title: Telephone counseling and attendance in a national mammography-screening program a randomized controlled trial.
abstract: BACKGROUND
  In Germany, a mammography-screening program (MSP) was implemented on a national level. It complies with all criteria of the European guidelines for quality assurance in screening mammography; however, the attendance rate is 54%, falling short of the target attendance rate of 70%. The aim of this study was to investigate whether additional telephone counseling improves attendance among nonresponders and the level of satisfaction with telephone counseling.
  
  
  METHODS
  In a prospective RCT, women identified as nonresponders in the MSP were randomized to a control group that received written reminders or to an intervention group that additionally received telephone counseling. In a follow-up, a subset of the intervention group was contacted by telephone regarding their satisfaction with telephone counseling.
  
  
  METHODS
  In 2008, a total of 5477 women aged 50-69 years who were eligible for the German MSP but had not participated up to 6 weeks after the first invitation were included in the study.
  
  
  METHODS
  Individual telephone counseling consisted of scripted calls from a trained counselor who provided information on MSP and answered the woman's questions.
  
  
  METHODS
  Report of mammography use provided by the screening unit 3 months after the reminder was sent.
  
  
  RESULTS
  Analysis was conducted in 2009. Comparison of screening attendance revealed a significantly higher attendance rate in the intervention group compared with controls (29.7% vs 26.1%, p=0.0035). When only women for whom telephone numbers were available were analyzed, attendance was even better (35.5% vs 29.7%, p=0.0004). In the follow-up, 278 of 404 women were actually surveyed. Of those, 33% stated that telephone counseling had influenced their decision, 56% stated that they had undergone screening mammography, and 77% agreed that personal telephone counseling should be used routinely to encourage nonresponders to go for screening.
  
  
  CONCLUSIONS
  Individual telephone counseling for nonresponders to a national program for breast cancer screening was well accepted by participants and effective.
  
  
  BACKGROUND
  This study is registered at the Australian New Zealand Clinical Trials Registry ACTRN12611000645954.
authors.affiliation: Department of Diagnostic Radiology and Neuroradiology, Ernst Moritz Arndt University Medical Center Greifswald, Germany. katrin.hegenscheid@uni-greifswald.de
authors.forename: Katrin
authors.initials: K
authors.lastname: Hegenscheid
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hoffmann
authors.forename: Sebastian
authors.initials: S
authors.lastname: Fochler
authors.forename: Martin
authors.initials: M
authors.lastname: Domin
authors.forename: Stefan
authors.initials: S
authors.lastname: Weiss
authors.forename: Birgit
authors.initials: B
authors.lastname: Hartmann
authors.forename: Ulrich
authors.initials: U
authors.lastname: Bick
authors.forename: Norbert
authors.initials: N
authors.lastname: Hosten
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000517:prevention & control*; D003376:Counseling / Q000379:methods*; D055088:Early Detection of Cancer; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000458:organization & administration*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011159:Population Surveillance; D011446:Prospective Studies; D017010:Reminder Systems; D013689:Telephone