title: Evaluation of a community breast screening promotion program.
abstract: BACKGROUND
  This study reports results of a controlled evaluation of a comprehensive community breast screening promotion program. This program promoted increased use of mammography, clinical breast examination, and breast self-examination through community organization, physician training, and public education.
  
  
  METHODS
  The program was conducted in one of three matched Florida study areas, with before and after assessment of breast screening behaviors, beliefs, and perceptions of women ages 40 and older. Baseline measures in 1990 were obtained by combining telephone and household survey data; follow-up measures using similar combined data were conducted with 4,096 women in 1997.
  
  
  RESULTS
  . There was no evidence that the breast screening promotion program achieved higher levels of screening among women ages 40 and older in the program area. Mammography use and supportive beliefs and perceptions of mammography increased in all three study areas between 1990 and 1997.
  
  
  CONCLUSIONS
  Among factors that may have reduced the differential impact of the program were public attention to breast cancer screening in the late 1980s throughout the U.S., effects of managed care, and limited penetration of a key program component. While the program was well received and served the community, its impact was overwhelmed by temporal trends observed in this study.
authors.affiliation: Office of Health Promotion Research, University of Vermont, Burlington 05401, USA. John.Worden@uvm.edu
authors.forename: John K
authors.initials: JK
authors.lastname: Worden
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Mickey
authors.forename: Pamela M
authors.initials: PM
authors.lastname: Vacek
authors.forename: Brian S
authors.initials: BS
authors.lastname: Flynn
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Solomon
authors.forename: Roger H
authors.initials: RH
authors.lastname: Secker-Walker
authors.forename: Joan M
authors.initials: JM
authors.lastname: Skelly
authors.forename: Nicholas L
authors.initials: NL
authors.lastname: Danigelis
authors.forename: Berta M
authors.initials: BM
authors.lastname: Geller
authors.forename: Susan L
authors.initials: SL
authors.lastname: Warner
authors.forename: Robert A
authors.initials: RA
authors.lastname: Clark
authors.forename: Roger S
authors.initials: RS
authors.lastname: Foster
authors.forename: J Luc
authors.initials: JL
authors.lastname: Vezina
authors.forename: Gloria
authors.initials: G
authors.lastname: Hooper
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D016504:Breast Self-Examination; D003153:Community Health Services / Q000458:organization & administration* / Q000592:standards; D005260:Female; D005431:Florida; D019538:Health Care Surveys; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data; D008403:Mass Screening / Q000458:organization & administration* / Q000706:statistics & numerical data; D008875:Middle Aged; D015397:Program Evaluation; D040241:Social Marketing