ACHIEVING REPEAT MAMMOGRAPHY--STEPPED-CARE/ SELF-CHOICE

描述：这项为期三年的以社区为基础的研究解决了一个 筛查乳房X光检查的重要挑战： 有助于促进重复筛查的干预策略 在最近进行过乳房X线检查的女性中（N=2120; 50-74岁的女性）。 重复乳房X光检查的比率似乎仍然不超过40% 在这个年龄段的女性中。建议的具体目标 研究是： 1.检查是否干预妇女在一个月后， 他们的乳房X光检查（短期随访）结果显示， 与延迟到两个月的干预措施相比，重复筛查 下一次乳房X光检查到期前几个月（延迟随访：邮寄 提醒、电话提醒）; 2.为了确定“阶梯式护理”干预方法， 在短期随访和延迟随访中均提供 条件下，结果在更高的百分比重复筛选相比， 或者，一封简单的邮件，或者一封简单的邮件， 电话提醒（Phone Reminder） 3.调查是否给予妇女自我选择的选择权， 干预组，与随机分配的妇女相比， 干预组，影响重复筛查率， 观察; 4.采用研究和数据收集设计，试图 尽量减少完全拒绝和失访，以检查 有关招聘和保留偏见的问题。 因此，在本建议中有四个不同的干预组。 项目：1）短期随访; 2）延迟随访; 3）电话随访 [4]《明史》：“明者，明也。第1组和第2组包括a 个人电话讨论筛选的障碍，作为步骤的一部分- 在乎研究的第二个要素有两个方面- 1）传统的 随机分配与2）自我选择。传统随机 分配通过标准随机化分配干预 程序.自我选择的手臂为女性提供了机会， 选择干预组。该项目是一个合作， 布朗和杜克大学。妇女将从全州范围内招募 健康维护组织和一家大型放射科诊所。

DESCRIPTION: This three year, community-based study addresses an important challenge for screening mammography: that is identifying intervention strategies which can help to promote repeated screening among women who have had a recent mammogram (N=2120; women aged 50-74). Rates of repeated mammography still appear to be no more than 40 percent among women of that age group. The Specific Aims of the proposed research are: 1. To examine whether intervening with women in the month following their mammogram (Short term Follow-up) results in a higher percentage of repeat screening compared to interventions which are delayed until two months before the next mammogram is due (Delayed Follow-up: Mailed Reminder, Phone Reminder); 2. To determine if a 'stepped-care' intervention methodology, which is delivered in both the Short term Follow-up and the Delayed Follow-up conditions, results in a higher percentage of repeat screening compared to either a simple reminder sent by mail (Mailed Reminder) or delivered by telephone (Phone Reminder); 3. To investigate whether giving women the option for self-selection of an intervention group, compared to the random assignment of women into intervention groups, affects the rates of repeated screening which are observed; 4. To employ a research and data collection design which attempts to minimize complete refusals and lost to follow-up, in order to examine questions pertinent to recruitment and retention bias. Therefore, there are four distinct intervention groups in this proposed project: 1) Short term Follow-up; 2) Delayed Follow-up; 3) Telephone Reminder Notice; 4) Mailed Reminder Notice. Groups 1 and 2 include a personal call to discuss barriers to screening as part of the stepped- care. The second element of the study has two arms -- 1) Traditional Random Assignment versus 2) Self- Selection. Traditional Random Assignment assigns the intervention by standard randomization procedures. The Self-Selection arm offers women the opportunity to choose the intervention group. This project is a collaboration between Brown and Duke Universities. Women will be recruited from a statewide HMO and a large radiology practice.