title: Improving breast self-examination compliance: a Southwest Oncology Group randomized trial of three interventions.
abstract: BACKGROUND
  Only 20-40% of U.S. women conduct breast self-examination (BSE). This Southwest Oncology Group experimental study compared the impact of three interventions on BSE compliance.
  
  
  METHODS
  Subjects were randomly assigned to one of three arms: (1) physician message; (2) physician message and BSE class; or (3) physician message, BSE class, and reinforcement (phone and postcard). Compliance (frequency and accuracy) was measured by interview at intake and at 6 months and by phone contact at 1 year. Logistic and multiple regression were employed.
  
  
  RESULTS
  This analysis included 2,233 subjects from six institutions. At 1 year the percentages of women doing BSE were 59, 62, and 78% for Arms 1-3, respectively; gains over intake frequency (27% average) were significant within each arm (P < or = 0.0001). At both 6 months and 1 year the differences between Arm 1 and Arm 2 average accuracy scores and the differences between Arm 2 and Arm 3 in the percentage of women doing BSE were significant (P < or = 0.0001). Findings within institutions were consistent with the overall findings.
  
  
  CONCLUSIONS
  The addition of a BSE class increased accuracy over physician message alone; physician message, BSE class, and reinforcement gave the highest percentage of women doing BSE.
authors.affiliation: University of Washington School of Nursing, Seattle 98195, USA.
authors.forename: C J
authors.initials: CJ
authors.lastname: Strickland
authors.forename: P
authors.initials: P
authors.lastname: Feigl
authors.forename: C
authors.initials: C
authors.lastname: Upchurch
authors.forename: D K
authors.initials: DK
authors.lastname: King
authors.forename: H I
authors.initials: HI
authors.lastname: Pierce
authors.forename: P K
authors.initials: PK
authors.lastname: Grevstad
authors.forename: J D
authors.initials: JD
authors.lastname: Bearden
authors.forename: M
authors.initials: M
authors.lastname: Dawson
authors.forename: W C
authors.initials: WC
authors.lastname: Loewen
authors.forename: F L
authors.initials: FL
authors.lastname: Meyskens
mesh_terms: D000328:Adult; D000367:Age Factors; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000517:prevention & control / Q000523:psychology; D016504:Breast Self-Examination / Q000706:statistics & numerical data*; D016009:Chi-Square Distribution; D005260:Female; D006266:Health Education / Q000379:methods / Q000592:standards*; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D010349:Patient Compliance; D010352:Patient Dropouts; D010819:Physician's Role; D015397:Program Evaluation; D011446:Prospective Studies; D011582:Psychological Theory; D012054:Reinforcement, Psychology; D016896:Treatment Outcome; D014481:United States; D016387:Women's Health