BACKGROUND: Despite interventions to promote regular mammography, underserved women face barriers to mammography. This is evident in high no-show appointment rates in community-based clinics. Understanding why women fail to follow-through with appointments may help improve adherence. OBJECTIVES: We conducted a focus group with women who were non-adherent to mammograms to evaluate psychosocial and structural barriers and design intervention messages. In phase two we conducted a small randomized controlled trial (RCT) to pilot test a brief telephone coaching adherence intervention (vs. control) to address barriers. METHOD:Eligible women were non-adherent to their mammography screening appointment at a community-based setting. Psychosocial factors and perceptions of barriers were measured via a baseline survey and used to tailor the telephone coaching session. In the RCT, the primary outcome was whether women rescheduled and kept their appointment (yes vs. no). Descriptive statistics were used to summarize the results. RESULTS:Fifty-four women participated in the study (17 in phase 1 and 31 in phase 2); 89% were Black and 11% were Latina. Overall, prior to the intervention, women had low perceptions of risk (m=4.2; SD=2.4) and cancer worry (m=4.2; SD=2.6) and these characteristics informed the telephone coaching. After the intervention, most women (94.5%) rescheduled their missed appointment. More women in the intervention group kept their appointment (54%) than those in the usual care group (46%). CONCLUSION: It appears feasible to implement a RCT in non-adherent underserved women. Addressing psychosocial and structural barriers in a brief telephone intervention may reduce non-adherence. Future studies that will test the efficacy of this approach are warranted.
RCT Entities:
BACKGROUND: Despite interventions to promote regular mammography, underserved women face barriers to mammography. This is evident in high no-show appointment rates in community-based clinics. Understanding why women fail to follow-through with appointments may help improve adherence. OBJECTIVES: We conducted a focus group with women who were non-adherent to mammograms to evaluate psychosocial and structural barriers and design intervention messages. In phase two we conducted a small randomized controlled trial (RCT) to pilot test a brief telephone coaching adherence intervention (vs. control) to address barriers. METHOD: Eligible women were non-adherent to their mammography screening appointment at a community-based setting. Psychosocial factors and perceptions of barriers were measured via a baseline survey and used to tailor the telephone coaching session. In the RCT, the primary outcome was whether women rescheduled and kept their appointment (yes vs. no). Descriptive statistics were used to summarize the results. RESULTS: Fifty-four women participated in the study (17 in phase 1 and 31 in phase 2); 89% were Black and 11% were Latina. Overall, prior to the intervention, women had low perceptions of risk (m=4.2; SD=2.4) and cancer worry (m=4.2; SD=2.6) and these characteristics informed the telephone coaching. After the intervention, most women (94.5%) rescheduled their missed appointment. More women in the intervention group kept their appointment (54%) than those in the usual care group (46%). CONCLUSION: It appears feasible to implement a RCT in non-adherent underserved women. Addressing psychosocial and structural barriers in a brief telephone intervention may reduce non-adherence. Future studies that will test the efficacy of this approach are warranted.
Authors: Lennarth Nyström; Ingvar Andersson; Nils Bjurstam; Jan Frisell; Bo Nordenskjöld; Lars Erik Rutqvist Journal: Lancet Date: 2002-03-16 Impact factor: 79.321
Authors: I M Lipkus; M Kuchibhatla; C M McBride; H B Bosworth; K I Pollak; I C Siegler; B K Rimer Journal: Cancer Epidemiol Biomarkers Prev Date: 2000-09 Impact factor: 4.254
Authors: Regina Otero-Sabogal; Desi Owens; Jesse Canchola; Jacqueline M Golding; Farzaneh Tabnak; Patrick Fox Journal: J Health Care Poor Underserved Date: 2004-08
Authors: Whitney L Hensing; Steven P Poplack; Cheryl R Herman; Siobhan Sutcliffe; Graham A Colditz; Foluso O Ademuyiwa Journal: Cancer Date: 2021-04-01 Impact factor: 6.921
Authors: Julie A Chambers; Ronan E O'Carroll; Alan Cook; Julie Cavanagh; Debbie Archibald; Rosemary Millar Journal: BMC Public Health Date: 2014-08-09 Impact factor: 3.295