Population-based screening programs can reduce breast cancer mortality by 31% (Tabar 1986) Yet, only a small proportion of U.S. women receive regular screening mammograms (Howard 1986). Mobile mammography technology has the potential to bring breast cancer screening to women at their worksites, reducing potential barriers by enhancing convenience and providing additional social support. In this study, we propose to test combinations of behavioral interventions to enhance adherence to routine mammograms at worksites. Our goal is to influence both initial and subsequent mammograms of eligible employees and spouses at participating worksites. The behavioral interventions have been selected on the basis of their replication potential. They will include a new educational slide-tape, revised printed materials for both women and men, alternative scheduling opportunities, appointment and follow-up reminders and modest incentives. A randomized modified-factorial design will be used to assess the impact of different combinations of interventions. Process, impact and outcome data will be collected through telephone interviews and self-administered questionnaires. The data collection points include: baseline prior to program announcement, group presentation, and during the van visit and telephone interviews 1, 14, and 24 months after the van visit. The major dependent variable is adherence with mammography; other variables of interest include knowledge, beliefs and related health behaviors. Our analyses will permit an assessment of the most effective combination of interventions and characteristics of worksites and women related to adherence.
