Comparison of three interventions to increase mammography screening in low income African American women.
BACKGROUND
Low-income African American women are more likely to die of breast cancer than their Caucasian counterparts, and at least part of the difference in mortality results from differential screening adherence. The purpose of this study was to identify more efficacious methods of promoting routine mammography screening in underserved populations.


METHODS
A prospective randomized intervention study of 344 low income African American women compared the impact of three interventions on mammography adherence and stage of readiness: (1) pamphlet only; (2) culturally appropriate video; and (3) interactive computer-assisted instruction program.


RESULTS
The interactive computer intervention program produced the greatest level of adherence to mammography (40.0%) compared to the video group (24.6%) and the pamphlet group (32.1%). When subjects in the pamphlet and video groups were combined to form a non-interactive group, this group had a significantly lower adherence than the group who received the interactive computer intervention (27.0% versus 40.0%). There was also significantly more forward movement in mammography stage of readiness among participants in the computer group (52.0%) compared to those in the pamphlet group (46.4%) or the video group (31.3%). When combining the non-interactive technology (pamphlet and video) there was also more forward movement in mammography stage of readiness for those in the interactive intervention group (52.0% moved 1 or 2 stages) compared to those in the non-interactive group (36.2%).


CONCLUSIONS
These data indicate that tailored approaches are more effective than targeted messages either in print or video format. Another finding of this study is that interactive interventions are more effective than non-interactive interventions in increasing adherence and moving African American women forward in their mammogram stage of readiness.
Champion
Victoria L
VL
Center for Research and Scholarship, Indiana University School of Nursing, Indianapolis, IN, USA. vchampio@iupui.edu
Springston
Jeffrey K
JK
Zollinger
Terry W
TW
Saywell
Robert M
RM
Monahan
Patrick O
PO
Zhao
Qianqian
Q
Russell
Kathleen M
KM
D000328:Adult; D001741:Black or African American / Q000523:psychology; D000368:Aged; D001294:Attitude to Health / Q000208:ethnology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000208:ethnology*; D003194:Computer-Assisted Instruction; D005260:Female; D006801:Humans; D008327:Mammography / Q000523:psychology / Q000706:statistics & numerical data*; D008403:Mass Screening; D008507:Medically Underserved Area; D008875:Middle Aged; D010174:Pamphlets; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D010353:Patient Education as Topic / Q000379:methods*; D011446:Prospective Studies; D012923:Social Class; D014741:Video Recording