Promoting mammography: results of a randomized trial of telephone counseling and a medical practice intervention.
Am J Prev Med
; 19(1): 39-46, 2000 Jul.
Article
em En
| MEDLINE
| ID: mdl-10865162
ABSTRACT
BACKGROUND:
Despite widespread promotion of mammography screening, a distinct minority of women have remained underusers of this effective preventive measure. We sought to measure the effects of barrier-specific telephone counseling (BSTC) and a physician-based educational intervention (MD-ED) on mammography utilization among underusers of mammography screening.DESIGN:
This was a randomized controlled trial. Women meeting criteria for mammography underuse at baseline (grouped by practice affiliation) were randomized to a reminder control condition (RC group received annual mailed reminders), BSTC or MD-ED interventions and followed for 3 years. Underuse was defined by failure to get two annual or biannual mammograms over a 2- to 4-year period prior to a baseline survey. PARTICIPANTS ANDSETTING:
The study included 1655 female underusers of mammography aged 50-80 years who were members of two health maintenance organizations (HMO) in central Massachusetts.INTERVENTIONS:
BSTC consisted of periodic brief, scripted calls from trained counselors to women who had not had a mammogram in the preceding 15 months. Women could receive up to three annual calls during the study. MD-ED consisted of physician and office staff trainings aimed at improving counseling skills and office reminder systems. MAIN OUTCOMEMEASURE:
Self-report of mammography use during the study period was the main outcome measure. Regular use was defined as > or =1 mammogram every 24 months.RESULTS:
Forty-four percent in each intervention group became regular users compared to 42% in the RC group. Among subjects who had prior but not recent mammograms at baseline, BSTC was effective (OR=1.48; 95% CI=1.04; 2. 10), and MD-ED marginally effective (OR=1.28; 95% CI=0.88, 1.85). Most recent users at baseline and few never users became regular users (61% and 17%, respectively) regardless of intervention status.CONCLUSIONS:
Among mammography underusers BSTC modestly increases utilization for former users at a reasonable cost ($726 per additional regular user).
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Mamografia
/
Aconselhamento
/
Promoção da Saúde
Tipo de estudo:
Clinical_trials
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Ano de publicação:
2000
Tipo de documento:
Article