"Tailored interventions -- those developed for one specific recipient based on her particular characteristics -- have shown great promise for increasing mammography," says researcher Victoria L. Champion, D.N.S., of the Indiana University School of Nursing.
Champion's study followed 976 women in St. Louis and Indianapolis who were 51 and older and who had not had a mammogram for at least the previous 15 months. They found that women who received telephone and mailed messages about the importance of breast cancer screening were more likely to get a mammogram than the women who did not receive such messages.
The women were divided into four groups: those who received no messages, those who received them by telephone only, those who received them by mail only and those who received them by a combination of mail and telephone.
"The combination intervention group had more than twice as many women who received mammograms by follow-up than did the usual care group," Champion notes. Mail and telephone messages separately also increased mammography screenings, at about the same rate in each group, but individually did not produce the level of follow-up seen in the combination group.
The messages responded to the women's answers to interview questions. For instance, women who expressed disbelief that mammograms can detect breast lumps while they are too small to be felt received a message that said something like: "Did you know that mammograms can find breast cancer about two years before it can even be felt by your doctor? Mammograms are the only way to find cancer this small. So, instead of waiting for the cancer to grow until it can be felt, women can get early treatment and be on the road to recovery."
Printed materials sent to participants in the tailored groups also included an introductory letter with messages geared to the recipient's age, family history of breast cancer and history of mammography screening. "This cover page was in the form of a letter addressing the woman by name and closing with the digitized signature of the physician she identified as her primary care provider," the researchers say. Women who indicated that they did not understand how to get a mammogram also received "text and graphics detailing how to set up a mammography appointment, where to go, what to wear, and so forth."
Telephone-only message recipients were not able to get the graphics, but did receive counseling on issues like the subject's perception of risks, benefits and barriers to mammography. The calls averaged about 15 minutes.
Regardless of format, the tailored messages hit home for women who did not have partners; nearly 40 percent of those in the combination group followed through with a mammography screening, compared to only 21 percent of women without partners who did not have any tailored messages sent to them.
The authors note that limitations to the study include its inclusion of only women who agreed to take part in the study -- meaning participants may have been "more motivated to comply than women who declined study participation."
The study by Champion and her colleagues appears in the August issue of the Annals of Behavioral Medicine.
Funding for the study came from the National Institutes of Health.
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