Finding the M.I.N.C. for Mammography Maintenance
- Compare the effectiveness of mammography reminder interventions using usual care
reminder vs enhanced automated phone reminder vs enhanced letter reminder in increasing
the proportion of women who undergo annual mammograms as recommended by medical
- Compare the impact of alternative delivery channels (mail vs automated phone reminders)
and enhanced messages in facilitating maintenance of mammography in these participants.
- Determine the incremental benefit of adding a consequence elaboration component to
barriers-specific telephone counseling in encouraging these participants to regain
adherence to mammography.
- Determine the minimum intervention needed for change to ensure annual mammography and
maintenance in participants.
OUTLINE: This is a randomized, controlled study. Participants are randomized to 1 of 3 arms.
- Arm I: Participants receive a usual care mammography reminder by telephone annually for
- Arm II: Participants receive an enhanced automated phone mammography reminder annually
for 4 years.
- Arm III: Participants receive an enhanced letter mammography reminder annually for 4
Insurance claims reports and patients' self reports as to whether or not they subsequently
underwent mammography are examined. Patients who do not undergo mammography within 6 months
after receiving a reminder are further randomized to 1 of 4 arms.
- Arm I: Participants receive no further reminders until the next annual reminder.
- Arm II: Participants receive an enhanced Barriers-Specific Counseling Call
(BarriConCall) annually for 4 years that focuses on positive consequences of undergoing
- Arm III: Participants receive an enhanced BarriConCall annually for 4 years that
focuses on negative consequences of not undergoing mammography.
- Arm IV: Participants receive a standard barrier call (BarriCall) annually for 4 years.
PROJECTED ACCRUAL: A total of 4,040 participants (1,000 for usual care mammography reminder;
1,520 for enhanced automated phone mammography reminder; and 1,520 for enhanced letter
mammography reminder) will be accrued for this study.
Observational Model: Cohort, Time Perspective: Prospective
The primary study objective was to identify the minimal intervention needed for sustained mammography adherence over 4 years. Average cumulative number of days non-adherent to mammography over 4 years based on annual screening guidelines. Claims data (monthly mammography claims information were reviewed to determine women's adherence status) and self-report (during annual telephone interviews, women were asked to confirm dates of their most recent and prior mammograms, based on claims data) were used to determine dates of screening.
Barbara K. Rimer, PhD
UNC Lineberger Comprehensive Cancer Center
United States: Institutional Review Board