Cancer causes & control : CCC [Cancer Causes Control] 2005 Sep; Vol. 16 (7), pp. 799-807.
Adult, Aged, Breast Neoplasms epidemiology, Female, Follow-Up Studies, Health Promotion, Humans, Middle Aged, Patient Education as Topic, Time Factors, United States epidemiology, Breast Neoplasms diagnostic imaging, Counseling, Mammography, Patient Compliance statistics numerical data, and Telephone
Background: Interventions to improve adherence to regular mammography screening have had conflicting results. Many studies have depended on women's self-report rather than clinical evidence of a mammography encounter. Methods: We tested the impact of two interventions on a population-based sample of NH women who were not receiving routine mammography to determine if adherence to screening could be improved. The interventions included a mailing of women's health information and a telephone counseling intervention based on the Transtheoretical Model. Participant eligibility and outcome measures were based on clinical events obtained from a population-based mammography registry. Results: Two hundred and fifty eight women completed all aspects of the intervention study. The women were randomly assigned to one of two study groups: 51% received the mail intervention and 49% received the telephone intervention. Among women who received the telephone counseling intervention, 67% percent reported being in either an action or maintenance stage at Call 1, which increased to 84% at Call 2 (p<0.001). Seventy-six percent of women identified barriers to screening mammography at Call 1, which decreased to 44% at Call 2 (p<0.01). The most frequently identified barrier was confusion over the guidelines for screening mammography. At the first assessment time interval, greater than 60% of women were up-to-date for screening mammography in the group that received telephone counseling versus 48% in the group that received health information by mail (p = 0.04). However, women's status as up-to-date fell for both groups between the first and second assessment time intervals. Conclusions: Tailored telephone counseling based on the Transtheoretical Model can improve adherence to screening mammography, though the duration of this effect is in question.