BACKGROUND: Managed care organizations and others reaching out to underscreened women seek strategies to encourage mammogram and Pap screening. METHODS:Female HMO members aged 50-69 years and overdue for a mammogram and a Pap test (n = 501) were followed for 24 months after interventions began. An Outreach intervention (tailored letters and motivational telephone interviews), an Inreach intervention (motivational interview delivered in clinics), and a Combined Inreach/Outreach intervention were compared to Usual Care at 24 months. Logistic regression and Cox hazard models examined predictors of obtaining screening services and time-to-service, respectively. RESULTS: Compared with Usual Care, the odds of Outreach women aged 50-64 obtaining a mammogram (OR = 2.06; 95% CI = 1.59-5.29), a Pap test (OR = 1.97; 95% CI = 1.12-3.53), or both (OR = 2.53; 95% CI = 1.40-4.63) remained significantly increased at 24 months. The average time-to-service for Outreach women was reduced by 4 months. Outreach effects persisted despite intensive, ongoing health plan efforts to improve screening of all women. CONCLUSIONS: This brief, tailored outreach intervention was an effective strategy for encouraging cervical and breast cancer screening among women overdue for both screening services. It also shortened time-to-service, an important benefit for early detection and treatment. Alternative strategies are needed for women who remain unscreened.
RCT Entities:
BACKGROUND: Managed care organizations and others reaching out to underscreened women seek strategies to encourage mammogram and Pap screening. METHODS: Female HMO members aged 50-69 years and overdue for a mammogram and a Pap test (n = 501) were followed for 24 months after interventions began. An Outreach intervention (tailored letters and motivational telephone interviews), an Inreach intervention (motivational interview delivered in clinics), and a Combined Inreach/Outreach intervention were compared to Usual Care at 24 months. Logistic regression and Cox hazard models examined predictors of obtaining screening services and time-to-service, respectively. RESULTS: Compared with Usual Care, the odds of Outreach women aged 50-64 obtaining a mammogram (OR = 2.06; 95% CI = 1.59-5.29), a Pap test (OR = 1.97; 95% CI = 1.12-3.53), or both (OR = 2.53; 95% CI = 1.40-4.63) remained significantly increased at 24 months. The average time-to-service for Outreach women was reduced by 4 months. Outreach effects persisted despite intensive, ongoing health plan efforts to improve screening of all women. CONCLUSIONS: This brief, tailored outreach intervention was an effective strategy for encouraging cervical and breast cancer screening among women overdue for both screening services. It also shortened time-to-service, an important benefit for early detection and treatment. Alternative strategies are needed for women who remain unscreened.
Authors: Adrianne C Feldstein; Nancy Perrin; A Gabriela Rosales; Jennifer Schneider; Mary M Rix; Russell E Glasgow Journal: J Womens Health (Larchmt) Date: 2011-01-28 Impact factor: 2.681
Authors: Richard G Roetzheim; Lisa K Christman; Paul B Jacobsen; Jennifer Schroeder; Rania Abdulla; Seft Hunter Journal: Ann Fam Med Date: 2005 Mar-Apr Impact factor: 5.166
Authors: Mira L Katz; Cathy M Tatum; Cecilia R Degraffinreid; Stephanie Dickinson; Electra D Paskett Journal: J Womens Health (Larchmt) Date: 2007 Jan-Feb Impact factor: 2.681
Authors: Thomas Everett; Andrew Bryant; Michelle F Griffin; Pierre Pl Martin-Hirsch; Carol A Forbes; Ruth G Jepson Journal: Cochrane Database Syst Rev Date: 2011-05-11