This study evaluated the impact of two interventions designed to encourage mammography use among HMO women aged 65-74 who had not had a mammogram within the past year and had not used their referral for a free mammogram. Ninety days after the referral mailing, women were randomized to receive (a) a survey, (b) a survey in addition to telephone mammography counseling, or (c) a survey, telephone counseling, and a letter. Follow-up data indicated that only 13% of control group women compared to 27% who received phone counseling and 32% who received counseling and a letter obtained a mammogram within 120 days following the baseline survey and/or intervention. Results of the logistic regression analysis indicated that having received either of the interventions, mammography history, access ease, breast cancer/mammography beliefs, and having a friend or family member with breast cancer were independently and significantly related to mammography use.
Get full access to this article
View all access options for this article.
References
1.
American Cancer Society . (1992). A nationwide survey on breast health. Atlanta: Author.
2.
American Cancer Society . (1994). Cancer facts and figures—1994. Atlanta: Author.
3.
AMC Cancer Center . (1991). Breast and cervical screening: Barriers and use among specific populations. Unpublished manuscript.
4.
Azjen, I. , & Fishbein, M. (1980). Understanding attitudes and predicting social behavior. Englewood Cliffs, NJ: Prentice-Hall.
5.
Bastani, R. , Marcus, A. C., & Hollatz-Brown, A. (1991). Screening mammography rates and barriers to use: A Los Angeles County survey. Preventive Medicine, 20, 350-363.
6.
Burg, M. A. , Lane, D. S., & Polednak, A. P. (1990). Age group differences in the use of breast cancer screening tests. Journal of Aging and Health, 2(4), 514-530.
7.
Dawson, D. A. , & Thompson, G. B. (1990). Breast cancer risk factors and screening: United States, 1987. Vital and Health Statistics (DHHS Publication No. PHS 90-1500). Hyattsville, MD: U.S. Department of Health and Human Services.
8.
Elwood, J. M. , Cox, B., & Richardson, A. K. (1993, February 25). The effectiveness of breast cancer screening by mammography in younger women. Online Journal of Current Clinical Trials [On-line serial]. Available: Doc. No. 32
9.
Forum for Breast Cancer Screening in Older Women . (1992). Screening recommendations of the forum panel [Special issue]. Journals of Gerontology, 47(5).
10.
Fries, J. F. , Green, L. W., & Levine, S. (1989, March 4). Health promotion and the compression of morbidity. Lancet, pp. 481-483.
11.
Harris, R. P. , Fletcher, S. W., Gonzalez, J. J., Lannin, D. R., Degnan, D., Earp, J. A., & Clark, R. (1991). Mammography and age: Are we targeting the wrong women?Cancer, 67, 2010-2014.
12.
Jams, I. L. (1982). Counseling on personal decisions. New Haven, CT: Yale University Press.
13.
Janis, I. L. , & Mann, L. (1977). Decision-making: A psychological analysis of conflict choice and commitment. New York: Free Press.
14.
King, E. , Resch, N., Rimer, B., Lerman, C., Boyce, A., & McGovern-Gorchov, P. (1993). Breast cancer screening practices among retirement community women. Preventive Medicine, 22, 1-19.
15.
King, E. , Rimer, B. K., Balshem, A., Ross, E., & Seay, J. (1993). Mammography related beliefs of older women: A survey of an HMO population. Journal of Aging and Health, 5, 82-100.
16.
King, E. , Rimer, B., Seay, J., Balshem, A., & Engstrom, P. (1994). How effective are stepped interventions to promote mammography?American Journal of Public Health, 84, 104-107.
17.
Lerman, C. L. , Hanjani, P., Caputo, C., Miller, S., Delmoor, E., Nolte, S., & Engstrom, P. (1992). Telephone counseling improves adherence to colposcopy among lower-income minority women. Journal of Clinical Oncology, 10, 330-333.
18.
Lerman, C. , Rimer, B., Trock, B., Balshem, A., & Engstrom, P. (1990). Factors associated with repeat adherence to breast cancer screening. Preventive Medicine, 19, 279-290.
19.
Manfredi, C. , Lacey, L., & Warnecke, R. (1990). Results of an intervention to improve compliance with referrals for evaluation of suspected malignancies at neighborhood public health centers. American Journal of Public Health, 80, 85-87.
20.
McClellan, C. (1988). Screening and early diagnosis of breast cancer. Journal of Family Practice, 26, 561-568.
21.
Myers, R. , Ross, E., Woh, T., Balshem, A., Jepson, C., & Millner, L. (1991). Behavioral interventions to increase stool blood test adherence in colorectal screening. Medical Care, 29. 1030-1059.
22.
National Cancer Institute (NCI) Breast Cancer Screening Consortium . (1990). Screening mammography—A missed clinical opportunity? Results of the NCI breast cancer screening consortium and national health interview survey studies. Journal of the American Medical Association, 264, 54-56.
23.
Newell, G. R. , Spitz, M. R., & Sider, J. G. (1989). Cancer and age. Seminars in Oncology, 16, 3-9.
24.
Orleans, C. T. , Schoenbach, V. S., & Wagner, E. H. (1991). Self-help quit smoking interventions: Effects of self-help materials, social support instructions, and telephone counseling. Journal of Consulting and Clinical Psychology, 59, 439-448.
25.
Prochaska, J. , & DiClemente, C. (1983). Stages and processes of self-change of smoking toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51, 390-395.
26.
Rakowski, W. , Rimer, B., & Bryant, S. (1993). Integrating behavior and intention regarding mammography by respondents in the 1990 national health interview survey of health promotion and disease prevention. Public Health Reports, 108, 605-624.
27.
Rimer, B. R. , Davis, S. W., Engstrom, P. F., Myers, R., & Rosan, J. (1988). Some reasons for compliance and noncompliance in a health maintenance organization breast cancer screening program. Journal of Compliance in Health Care, 3, 103-114.
28.
Rimer, B. R. , Engstrom, P., Kasper-Keintz, M., Myers, R., & Rosan, J. (1989). Barriers and facilitators to compliance with routine mammographic screening. In P. N. Anderson, P. F. Engstrom, & L. Mortenson (Eds.), Cancer control: Innovations and research (pp. 125-133). New YorkAlan R. Liss.
29.
Rimer, B. K. , Resch, N.King, E., Ross, E., Lerman, C., Boyce, A., Kessler, H., & Engstrom, P. (1992). The role of a multistrategy health education program in increasing mammography use among women 65+. Public Health Reports, 107(4), 369-380.
30.
Rimer, B. K. , Ross, E., Cristinzio, C. S., & King, E. (1992). Older women's participation in breast screening [Special issue]. Journals of Gerontology, 47, 85-91.
31.
Rosenstock, I. M. (1990). The health belief model: Explaining health behavior through expectancies. In K. Glanz, F. M. Lewis, & B. K. Rimer (Eds.), Health behavior and health education (pp. 39-62). San Francisco, CA: Jossey-Bass.
32.
Satariano, W. A. , Ragheb, B. E., & Dupuis, M. H. (1989). Comorbidity in older women with breast cancer: An epidemiologic approach. In R. Yancik & J. W. Yates (Eds.), Cancer in the elderly: Approaches to early detection and treatment (pp. 71-107). New York: Springer.
33.
Shapiro, S. , Venet, W., Strax, P., Venet, L., & Roeser, R. (1985). Selections, follow-up, and analysis in the Health Insurance Plan Study: A randomized trial with breast cancer screening. National Cancer Institute Monograph, 67. 65-74.
34.
Stewart, J. H. , & Foster, R. S. (1989). Breast cancer and aging. Seminars in Oncology, 16, 41-50.
35.
Tabar, L. , Fagerberg, C.J.G., Gad, A., Baldetorp, L., Holmberg, L. H., Grontoft, O., Ljungquist, U., Lundstrom, B., Monson, J. C., Eklund, G., Day, N. E., & Pethersson, F. (1985, April 13). Reduction in mortality in breast cancer after mass screening with mammography. Lancet, pp. 829-832.
36.
U.S. Department of Health and Human Services . (1990). Healthy people 2000: National health promotion and disease prevention objectives (DHHS Publication No. PHS 91-50212). Washington, DC: U.S. Department of Health & Human Services.
37.
U.S. Senate Special Committee on Aging . (1991). Aging America: Trends and projections, 1991 edition (DHHS Publication No. FCoA 91-280001). Washington, DC: U.S. Government Printing Office.
38.
Yancik, R. , & Ries, L. (1991). Cancer in the aged: An epidemiologic perspective on treatment issues. Cancer, 68, 2502-2510.
39.
Yancik, R. , Ries, L., & Yates, J. (1989). Breast cancer in aging women: A population based study on contrasts in stage, surgery, and survival. Cancer, 63, 976-981.
40.
Zapka, J. G. , Stoddard, A., Costanza, M. E., & Greene, H. L. (1989). Breast cancer screening by mammography: Utilization and associated factors. American Journal of Public Health, 79, 1499-1502.
