Cancer Control Research
5R01CA062119-04
Taylor, Victoria M.
MAMMOGRAPHY USE BY LOW INCOME WOMEN
AbstractThere is evidence that the use of mammographic screening is relatively low
among socioeconomically disadvantaged and minority women. In-reach
activities, which use contacts with the health care system to educate and
motivate patients, have considerable potential for increasing mammography
completion rates. The overall aim of the proposed research is to increase
screening mammography participation by women from hard-to-reach groups
through a clinic-based intervention program. Specific study objectives are
to obtain information about the screening behavior of disadvantaged women;
develop, implement, and evaluate the effect of a mammography program; and
assess the costs of intervention activities.
The setting for the study will be the Adult Medicine Clinic of Seattle's
Harborview Medical Center. Subjects for the study will be women aged 50-69
who visit the clinic during an 18-month period. The intervention pro gram
will be guided by a comprehensive theoretical framework that addresses
both environmental and individual considerations. Attention will be given
to organization of the clinic through implementation of patient tracking
and provider reminder systems; and education of physicians and clinic
staff. The Theory of Reasoned Action, as well as quantitative and
qualitative data collection methods, will be used to understand the target
population's screening behavior and to guide the development of patient
intervention activities. These will include use of audio-visual and print
education materials; physician reinforcement of mammography;
transportation assistance; pre-appointment reminders; and telephone
follow-up if appointments are missed.
A randomized controlled trial employing "Firm System" research methodology
will be employed to evaluate the effect of the intervention program on
mammography participation. The study sample will include a minimum of 140
experimental and 280 control women who will have previously been
individually randomized to one of three equivalent group practices. The
outcome variable of interest will be mammography completion within three
months of initial exposure to the intervention program. Costs of the
intervention program will be systematically assessed.
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