Impact of a telephone counseling intervention on transitions in stage of change and adherence to interval mammography screening (United States).
BACKGROUND
Interventions to improve adherence to regular mammography screening have had conflicting results. Many studies have depended on women's self-report rather than clinical evidence of a mammography encounter.


METHODS
We tested the impact of two interventions on a population-based sample of NH women who were not receiving routine mammography to determine if adherence to screening could be improved. The interventions included a mailing of women's health information and a telephone counseling intervention based on the Transtheoretical Model. Participant eligibility and outcome measures were based on clinical events obtained from a population-based mammography registry.


RESULTS
Two hundred and fifty eight women completed all aspects of the intervention study. The women were randomly assigned to one of two study groups: 51% received the mail intervention and 49% received the telephone intervention. Among women who received the telephone counseling intervention, 67% percent reported being in either an action or maintenance stage at Call 1, which increased to 84% at Call 2 (p<0.001). Seventy-six percent of women identified barriers to screening mammography at Call 1, which decreased to 44% at Call 2 (p<0.01). The most frequently identified barrier was confusion over the guidelines for screening mammography. At the first assessment time interval, greater than 60% of women were up-to-date for screening mammography in the group that received telephone counseling versus 48% in the group that received health information by mail (p = 0.04). However, women's status as up-to-date fell for both groups between the first and second assessment time intervals.


CONCLUSIONS
Tailored telephone counseling based on the Transtheoretical Model can improve adherence to screening mammography, though the duration of this effect is in question.
Carney
Patricia A
PA
Department of Community and Family Medicine, Dartmouth Medical School, Norris Cotton Cancer Center, 1 Medical Center Dr, Lebanon, NH 30756, USA. patricia.a.carney@dartmouth.edu
Harwood
Beth G
BG
Greene
Mary Ann
MA
Goodrich
Martha E
ME
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology; D003376:Counseling; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D013689:Telephone; D013997:Time Factors; D014481:United States / Q000453:epidemiology