title: A randomized trial of breast cancer risk counseling: the impact on self-reported mammography use.
abstract: OBJECTIVE
  We evaluated the impact of individualized breast cancer risk counseling on mammography use among women at risk for breast cancer.
  
  
  METHODS
  Participants (n = 508) were randomized to the breast cancer risk counseling intervention or a general health education control intervention, and 85% completed follow-up.
  
  
  RESULTS
  In multivariate modeling, a significant group-by-education interaction demonstrated that among less-educated participants, breast cancer risk counseling led to reduced mammography use. There was no intervention effect among the more-educated participants.
  
  
  CONCLUSIONS
  These results suggest that standard breast cancer risk counseling could have an adverse impact on the health behaviors of less-educated women.
authors.affiliation: Georgetown University Medical Center/Lombardi Cancer Center, Cancer Genetics, Washington, DC 20007, USA. schwartm@gunet.georgetown.edu
authors.forename: M D
authors.initials: MD
authors.lastname: Schwartz
authors.forename: B K
authors.initials: BK
authors.lastname: Rimer
authors.forename: M
authors.initials: M
authors.lastname: Daly
authors.forename: C
authors.initials: C
authors.lastname: Sands
authors.forename: C
authors.initials: C
authors.lastname: Lerman
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000209:etiology / Q000517:prevention & control*; D003376:Counseling / Q000379:methods*; D004522:Educational Status; D005260:Female; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D015999:Multivariate Analysis; D015397:Program Evaluation; D012307:Risk Factors; D012959:Socioeconomic Factors