Journal Article

Randomized Trial of an Intervention to Improve Mammography Utilization Among a Triracial Rural Population of Women

Electra Paskett, Cathy Tatum, Julia Rushing, Robert Michielutte, Ronny Bell, Kristie Long Foley, Marisa Bittoni, Stephanie L. Dickinson, Ann Scheck McAlearney and Katherine Reeves

in JNCI: Journal of the National Cancer Institute

Volume 98, issue 17, pages 1226-1237
Published in print September 2006 | ISSN: 0027-8874
Published online September 2006 | e-ISSN: 1460-2105 | DOI: http://dx.doi.org/10.1093/jnci/djj333
Randomized Trial of an Intervention to Improve Mammography Utilization Among a Triracial Rural Population of Women

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Introduction: Mammography is underused by certain groups of women, in particular poor and minority women. We developed a lay health advisor (LHA) intervention based on behavioral theories and tested whether it improved mammography attendance in Robeson County, NC, a rural, low-income, triracial (white, Native American, African American) population. Methods: A total of 851 women who had not had a mammogram within the past year were randomly assigned to the LHA intervention (n = 433) or to a comparison arm (n = 418) during 1998–2002. Rates of mammography use after 12–14 months (as verified by medical record review) were compared using a chi-square test. Baseline and follow-up (at 12–14 months) surveys were used to obtain information on demographics, risk factors, and barriers, beliefs, and knowledge about mammography. Linear regression, Mantel–Haenszel statistics, and logistic regression were used to compare barriers, beliefs, and knowledge from baseline to follow-up and to identify baseline factors associated with mammography. Results: At follow-up, 42.5% of the women in the LHA group and 27.3% of those in the comparison group had had a mammogram in the previous 12 months (relative risk = 1.56, 95% confidence interval [CI] = 1.29 to 1.87). Compared with those in the comparison group, women in the LHA group displayed statistically significantly better belief scores (difference = 0.46 points on a 0–10 scale, 95% CI = 0.15 to 0.77) and reduced barriers at follow-up (difference = −0.77 points, 95% CI = −1.02 to −0.53), after adjusting for baseline scores. Conclusions: LHA interventions can improve mammography utilization. Future studies are needed to assess strategies to disseminate effective LHA interventions to underserved populations.

Journal Article.  9248 words.  Illustrated.

Subjects: Medical Oncology

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