Costs and cost-effectiveness of a church-based intervention to promote mammography screening.
OBJECTIVE
To evaluate the costs of implementing a church-based, telephone-counseling program for increasing mammography use, and to identify the components of costs and the likely cost-effectiveness in hypothetical communities with varying characteristics.


METHODS
An ethnically and socioeconomically diverse sample of 1,443 women recruited from 45 churches participating in the Los Angeles Mammography Promotion (LAMP) program were followed from 1995 to 1997.


METHODS
Churches were stratified into blocks and randomized into three intervention arms-telephone counseling, mail counseling, and control. We surveyed participants before and after the intervention to collect data on mammography use and demographic characteristics.


METHODS
We used call records, activity reports, and interviews to collect data on the time and materials needed to organize and carry out the intervention. We constructed a standard model of costs and cost-effectiveness based on these data and the Year One results of the LAMP program.


RESULTS
The cost in materials and overhead to the church site was $10.89 per participant and $188 per additional screening. However, when the estimated cost for church volunteers' time was included, the cost of the intervention increased substantially.


CONCLUSIONS
A church-based program to promote the use of mammography would be feasible for many churches with the use of volunteer labor and resources.
Stockdale
S E
SE
RAND, Santa Monica, CA 90407-2138, USA.
Keeler
E
E
Duan
N
N
Derose
K P
KP
Fox
S A
SA
D000368:Aged; D000369:Aged, 80 and over; D002835:Christianity; D003159:Community-Institutional Relations / Q000191:economics*; D003362:Cost-Benefit Analysis; D005240:Feasibility Studies; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006293:Health Promotion / Q000191:economics*; D006302:Health Services Research; D006801:Humans; D015141:Los Angeles; D008327:Mammography / Q000191:economics* / Q000706:statistics & numerical data; D008403:Mass Screening / Q000191:economics*; D008875:Middle Aged; D008913:Minority Groups; D017059:Models, Econometric; D011203:Poverty; D015397:Program Evaluation; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D014932:Women's Health Services / Q000191:economics* / Q000706:statistics & numerical data