title: Barriers to breast cancer screening in a managed care population.
abstract: OBJECTIVE
  In 2006, Sharp Health Plan (SHP) conducted a campaign to increase mammography screening for at-risk female members that consisted of mailing each eligible member an informational mammography postcard with an appointment tracker. Then came an automated phone call reminder. After the mammography campaign, 70 percent of SHP members sought mammography screening while 30 percent remained nonadherent. SHP decided to conduct a survey to better understand members' barriers to breast cancer screening.
  
  
  METHODS
  A survey based on Prochaska and Velicier's Transtheoretical Model of Change was designed to assess members' behavioral stage and barriers to breast cancer screening.
  
  
  METHODS
  The survey was administered to all nonadherent members via personal phone calls with nearly 50 percent of the nonadherent completing the interview. All quantitative data were examined, and a code book was created to assess additional qualitative data. Findings were further analyzed by stage of change, ethnicity/race, and region of San Diego.
  
  
  RESULTS
  The top three barriers identified were: Mammogram not a priority, Knowledge deficit, and Had a bad experience in the past.
  
  
  CONCLUSIONS
  A common set of mammography barriers was found in the SHP member population. However, when segmented into ethnic, racial, geographic, and behavioral stage groups, various barriers were identified. SHP providers can use this information to develop more tailored interventions and to increase the rate of breast cancer screening for their member population.
authors.affiliation: Sharp Health Plan, USA. sandra.parkington@sharp.com
authors.forename: Sandra R
authors.initials: SR
authors.lastname: Parkington
authors.forename: Nora
authors.initials: N
authors.lastname: Faine
authors.forename: Marcia C
authors.initials: MC
authors.lastname: Nguyen
authors.forename: Michelle T
authors.initials: MT
authors.lastname: Lowry
authors.forename: Poorva A
authors.initials: PA
authors.lastname: Virginkar
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D002140:California; D005260:Female; D006306:Health Surveys; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008329:Managed Care Programs; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D036301:Qualitative Research