title: Do vouchers improve breast cancer screening rates? Results from a randomized trial.
abstract: OBJECTIVE
  To determine the effect of a voucher for free mammography on compliance with recommended mammography screening guidelines.
  
  
  METHODS
  Vouchers for free mammography distributed to a random sample of women over the age of 50 in two rural southern Minnesota counties. The vouchers were good for one year. Baseline and follow-up data were collected and rates of compliance with current mammography guidelines were observed for the voucher group and a control group of women living in the same counties.
  
  
  METHODS
  Logistic regression models were used to estimate the effect of the voucher on compliance with mammography guidelines and the impact of factors potentially influencing the effectiveness of the voucher.
  
  
  RESULTS
  The voucher improved mammography rates primarily through increasing screening among women who were out of compliance at baseline.
  
  
  CONCLUSIONS
  Vouchers, even when distributed randomly within a population of rural Midwestern women, can significantly improve compliance rates. Vouchers are no less effective a means of increasing screening among vulnerable women than among other women.
authors.affiliation: Division of Health Services Research, University of Minnesota School of Public Health, Minneapolis 55455-0392, USA.
authors.forename: T J
authors.initials: TJ
authors.lastname: Stoner
authors.forename: B
authors.initials: B
authors.lastname: Dowd
authors.forename: W P
authors.initials: WP
authors.lastname: Carr
authors.forename: G
authors.initials: G
authors.lastname: Maldonado
authors.forename: T R
authors.initials: TR
authors.lastname: Church
authors.forename: J
authors.initials: J
authors.lastname: Mandel
mesh_terms: D000328:Adult; D000368:Aged; D000383:Agriculture; D001943:Breast Neoplasms / Q000517:prevention & control*; D005260:Female; D005378:Financial Support; D019983:Guideline Adherence; D017048:Health Care Costs; D006801:Humans; D008327:Mammography / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D009042:Motivation; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010349:Patient Compliance; D019035:Rural Health Services / Q000191:economics / Q000706:statistics & numerical data*