Abstract
Mammography screening continues to be under-utilized, especially among women from lower socioeconomic groups. In order to determine whether having direct access to health care services has an effect on mammography use among low income women, we conducted a randomized trial of two alternative letter reminders among 1,717 women who were enrolled at two locations of a multi-site inner city health department in Detroit. All participants were 39 1/2 years of age and older and were due for a screening mammogram at randomization. A physician-directed reminder form was placed in each of the participant’s medical records at the beginning of the study. In addition participants were randomized to receive either a letter directing them to visit their primary care physician, a letter directing them to contact the clinic directly to schedule a mammogram, or no letter. Study participants were predominantly African–American, two-thirds of whom were over age 50, and who had minimal health insurance coverage. During the intervention year, mammograms were completed by 179 out of 967 study women at site one (18.5%), and 90 out of 750 study women at site two (12%). A multivariate model controlling for the simultaneous effect of age, insurance type, visit history and past mammography use, showed no significant independent effect of either type of letter reminder on mammography completion during the study year. In conclusion, letters targeted at women due for screening mammograms did not have a beneficial effect on mammography utilization above and beyond that of a physician medical record reminder.
References
Simon MS, Severson RK: Racial differences in survival of female breast cancer in the Detroit Metropolitan Area. Cancer 77: 308, 1996
Sondik EJ: Breast cancer trends. Cancer 74: 995, 1994
Joslyn SA, West MM: Racial differences in breast carcinoma survival. Cancer 88: 114, 2000
SEER Cancer Statistics Review, 1973-1997: Ries LAG, Eisner MP, Kosary CL, Hankey BF, Miller BA, Clegg L, Edwards BK: Bethesda, MD, National Cancer Institute
Shapiro S: Periodic screening for breast cancer: the HIP randomized controlled trial. J Natl Cancer Inst Monogr 22: 27, 1997
Fletcher SW, Black W, Harris R, Rimer BK, Shapiro S: Report of the international workshop on screening for breast cancer. J Natl Cancer Inst 85: 1644, 1993
Tabar L, Fagerberg G, Duffy SW, Day NE, Gad A, Grontoft O: Update of the Swedish two-county program of mammographic screening for breast cancer. Radiol Clin North Am 30: 187, 1992
Mickey RM, Vezina JL, Worden JK, Warner SL: Breast screening behavior and interactions with health care providers among lower income women. Medical Care 35: 1204, 1997
Blustein J: Medicare coverage, supplemental insurance, and the use of mammography by older women. N Engl J Med 332: 1138, 1995
Danigelis NL, Roberson NL, Worden JK, Flynn BS, Dorwaldt AL, Ashley JA, Skelly JM, Mickey RM: Breast screening by African-American women: Insights from a household survey and focus groups. Am J Prev Med 11: 311, 1995
Skinner CS, Strecher VL, Hospers H: Physicians’ recommendations for mammography: Do tailored messages make a difference? Am J Public Health 84: 43, 1994
Calle EE, Flanders WD, Thum MJ, Martin LM: Demographic predictors of mammography and pap smear screening in US women. Am J Public Health 83: 53, 1993
Burack RC, Gimotty PA, Stengle W, Warbasse L, Moncrease A: Patterns of use of mammography among inner-city Detroit women: Contrasts between a health department, HMO, and private hospital. Medical Care 31: 322, 1993
Price JH, Desmond SM, Slenker S, Smith D, Stewart PW: Urban black women's perceptions of breast cancer and mammography. J Community Health 17: 191, 1992
Bastini R, Marcus AC, Hollatz-Brown A: Screening mammography rates and barriers to use: A Los Angeles County Survey. Preventive Med 20: 350, 1991
Anda RF, Sienko DG, Remington PL, Gentry EM, Marks JS: Screening mammography for women 50 years of age and older: Practices and trends, 1987. Am J Prev Med 6: 123, 1990
Zapka JG, Stoddard AM, Costanza ME, Greene HL: Breast cancer screening by mammography: Utilization and associated factors. Am J Public Health 79: 1499, 1989
Margolis KL, Lurie N, McGovern PG, Tyrrell M, Slater JS: Increasing breast and cervical cancer screening in low-income women. J Gen Intern Med 13: 515, 1998
Margolis KL, Menart TC: A test of two interventions to improve compliance with scheduled mammography appointments. J Gen Intern Med 11: 539, 1996
Taplin SH, Anderman C, Grothaus L, Curry SJ, Montano D: Using physician correspondence and postcard reminders to promote mammography use. Am J Public Health 84: 571, 1994
King ES, Rimer BK, Seay J, Balshem A, Engstrom PF: Promoting mammography use through progressive interventions: Is it effective? Am J Public Health 84: 104, 1994
Curry SJ, Taplin SH, Anderman C, Barlow WE, McBride C: A randomized trial of the impact of risk assessment and feedback on participation in mammography screening. Preventive Med 22: 350, 1993
Mandelblatt J, Traxler M, Lakin P, Thomas L, Chauhan P, Matseoane S, Kanetsky P: A nurse practitioner intervention to increase breast and cervical cancer screening for poor, elderly black women. J Gen Intern Med 8: 173, 1993
Rimer BK, Resch N, King E, Ross E, Kerman C, Boyce A, Kessler H, Engstrom PF: Multistrategy health education program to increase mammography use among women ages 65 and older. Public Health Reports 107: 369, 1992
Dickey LL, Petitti D: A patient-held minirecord to promote adult preventive care. J Fam Pract 34: 457, 1992
Burack RC, Gimotty PA: Promoting screening mammography in inner-city settings. The sustained effectiveness of computerized reminders in a randomized controlled trial. Medical Care 35: 921, 1997
Ornstein SM, Garr DR, Jenkins RG, Rust PF, Arnon A: Computer-generated physician and patient reminders. Tools to improve population adherence to selected preventive services. J Fam Pract 32: 82, 1991
Yabroff KR, Mandelblatt JS: Interventions targeted torward patients to increase mammography use. Cancer Epidemiol Biomarkers & Prev 8: 749, 1999
Wagner TH: The effectiveness of mailed patient reminders on mammography screening: ameta-analysis. Am J PrevMed 14: 64, 1998
Burack RC, Gimotty PA, George J, Stengle W, Warbasse L, Moncrease A: Promoting screening mammography in innercity settings: A randomized controlled trial of computerized reminders as a component of a program to facilitate mammography. Medical Care 32: 609, 1994
Burack RC, Gimotty PA, Stengle W, Eckert D, Warbasse L, Moncrease A: Detroit's avoidable mortality project: Breast cancer control for inner-city women. Public Health Reports 104: 527, 1989
Burack RC, Gimotty PA, George J, Simon MS, Dews P, Moncrease A: The effect of patient and physician reminders on use of screening mammography in a Health Maintenance Organization. Results of a randomized controlled trial. Cancer 78: 1708, 1996
Hosmer DW and Lemeshaw S: Applied logistic regression. Wiley, New York, 1989
Kalbfleisch JD and Prentice RL: The statistical analysis of failure time data. Wiley, New York, 1980
Simon MS, Gimotty PA, Coombs J, McBride S, Moncrease A, Burack RC: Factors affecting participation in a mammography screening program among members of an urban Detroit HMO. Cancer Detection and Prevention 22: 30, 1998
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Simon, M.S., Gimotty, P.A., Moncrease, A. et al. The Effect of Patient Reminders on the Use of Screening Mammography in an Urban Health Department Primary Care Setting. Breast Cancer Res Treat 65, 63–70 (2001). https://doi.org/10.1023/A:1006410711370
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DOI: https://doi.org/10.1023/A:1006410711370