title: Promoting mammography adherence in underserved women: the telephone coaching adherence study.
abstract: BACKGROUND
  Despite interventions to promote regular mammography, underserved women face barriers to mammography. This is evident in high no-show appointment rates in community-based clinics. Understanding why women fail to follow-through with appointments may help improve adherence.
  
  
  OBJECTIVE
  We conducted a focus group with women who were non-adherent to mammograms to evaluate psychosocial and structural barriers and design intervention messages. In phase two we conducted a small randomized controlled trial (RCT) to pilot test a brief telephone coaching adherence intervention (vs. control) to address barriers.
  
  
  METHODS
  Eligible women were non-adherent to their mammography screening appointment at a community-based setting. Psychosocial factors and perceptions of barriers were measured via a baseline survey and used to tailor the telephone coaching session. In the RCT, the primary outcome was whether women rescheduled and kept their appointment (yes vs. no). Descriptive statistics were used to summarize the results.
  
  
  RESULTS
  Fifty-four women participated in the study (17 in phase 1 and 31 in phase 2); 89% were Black and 11% were Latina. Overall, prior to the intervention, women had low perceptions of risk (m=4.2; SD=2.4) and cancer worry (m=4.2; SD=2.6) and these characteristics informed the telephone coaching. After the intervention, most women (94.5%) rescheduled their missed appointment. More women in the intervention group kept their appointment (54%) than those in the usual care group (46%).
  
  
  CONCLUSIONS
  It appears feasible to implement a RCT in non-adherent underserved women. Addressing psychosocial and structural barriers in a brief telephone intervention may reduce non-adherence. Future studies that will test the efficacy of this approach are warranted.
authors: Breast Cancer Program, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, 3300 Whitehaven Street NW, Washington, DC 20007, United States. vls3@georgetown.edu
authors: Vanessa B
authors: VB
authors: Sheppard
authors: Judy
authors: J
authors: Huei-yu Wang
authors: Jennifer
authors: J
authors: Eng-Wong
authors: Shiela Harmon
authors: SH
authors: Martin
authors: Alejandra
authors: A
authors: Hurtado-de-Mendoza
authors: George
authors: G
authors: Luta
mesh_terms: D005260:Female; D017144:Focus Groups; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D010865:Pilot Projects; D013689:Telephone; D035862:Vulnerable Populations