NURSING STUDY TO IMPROVE INTERVAL MAMMOGRAPHY RATES

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DESCRIPTION (Adapted from the Investigator's Abstract): Interval adherence to mammography rates are less than exerts advise. Conflicting reports have been published on factors related to interval adherence. Intervention studies have focused on very narrowly defined populations. This study, guided by the Health Belief Model, will be conducted in two overlapping phases. In Phase I, factors related to interval mammography utilization ion 640 women age 50 years and older who have received on screening mammogram and who either adhere or do not adhere to interval screening will be assessed. Participants will be randomly selected from a state-wide mammography registry. Variables will include knowledge about breast cancer, screening, and risk; anxiety about breast cancer and breast cancer screening; and perceived benefits and barriers to mammography screening. In Phase II a nurse delivered telephone education/counseling intervention based on the Transtheoretical Model will be tested to assess its impact on interval mammography adherence as well as the factors under study in Phase I. In Phase II, 320 women will be randomized to receive or not receive the intervention (n=160) in the intervention group; n=160 in the control group). Statistical analyses will include: descriptive statistics, chi- square test (or fisher's exact test where appropriate), co-variance and stepwise regression methods. Ratios of perceived-to-calculated probability of developing or dying from the disease will be assessed using the Gail Model in women without a family history of breast cancer. Because of the possibility of the breast cancer susceptibility gene in women with a family history, their objective risk will be explored separately. Repeated measures analyses will be conducted to assess how study variables change over time. The objective of Phase I, is to identify a profile of those at risk of poor mammography adherence, and the objective of Phase II is to improve internal mammography adherence in the general population.