Health education to improve repeat participation in the Dutch breast cancer screening programme: evaluation of a leaflet tailored to previous participants.

Participation in breast cancer screening programmes often declines in the course of the programme. The purpose of the present study was to examine whether health education could diminish the amount of drop-outs between two screening rounds. The health education was tailored to women who previously underwent mammography. Based on the Elaboration Likelihood Model two versions of the tailored leaflet were made: a simple version and a version with additional peripheral cues. In an experimental study among 2961 women the effects of the tailored leaflets on reparticipation were tested against a standard leaflet. Re-participation rates were high (> 90%) and did not differ between the 3 groups. No significant differences regarding beliefs about re-participating were found between the 3 groups. Results indicate that the tailored information leaflets did not enhance re-participation. Therefore, the required additional efforts and costs do not seem to be justified. The results of the study provide indications that less painful mammograms and friendly staff might improve re-participation.