Comparison of tailored interventions to increase mammography screening in nonadherent older women.
BACKGROUND
Recent increases in mammography use have led to a decrease in mortality from breast cancer.


METHODS
Building on the Health Belief Model, the Transtheoretical Model, and past effectiveness of tailored interventions, we conducted a prospective randomized trial (n = 773) to test the efficacy on mammography adherence of tailored interventions delivered by five different methods, i.e., telephone counseling, in-person counseling, physician letter, and combinations of telephone with letter and in-person with letter.


RESULTS
All five interventions increased mammography adherence significantly relative to usual care (odds ratios, 1.93 to 3.55) at 6 months post intervention. The combination of in-person with physician letter was significantly more effective than telephone alone or letter alone. Women thinking about getting a mammogram at baseline were more likely to be adherent by 6 months; even those in usual care achieved 48% adherence compared with 50-70% in the intervention groups. In contrast, women not thinking about getting a mammogram needed the interventions to increase their adherence from 13% to over 30%.


CONCLUSIONS
All five interventions were effective at increasing mammography adherence. Women not thinking about getting a mammogram were most likely to benefit from these tailored interventions while other women might need less intensive interventions.
Champion
Victoria
V
Indiana University School of Nursing, 1111 Middle Drive, Indianapolis, IN 46202, USA. vchampio@iupui.edu
Maraj
Maltie
M
Hui
Siu
S
Perkins
Anthony J
AJ
Tierney
William
W
Menon
Usha
U
Skinner
Celette Sugg
CS
D001943:Breast Neoplasms / Q000175:diagnosis*; D004522:Educational Status; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007182:Income; D016015:Logistic Models; D008327:Mammography; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D012307:Risk Factors