title: The effectiveness of mammography promotion by volunteers in rural communities.
abstract: BACKGROUND
  The Community Trial of Mammography Promotion assessed the effectiveness of mammography promotion by community volunteer groups in rural areas. Three interventions were tested. One used an individual counseling strategy, one used a community activities strategy, and a third combined the two strategies.
  
  
  METHODS
  The effects of the interventions were tested by randomizing 40 communities either to the study interventions or to a control group. A cohort of 352 women from each community was randomly selected and used to evaluate the interventions' effectiveness. Of these, 6592 women were eligible for screening mammography at baseline and follow-up and were successfully interviewed prior to and after study intervention activities.
  
  
  RESULTS
  Although the interventions did not significantly increase women's overall use of mammography, the community activities intervention increased use at follow-up by regular users over baseline by 2.9% (p = 0.01). Intervention appears to have increased the use of mammography among certain groups of women who were not regular users at baseline, including those in communities without female physicians (10% to 16%; p < 0.05), and among women with no health insurance (10% to 23%; p </= 0.05).
  
  
  CONCLUSIONS
  Volunteers can effectively promote mammography in rural communities.
authors.affiliation: Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center (Andersen, Yasui, Kuniyuki, Etzioni, Urban), Seattle, Washington 98109-1024, USA. Rander@FHCRC.ORG
authors.forename: M R
authors.initials: MR
authors.lastname: Andersen
authors.forename: Y
authors.initials: Y
authors.lastname: Yasui
authors.forename: H
authors.initials: H
authors.lastname: Meischke
authors.forename: A
authors.initials: A
authors.lastname: Kuniyuki
authors.forename: R
authors.initials: R
authors.lastname: Etzioni
authors.forename: N
authors.initials: N
authors.lastname: Urban
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000517:prevention & control*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D015397:Program Evaluation; D012424:Rural Population; D014861:Washington