Augmentation of Pap smear screening of high risk Aboriginal women: use of a computerised process tool within the Broome Aboriginal Medical Service

Objective: The Broome Regional Aboriginal Medical Service (BRAMS) in Broome, Western Australia, conducted a 4 month program to augment the Pap smear screening of Aboriginal women. The emphasis was on those with a past history of abnormal smears, aged greater than 40 years, living in remote communities and very (more than 5 years) overdue. Method: Continuation of existing opportunistic recall processes supplemented by three components: the development of an Aboriginal Health Worker (AHW) run Pap smear clinic; the provision of Aboriginal outstation screening; and active recruitment of targeted women (by AHW staff) using worklists. All components used Healthplanner, a computerised process tool to facilitate targeting and recall. Main Outcome Measures: The number of Pap smears taken from the target groups before and after intervention and the proportion screened from the women eligible in each target group at the start of the program. Results: There was statistically significant increase in the coverage of Aboriginal women overall, those over the age of 40 years, and those from remote communities when compared with the same period the previous years. In 4 months, 21-30% of Aboriginal women eligible for Pap smears in these high risk categories including those with past abnormal smears were screened. Over-screening of women did not occur as only 4% of smears taken were from women screened less than 12 months previously. Smears taken by AHW staff were of high quality. Conclusion: Use of a computerised process tool in a remote setting can facilitate selective recruitment of high risk women overdue for Pap smears