title: Proactive screening mammography counseling within the Cancer Information Service: results from a randomized trial.
abstract: In 1987, the Division of Cancer Prevention and Control, National Cancer Institute (NCI), funded a randomized trial of a proactive counseling protocol to promote screening mammography among age-eligible female callers to the Cancer Information Service (CIS). This protocol included interactive counseling by CIS counselors to help callers overcome barriers to screening mammography; this counseling was an extension of usual service and was combined with a 2-week follow-up mailout to reinforce the brief (6-minute) proactive telephone-counseling protocol. The screening-mammography counseling intervention was tested in two regional CIS offices using a randomized two-group design. Callers were randomly assigned to the intervention or control group based on the week of their call to the CIS (n = 1831 eligible female callers). Self-reported adherence to NCI screening-mammography guidelines was assessed from telephone interviews conducted at 12 months' follow-up (87% response rate). Among all CIS callers enrolled in this study, self-reported adherence to screening-mammography guidelines at 12 months' follow-up was 63.5%. The most frequently cited barriers to screening mammography reported by CIS callers were inconvenience/being too busy (52%), cost (36%), lack of physician referral (34%), no symptoms (34%), and fear of radiation (29%). A significant intervention effect on adherence behavior was found but only in one of the two test sites and only among CIS callers reporting total family income of $30,000 or more (odds ratio = 1.38, P = .04). The vast majority (90%) of CIS callers (both intervention and control subjects) endorsed the concept of proactive counseling by the CIS. The implications of these findings for the CIS and future research are discussed.
authors.affiliation: AMC Cancer Research Center, Denver, CO 80214.
authors.forename: A C
authors.initials: AC
authors.lastname: Marcus
authors.forename: R
authors.initials: R
authors.lastname: Bastani
authors.forename: K
authors.initials: K
authors.lastname: Reardon
authors.forename: S
authors.initials: S
authors.lastname: Karlins
authors.forename: I P
authors.initials: IP
authors.lastname: Das
authors.forename: M P
authors.initials: MP
authors.lastname: Van Herle
authors.forename: M W
authors.initials: MW
authors.lastname: McClatchey
authors.forename: L A
authors.initials: LA
authors.lastname: Crane
mesh_terms: D000328:Adult; D000368:Aged; D003376:Counseling; D005260:Female; D006801:Humans; D007255:Information Services; D008327:Mammography; D008403:Mass Screening; D008495:Medical Oncology / Q000193:education*; D008875:Middle Aged