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Research ArticleOriginal Article

The Effect Of A Comprehensive Breast Screening Program On Self-Reported Mammography Use By Primary Care Physicians And Women In A Health Maintenance Organization

Barbara K. Rimer, Eric Ross, Andrew Balshem and Paul F. Engstrom
The Journal of the American Board of Family Practice September 1993, 6 (5) 443-451; DOI: https://doi.org/10.3122/jabfm.6.5.443
Barbara K. Rimer
From the Cancer Prevention, Detection and Control Research Program, Duke Comprehensive Cancer Center, Duke University Medical Center, Durham, North Carolina. Address reprint requests to Barbara K. Rimer, DPH, Cancer Prevention, Detection and Control Research Program, Duke Comprehensive Cancer Center, Duke University Medical Center, Box 2949, Durham, NC 27710.
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Eric Ross
From the Cancer Prevention, Detection and Control Research Program, Duke Comprehensive Cancer Center, Duke University Medical Center, Durham, North Carolina. Address reprint requests to Barbara K. Rimer, DPH, Cancer Prevention, Detection and Control Research Program, Duke Comprehensive Cancer Center, Duke University Medical Center, Box 2949, Durham, NC 27710.
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Andrew Balshem
From the Cancer Prevention, Detection and Control Research Program, Duke Comprehensive Cancer Center, Duke University Medical Center, Durham, North Carolina. Address reprint requests to Barbara K. Rimer, DPH, Cancer Prevention, Detection and Control Research Program, Duke Comprehensive Cancer Center, Duke University Medical Center, Box 2949, Durham, NC 27710.
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Paul F. Engstrom
From the Cancer Prevention, Detection and Control Research Program, Duke Comprehensive Cancer Center, Duke University Medical Center, Durham, North Carolina. Address reprint requests to Barbara K. Rimer, DPH, Cancer Prevention, Detection and Control Research Program, Duke Comprehensive Cancer Center, Duke University Medical Center, Box 2949, Durham, NC 27710.
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Abstract

Background: Mammography use is increasing in the United States, but most women older than 50 years still are not being screened regularly. A multicomponent program, with components for women and physicians, was conducted to increase screening among women aged 50 to 74 years in an independent practice association (IPA)-model health maintenance organization (HMO).

Methods: The participating women and physicians were surveyed in four waves to evaluate the program. We report on changes in mammography practices by both women and physicians between 1988 (preintervention year) and 1992 (postintervention year). Bivariate and multivariate analyses were calculated.

Results: The proportion of responding HMO physicians who recommended annual mammograms for women aged 50 to 74 years increased by 16 percent from 1988 to 1992 compared with an increase of 10 percent for control group physicians (nonsignificant). There was a 30 percent increase from 1988 to 1992 in the proportion of HMO women respondents who reported having had a mammogram in the past year compared with a 19 percent increase among control group women. The difference between these differences was highly significant. The intervention had the strongest effect on women with incomes of less than $30,000.

Conclusions: A multicomponent program in an IPA-model HMO resulted in significant increases in the proportion of HMO women who had mammograms. Similar approaches should be tested in other settings.

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The Journal of the American Board of Family     Practice: 6 (5)
The Journal of the American Board of Family Practice
Vol. 6, Issue 5
1 Sep 1993
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The Effect Of A Comprehensive Breast Screening Program On Self-Reported Mammography Use By Primary Care Physicians And Women In A Health Maintenance Organization
Barbara K. Rimer, Eric Ross, Andrew Balshem, Paul F. Engstrom
The Journal of the American Board of Family Practice Sep 1993, 6 (5) 443-451; DOI: 10.3122/jabfm.6.5.443

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The Effect Of A Comprehensive Breast Screening Program On Self-Reported Mammography Use By Primary Care Physicians And Women In A Health Maintenance Organization
Barbara K. Rimer, Eric Ross, Andrew Balshem, Paul F. Engstrom
The Journal of the American Board of Family Practice Sep 1993, 6 (5) 443-451; DOI: 10.3122/jabfm.6.5.443
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