Abstract
Background
The main benefits of mammography come from regular on-schedule screening. However,
few studies have examined interventions to achieve repeat screening.
Setting and participants
Participants were women aged 50 to 74, recruited through one setting in Rhode Island
and another in North Carolina. Participants had a mammogram already scheduled at recruitment,
and had to keep that appointment in order to be eligible for the repeat mammography
intervention. A total of 1614 women were in the intervention sample.
Design
A four-group randomized design was used: Group 1, a simple reminder letter; Group
2, a 2-month, tailored, stepped intervention delivered 2 months after the completed
mammogram; Group 3, a 10-month, tailored, stepped intervention delivered 2 months
before the repeat mammogram was due; and Group 4, self-choice of one of the above
three strategies.
Intervention
The intervention took place between June 1996 and May 1997. The reminder letter and
two levels of the stepped intervention were delivered by mail. The third level of
the stepped strategy was a counselor telephone call. Groups 2 and 3 were identical,
except for timing.
Outcome measure
Obtaining the next due mammogram within 15 months, based on clinic records.
Results
There were no statistically significant differences among the four groups, both in
the total sample and at the two sites separately.
Conclusions
On average, a simple reminder may be as effective as more complex strategies for women
with a prior on-schedule exam. However, attention is still needed to identify women
at risk of lapsing from screening. Some women may require more-intensive interventions.
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© 2003 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
