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dc.contributor.authorCostanza, Mary E.
dc.contributor.authorStoddard, Anne M.
dc.contributor.authorLuckmann, Roger S.
dc.contributor.authorWhite, Mary Jo
dc.contributor.authorAvrunin, Jill S.
dc.contributor.authorClemow, Lynn
dc.date2022-08-11T08:11:04.000
dc.date.accessioned2022-08-23T17:30:57Z
dc.date.available2022-08-23T17:30:57Z
dc.date.issued2000-06-24
dc.date.submitted2007-07-30
dc.identifier.citation<p>Am J Prev Med. 2000 Jul;19(1):39-46.</p>
dc.identifier.issn0749-3797 (Print)
dc.identifier.doi10.1016/S0749-3797(00)00150-1
dc.identifier.pmid10865162
dc.identifier.urihttp://hdl.handle.net/20.500.14038/50623
dc.description.abstractBACKGROUND: Despite widespread promotion of mammography screening, a distinct minority of women have remained underusers of this effective preventive measure. We sought to measure the effects of barrier-specific telephone counseling (BSTC) and a physician-based educational intervention (MD-ED) on mammography utilization among underusers of mammography screening. DESIGN: This was a randomized controlled trial. Women meeting criteria for mammography underuse at baseline (grouped by practice affiliation) were randomized to a reminder control condition (RC group received annual mailed reminders), BSTC or MD-ED interventions and followed for 3 years. Underuse was defined by failure to get two annual or biannual mammograms over a 2- to 4-year period prior to a baseline survey. PARTICIPANTS AND SETTING: The study included 1655 female underusers of mammography aged 50-80 years who were members of two health maintenance organizations (HMO) in central Massachusetts. INTERVENTIONS: BSTC consisted of periodic brief, scripted calls from trained counselors to women who had not had a mammogram in the preceding 15 months. Women could receive up to three annual calls during the study. MD-ED consisted of physician and office staff trainings aimed at improving counseling skills and office reminder systems. MAIN OUTCOME MEASURE: Self-report of mammography use during the study period was the main outcome measure. Regular use was defined as > or =1 mammogram every 24 months. RESULTS: Forty-four percent in each intervention group became regular users compared to 42% in the RC group. Among subjects who had prior but not recent mammograms at baseline, BSTC was effective (OR=1.48; 95% CI=1.04; 2. 10), and MD-ED marginally effective (OR=1.28; 95% CI=0.88, 1.85). Most recent users at baseline and few never users became regular users (61% and 17%, respectively) regardless of intervention status. CONCLUSIONS: Among mammography underusers BSTC modestly increases utilization for former users at a reasonable cost ($726 per additional regular user).
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10865162&dopt=Abstract">Link to article in PubMed</a></p>
dc.relation.urlhttp://dx.doi.org/10.1016/S0749-3797(00)00150-1
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectCost-Benefit Analysis
dc.subject*Counseling
dc.subjectEffect Modifiers (Epidemiology)
dc.subjectFemale
dc.subjectHealth Promotion
dc.subjectHumans
dc.subjectMammography
dc.subjectMassachusetts
dc.subjectMiddle Aged
dc.subjectTelephone
dc.subjectLife Sciences
dc.subjectMedicine and Health Sciences
dc.subjectWomen's Studies
dc.titlePromoting mammography: results of a randomized trial of telephone counseling and a medical practice intervention
dc.typeJournal Article
dc.source.journaltitleAmerican journal of preventive medicine
dc.source.volume19
dc.source.issue1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/wfc_pp/151
dc.identifier.contextkey330387
html.description.abstract<p>BACKGROUND: Despite widespread promotion of mammography screening, a distinct minority of women have remained underusers of this effective preventive measure. We sought to measure the effects of barrier-specific telephone counseling (BSTC) and a physician-based educational intervention (MD-ED) on mammography utilization among underusers of mammography screening.</p> <p>DESIGN: This was a randomized controlled trial. Women meeting criteria for mammography underuse at baseline (grouped by practice affiliation) were randomized to a reminder control condition (RC group received annual mailed reminders), BSTC or MD-ED interventions and followed for 3 years. Underuse was defined by failure to get two annual or biannual mammograms over a 2- to 4-year period prior to a baseline survey.</p> <p>PARTICIPANTS AND SETTING: The study included 1655 female underusers of mammography aged 50-80 years who were members of two health maintenance organizations (HMO) in central Massachusetts.</p> <p>INTERVENTIONS: BSTC consisted of periodic brief, scripted calls from trained counselors to women who had not had a mammogram in the preceding 15 months. Women could receive up to three annual calls during the study. MD-ED consisted of physician and office staff trainings aimed at improving counseling skills and office reminder systems.</p> <p>MAIN OUTCOME MEASURE: Self-report of mammography use during the study period was the main outcome measure. Regular use was defined as > or =1 mammogram every 24 months.</p> <p>RESULTS: Forty-four percent in each intervention group became regular users compared to 42% in the RC group. Among subjects who had prior but not recent mammograms at baseline, BSTC was effective (OR=1.48; 95% CI=1.04; 2. 10), and MD-ED marginally effective (OR=1.28; 95% CI=0.88, 1.85). Most recent users at baseline and few never users became regular users (61% and 17%, respectively) regardless of intervention status.</p> <p>CONCLUSIONS: Among mammography underusers BSTC modestly increases utilization for former users at a reasonable cost ($726 per additional regular user).</p>
dc.identifier.submissionpathwfc_pp/151
dc.contributor.departmentDepartment of Family Medicine & Community Health
dc.contributor.departmentDepartment of Medicine, Division of Hematology/Oncology
dc.source.pages39-46


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