title: Targeted mailed materials and the Medicare beneficiary: increasing mammogram screening among the elderly.
abstract: OBJECTIVE
  Older women have the highest breast cancer rates but are underscreened relative to their risk. Racial/ethnic minority women especially have low screening rates, often because of financial constraints. In response, Medicare introduced subsidized biennial mammogram benefits in 1991. This study examined the effect on mammography rates of an intervention that informed women about the Medicare benefit.
  
  
  METHODS
  A list frame method of subject selection was used to select random samples of eligible women from the Health Care Financing Administration's master beneficiary file. Women were interviewed by telephone in 1991 (N = 917) before the targeted mailing and in 1993 (N = 922). One control and 2 treatment communities participated.
  
  
  RESULTS
  Mammogram use increased significantly among minorities in the treatment groups. Among minorities who received the intervention, Black women were twice as likely (odds ratio = 1.97) and Hispanic women were more than twice as likely (odds ratio = 2.33) to undergo screening relative to their untreated cohorts.
  
  
  CONCLUSIONS
  A targeted low-cost mailed intervention can help increase screening rates among elderly minority women. The Health Care Financing Administration should promote its benefits aggressively if it expects to reach its target--elderly beneficiaries.
authors.affiliation: RAND, 1700 Main St, PO Box 2138, Santa Monica, CA 90407-2138, USA. sarah_fox@rand.org
authors.forename: S A
authors.initials: SA
authors.lastname: Fox
authors.forename: J A
authors.initials: JA
authors.lastname: Stein
authors.forename: R J
authors.initials: RJ
authors.lastname: Sockloskie
authors.forename: M G
authors.initials: MG
authors.lastname: Ory
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D002140:California; D016022:Case-Control Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage; D016015:Logistic Models; D008327:Mammography / Q000191:economics* / Q000706:statistics & numerical data*; D006278:Medicare; D016017:Odds Ratio; D011177:Postal Service; D014481:United States; D044465:White People / Q000706:statistics & numerical data