.2% of patients who received a Pap test as part of this intervention had high-risk genital human papillomavirus (HPV).
During their appointments, patients could also receive immunizations and screening for breast cancer and colon cancer.
Forty patients in the intervention population scheduled a Pap test appointment during the study period, but either canceled or did not show up. Of the patients who did not attend their scheduled appointment, 68.2% were white, 9.1% were African American, 18.2% were of Asian descent, and 4.5% were other races.
The researchers considered the initial appointment scheduling process for eligible patients to be successful; however, one shortcoming of this intervention was the lack of ability to quickly connect a patient to an appointment time that opened up suddenly due to a cancellation.
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Francis M, Gertner G, Abdi D, et. al. Saturday pap smear clinic: addressing barriers to women’s health. Presented at: AAPA national conference; May 20-24, 2023; Nashville, TN.