title: Intervention to increase mammography utilization in a public hospital.
abstract: OBJECTIVE
  To study the effects of three approaches to increasing utilization of screening mammography in a public hospital setting in Northwest Louisiana.
  
  
  METHODS
  Randomized intervention study.
  
  
  METHODS
  Four hundred forty-five women aged 40 years and over, predominantly low-income and with low literacy skills, who had not had a mammogram in the preceding year.
  
  
  METHODS
  All interventions were chosen to motivate women to get a mammogram. Group 1 received a personal recommendation from one of the investigators. Group 2 received the recommendation plus an easy-to-read National Cancer Institute (NCI) brochure. Group 3 received the recommendation, the brochure, and a 12-minute interactive educational and motivational program, including a soap-opera-style video, developed in collaboration with women from the target population.
  
  
  RESULTS
  Mammography utilization was determined at 6 months and 2 years after intervention. A significant increase (p = .05) in mammography utilization was observed after the intervention designed in collaboration with patients (29%) as compared with recommendation alone (21%) or recommendation with brochure (18%) at 6 months. However, at 2 years the difference favoring the custom-made intervention was no longer significant.
  
  
  CONCLUSIONS
  At 6 months there was at least a 30% increase in the mammography utilization rate in the group receiving the intervention designed in collaboration with patients as compared with those receiving the recommendation alone or recommendation with brochure. Giving patients an easy-to-read NCI brochure and a personal recommendation was no more effective than giving them a recommendation alone, suggesting that simply providing women in a public hospital with a low-literacy-level, culturally appropriate brochure is not sufficient to increase screening mammography rates. In a multivariate analysis, the only significant predictor of mammography use at 6 months was the custom-made intervention.
authors.affiliation: Department of Internal Medicine, Louisiana State University Medical Center School of Medicine in Shreveport, 71130-3932, USA.
authors.forename: T C
authors.initials: TC
authors.lastname: Davis
authors.forename: H J
authors.initials: HJ
authors.lastname: Berkel
authors.forename: C L
authors.initials: CL
authors.lastname: Arnold
authors.forename: I
authors.initials: I
authors.lastname: Nandy
authors.forename: R H
authors.initials: RH
authors.lastname: Jackson
authors.forename: P W
authors.initials: PW
authors.lastname: Murphy
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D008145:Louisiana; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D010353:Patient Education as Topic