title: A randomised trial of weekend and evening breast screening appointments.
abstract: BACKGROUND
  There is a need to research interventions that improve access to and convenience of breast cancer screening services.
  
  
  METHODS
  We conducted a randomised trial comparing invitations to out-of-hours appointments with standard office hour appointments. Women who were to be invited for routine breast screening were randomised (3 : 1 : 1 : 1) to one of these screening invitations: standard office hour appointment, office hour appointment with the option to change to an out-of-hours appointment, weekday evening appointment, or weekend appointment.
  
  
  RESULTS
  A total of 9410 women were invited to an office hour, 3519 to an office hour with the option to change, 3271 to a weekday evening, and 3162 to a weekend appointment. The offer of an initial out-of-hours appointment was associated with a non-significant decrease in attendance rates (73.7% vs 74.1%). The highest attendance was observed in the group offered an initial office hour appointment with the option to change to out-of-hours (76.1% vs 73.3% for standard office hour, P=0.001), with 7% of invitees exercising the option to change.
  
  
  CONCLUSIONS
  The optimum strategy for improving attendance at breast screening is to offer a traditional office hour appointment and including in the letter of invitation an option to change to an evening or weekend appointment if wished.
authors.affiliation: Barts and the London School of Medicine and Dentistry, Queen Mary, University of London, London EC1M 6BQ, UK.
authors.forename: J
authors.initials: J
authors.lastname: Offman
authors.forename: M
authors.initials: M
authors.lastname: Wilson
authors.forename: M
authors.initials: M
authors.lastname: Lamont
authors.forename: H
authors.initials: H
authors.lastname: Birke
authors.forename: E
authors.initials: E
authors.lastname: Kutt
authors.forename: S
authors.initials: S
authors.lastname: Marriage
authors.forename: Y
authors.initials: Y
authors.lastname: Loughrey
authors.forename: S
authors.initials: S
authors.lastname: Hudson
authors.forename: A
authors.initials: A
authors.lastname: Hartley
authors.forename: J
authors.initials: J
authors.lastname: Smith
authors.forename: B
authors.initials: B
authors.lastname: Eckersley
authors.forename: F
authors.initials: F
authors.lastname: Dungey
authors.forename: D
authors.initials: D
authors.lastname: Parmar
authors.forename: J
authors.initials: J
authors.lastname: Patnick
authors.forename: S W
authors.initials: SW
authors.lastname: Duffy
mesh_terms: D000368:Aged; D001071:Appointments and Schedules; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000517:prevention & control*; D055088:Early Detection of Cancer / Q000379:methods* / Q000523:psychology; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008327:Mammography; D008875:Middle Aged