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

描述：这项为期三年、以社区为基础的研究致力于 筛查乳房X光检查的重要挑战：即识别 有助于促进重复筛查的干预策略 在最近做过乳房X光检查的女性中(N=2120；女性年龄50-74岁)。 重复乳房X光检查的比率似乎仍不超过40%。 在这个年龄段的女性中。建议的具体目标 研究内容包括： 1.检查是否在接下来的一个月内对女性进行干预 他们的乳房X光检查(短期随访)导致更高比例的 与推迟到两点的干预措施相比，重复筛查 在下一次乳房X光检查到期前几个月(延迟随访：邮寄 提醒、电话提醒)； 2.确定是否采用了“阶梯式护理”干预方法，即 在短期后续行动和延迟后续行动中交付 条件，导致更高的重复筛查百分比相比较 发送到通过邮件发送的简单提醒(邮寄提醒)或递送 电话(电话提醒)； 3.调查是否让妇女有权自行选择 干预组，与随机将女性分配到 干预组，影响重复筛查率，这是 观察； 4.采用研究和数据收集设计，试图 最大限度地减少完全拒绝和失访，以便检查 与招聘和留住偏见有关的问题。 因此，在这项提议中，有四个不同的干预小组 项目：1)短期跟踪；2)延迟跟踪；3)电话 催款通知；4)邮寄催款通知。组1和组2包括 个人呼吁讨论筛查障碍作为阶梯式- 关心。这项研究的第二个要素有两个方面--传统 随机分配与2)自我选择。传统随机 ASSIGN通过标准随机化分配干预 程序。自选机构为女性提供了一个机会 选择干预组。这个项目是两国之间的合作 布朗大学和杜克大学。女性将从全州范围内招募 医疗保健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.