Influence of socioeconomic status, ethnicity and an educational brochure on compliance with a postal faecal occult blood test

Abstract

Abstract: The study aimed to determine if socioeconomic status and ethnicity affect compliance with postal faecal occult blood test screening, and if compliance can be increased by adding an educational brochure. A pilot intervention study was used in socioeconomically defined postcodes and defined census collection districts of the Southern Sydney Area Health Service. The study population of men and women aged 45 to 75 years was selected from general practice lists in the defined postcodes. Samples were comparable for age, sex, and socioeconomic indices. Compliance, using a general practitioner letter alone, was: for the Australian middle‐socioeconomic status sample, 65.8 per cent (95 per cent confidence interval (CI) 59.5 to 72.1), the Australian low‐socioeconomic status sample, 63.9 per cent (CI 57.3 to 70.5), the Arabic low‐socioeconomic status sample, 33.3 per cent (CI 27.2 to 39.4). With the general practitioner letter plus brochure, compliance was: Australian middle‐socioeconomic status sample, 67.0 per cent (CI 60.5 to 73.5), Australian low‐socioeconomic status sample, 62.1 per cent (CI 55.3 to 68.9) and Arabic low‐socioeconomic status sample, 36.8 per cent (CI 30.6 to 43.0). Compliance was higher in all Australian samples than in Arabic samples. A brochure, designed to increase compliance with testing, had no significant effect in Australian samples. Australian samples of different socioeconomic status complied almost equally. Results suggest that advice from the local doctor is very effective in motivating patients to screen with faecal occult blood testing. Low compliance to an invitation in Arabic and English in an Arabic low‐socioeconomic status population suggests that low literacy in one or both languages may preclude compliance with screening in this group. 1994 Public Health Association of Australia