Elsevier

Preventive Medicine

Volume 34, Issue 1, January 2002, Pages 40-50
Preventive Medicine

Regular Article
Screening HMO Women Overdue for both Mammograms and Pap Tests

https://doi.org/10.1006/pmed.2001.0949Get rights and content

Abstract

Background. Regular screening has the potential to reduce breast and cervical cancer mortality, but despite health plan programs to encourage screening, many women remain unscreened. Tailored communications have been identified as a promising approach to promote mammography and Pap test screening.

Methods. The study used a four-group randomized design to compare with Usual Care the separate and combined effects of two tailored, motivational interventions to increase screening—a clinical office In-reach intervention and a sequential letter/telephone Outreach intervention. Subjects were 510 female HMO members ages 52–69 who had had no mammogram in the past 2 years and no Pap smear in the past 3 years. Primary outcomes were the percentage of women in each condition who received a mammogram, a Pap smear, or both screening tests during the 14-month study period.

Results. Thirty-two percent of the Combined group, 39% of the Outreach group, and 26% of the In-reach group obtained both services versus 19% of Usual Care participants. Overall, compared with Usual Care, both Outreach (P = 0.006) and Combined (P = 0.05) screened significantly more women. For subjects ages 65–69, Outreach rates were lower than those of Usual Care.

Conclusion. A tailored letter-telephone Outreach appears to be more effective at screening women ages 52–64 than a tailored office-based intervention, in large part because most In-reach women did not have clinic visits at which to receive the intervention.

References (47)

  • S Rollnick et al.

    Helping smokers make decisions: the enhancement of brief intervention for general medical practice

    Patient Educ Couns

    (1997)
  • B Valanis et al.

    Maternal smoking cessation and relapse prevention during health care visits

    Am J Prev Med

    (2001)
  • IM Lipkus et al.

    Can tailored interventions increase mammography use among HMO women?

    Am J Prev Med

    (2000)
  • BL Funke et al.

    Factors affecting patient compliance among women with abnormal Pap smears

    Patient Educ Couns

    (1993)
  • PG McGovern et al.

    Accuracy of self-report of mammography and Papanicolaou smear in a low-income urban population

    Am J Prev Med

    (1998)
  • VA Lawrence et al.

    Systematic differences in validity of self-reported mammography behavior: a problem for intergroup comparisons?

    Prev Med

    (1999)
  • Healthy People 2000: midcourse review and 1995 revisions

    (1995)
  • SJ Curry et al.

    Theoretical models for predicting and improving compliance with breast cancer screening

    Ann Behav Med

    (1994)
  • JS Mandelblatt et al.

    Effectiveness of interventions designed to increase mammography use: a meta-analysis of provider-targeted strategies

    Cancer Epidemiol Biomarkers Prev

    (1999)
  • RK Yabroff et al.

    Interventions targeted toward patients to increase mammography use

    Cancer Epidemiol Biomarkers Prev

    (1999)
  • MMWR

    (1997)
  • LM Anderson et al.

    Has the use of cervical, breast, and colorectal cancer screening increased in the United States?

    Am J Public Health

    (1995)
  • HEDIS 3.0: 1997 standards for accreditation of managed care organizations

    (1997)
  • Cited by (0)

    This study was funded by a program project grant from the National Cancer Institute: PO1 CA72085.

    2

    To whom correspondence and reprint requests should be addressed at Kaiser Permanente-Center for Health Research, 3800 N. Interstate Avenue, Portland, OR 97227. Fax: (503) 335-2424. E-mail: [email protected].

    View full text