Champion V, Maraj M, Hui S, Perkins AJ, Tierney WM, Menon U, Skinner CS. Comparison of tailored interventions to
increase mammography screening in nonadherent older women. Prev Med 2003; 36(2):150-158.
Background: Recent increases in mammography use have led to a decrease in mortality from breast cancer.
Methods: Building on the Health Belief Model, the Transtheoretical Model, and past effectiveness of tailored
interventions, we conducted a prospective randomized trial (n = 773) to test the efficacy on mammography adherence
of tailored interventions delivered by five different methods, i.e., telephone counseling, in-person counseling,
physician letter, and combinations of telephone with letter and in-person with letter.
Results: All five interventions increased mammography adherence significantly relative to usual care
(odds ratios, 1.93 to 3.55) at 6 months post intervention. The combination of in-person with physician letter was
significantly more effective than telephone alone or letter alone. Women thinking about getting a mammogram at baseline
were more likely to be adherent by 6 months; even those in usual care achieved 48% adherence compared with 50–70% in
the intervention groups. In contrast, women not thinking about getting a mammogram needed the interventions to increase
their adherence from 13% to over 30%.
Conclusions: All five interventions were effective at increasing mammography adherence. Women not thinking about getting
a mammogram were most likely to benefit from these tailored interventions while other women might need less intensive
interventions.
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