Cancer Control Research
5R01CA068556-03
Rakowski, William
ACHIEVING REPEAT MAMMOGRAPHY--STEPPED-CARE/ SELF-CHOICE
AbstractDESCRIPTION: This three year, community-based study addresses an
important challenge for screening mammography: that is identifying
intervention strategies which can help to promote repeated screening
among women who have had a recent mammogram (N=2120; women aged 50-74).
Rates of repeated mammography still appear to be no more than 40 percent
among women of that age group. The Specific Aims of the proposed
research are:
1. To examine whether intervening with women in the month following
their mammogram (Short term Follow-up) results in a higher percentage of
repeat screening compared to interventions which are delayed until two
months before the next mammogram is due (Delayed Follow-up: Mailed
Reminder, Phone Reminder);
2. To determine if a 'stepped-care' intervention methodology, which is
delivered in both the Short term Follow-up and the Delayed Follow-up
conditions, results in a higher percentage of repeat screening compared
to either a simple reminder sent by mail (Mailed Reminder) or delivered
by telephone (Phone Reminder);
3. To investigate whether giving women the option for self-selection of
an intervention group, compared to the random assignment of women into
intervention groups, affects the rates of repeated screening which are
observed;
4. To employ a research and data collection design which attempts to
minimize complete refusals and lost to follow-up, in order to examine
questions pertinent to recruitment and retention bias.
Therefore, there are four distinct intervention groups in this proposed
project: 1) Short term Follow-up; 2) Delayed Follow-up; 3) Telephone
Reminder Notice; 4) Mailed Reminder Notice. Groups 1 and 2 include a
personal call to discuss barriers to screening as part of the stepped-
care. The second element of the study has two arms -- 1) Traditional
Random Assignment versus 2) Self- Selection. Traditional Random
Assignment assigns the intervention by standard randomization
procedures. The Self-Selection arm offers women the opportunity to
choose the intervention group. This project is a collaboration between
Brown and Duke Universities. Women will be recruited from a statewide
HMO and a large radiology practice.
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