title: Comparative effectiveness of mailed reminder letters on mammography screening compliance.
abstract: OBJECTIVE
  Reminder letters are effective at prompting women to schedule mammograms. Less well studied are reminders addressing multiple preventive service recommendations. We compared the effectiveness of a mammogram-specific reminder sent when a woman was due for a mammogram to a reminder letter addressing multiple preventive services and sent on a woman's birthday on mammography receipt.
  
  
  METHODS
  The study included 48,583 women 52-74 years enrolled in Group Health Cooperative, a health plan in Washington State. From 2005 to 2009, women were mailed 88,605 mammogram-specific or birthday letters. In this one group pretest-posttest study, we modeled the odds of obtaining a screening mammogram after receiving a letter by reminder type using logistic regression, controlling for demographic and healthcare use characteristics and stratifying by whether women were overdue or up-to-date with mammography at the mailing.
  
  
  RESULTS
  Among women up-to-date with screening, birthday letters were negatively associated with mammography receipt compared to mammogram-specific letters (birthday letters with 1-2 recommendations: OR=0.73; 95% CI:0.68-0.79; 3 recommendations: OR=0.74; 95% CI:0.69-0.78; 4-8 recommendations: OR=0.62 95% CI:0.55-0.68) after. Among overdue women, birthday letters with 4-8 recommendations were negatively associated with mammography receipt.
  
  
  CONCLUSIONS
  Transitioning from mammogram-specific reminder letters to multiple preventive service birthday letters was associated with decreased mammography receipt.
authors.affiliation: RTI International, 3040 E. Cornwallis Rd, Research Triangle Park, NC 27709, USA. mromaire@rti.org
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Romaire
authors.forename: Erin J Aiello
authors.initials: EJ
authors.lastname: Bowles
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Anderson
authors.forename: Diana S M
authors.initials: DS
authors.lastname: Buist
mesh_terms: D000368:Aged; D000846:Anniversaries and Special Events; D001943:Breast Neoplasms / Q000175:diagnosis*; D057186:Comparative Effectiveness Research; D015709:Correspondence as Topic; D004954:Esthetics; D005260:Female; D006801:Humans; D016015:Logistic Models; D008327:Mammography / Q000523:psychology*; D008403:Mass Screening / Q000523:psychology* / Q000706:statistics & numerical data; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D011177:Postal Service; D011314:Preventive Health Services / Q000379:methods; D012054:Reinforcement, Psychology; D017010:Reminder Systems; D014861:Washington