title: Enhancing compliance with screening mammography recommendations: a clinical trial in a primary care office.
abstract: OBJECTIVE
  Despite consensus that screening mammography is an appropriate preventive tool, many women do not receive this examination. This study was undertaken to evaluate the relative efficacy and cost-effectiveness of three interventions designed to increase mammography rates.
  
  
  METHODS
  A total of 151 women, aged 50-59, were randomized into four groups: control, physician telephone call, medical assistant telephone call, and physician letter.
  
  
  RESULTS
  The women in the medical assistant telephone call group (16 of 37 = 43%) and the physician telephone call group (11 of 38 = 29%) responded significantly better than those in the control group (4 of 38 = 11%) (P < .05). None of the 10 widows in the entire study obtained a mammogram, compared with 38 of 141 (27%) women in all other marital groups (P < .05). The cost per intervention and cost per mammogram obtained were, respectively, physician telephone call: $15, $51.82; physician letter: $2.50, $13.57; medical assistant call: $1.30, $3.
  
  
  CONCLUSIONS
  Medical assistant telephone callers are a cost-effective strategy to encourage mammography adherence. Widows appear particularly resistant to all screening mammography interventions.
authors.affiliation: Family Physicians of Western Colorado, Grand Junction, USA.
authors.forename: P J
authors.initials: PJ
authors.lastname: Mohler
mesh_terms: D001071:Appointments and Schedules; D015709:Correspondence as Topic; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007348:Insurance, Health; D008327:Mammography / Q000191:economics / Q000706:statistics & numerical data*; D008875:Middle Aged; D010349:Patient Compliance; D010818:Practice Patterns, Physicians'; D017010:Reminder Systems / Q000191:economics; D013689:Telephone