Breast Cancer Screening in a Low Income Managed Care Population
Abstract
Low-income women have a high mortality from breast cancer. Yet, they participate in breast cancer early detection screening programs less than women in the general population. A randomized trial was designed to find the most effective intervention strategy to improve screening mammography rates of women participating in Tennessee's TennCare program. The strategies were: a) a prompter letter from Managed Care Organization (MCO); b) a reminder letter from primary care physician(PCP); c) telephone and/or in home counseling. These strategies and placebo were randomly assigned to 2357 participants. Control group(n=780) did not receive any intervention; Simple intervention group(n=79l) were mailed MCO letter; and Step-wise intervention group(n= 786) targeted MCO and PCP letter, and/or Counseling. The result shows that counseling was three more likely to increase mammography screening (RR=3.02;P=0.000001; CI:2.10, 4.34) than no intervention and about two and half time more likely than MCO letter (RR=2.33; P=0.00001; CI: 1.68,3.24). The PCP letter was one and half time more likely to increase the mammography rate than the no intervention (RR=1.5; P= 0.02; CI: 1.11,2.22). The study concluded that Counseling is the most effective and PCP letter was also found to be effective to improve mammography rates over no intervention group and MCO letter group.
Document Details
- Document Type
- Technical Report
- Publication Date
- Nov 01, 2000
- Accession Number
- ADA392202
Entities
People
- Nasar U. Ahmed
Organizations
- Meharry Medical College