As a consequence of more widespread use of mammography, there is a growing number of American women who have received an abnormal result on a screening mammogram. Our preliminary research suggests that there are significant psychological costs associated with this experience. Moreover, these psychological consequences of having an abnormal mammogram may interfere with adherence to future breast screening and follow-up. To date, however, there have been no studies conducted to understand this phenomenon and no interventions designed to meet the needs of women with abnormal mammograms. In the proposed study, we will develop and test a psychoeducational intervention to promote adherence to annual mammography and follow-up in women who have had abnormal mammograms. We also will evaluate the relative impact on adherence of two different styles of presenting educational information. The study population will be 600 women aged 50 and older who are participants of US HEALTHCHECK, a breast screening program for members of HMO PA/NJ. They will be women who have had a recent abnormal mammogram and who are eligible to receive their annual screening mammogram. Subjects will be randomly assigned either to receive the standard US HEALTHCHECK annual breast screening packet/referral (control) or the standard packet/referral plus a psychoeducational manual which is tailored to the needs of women with abnormal mammograms (experimental). Pre-intervention telephone surveys will be used to evaluate the independent effects of sociodemographic characteristics and baseline levels of knowledge, health beliefs, coping, and physician-patient communication on women's subsequent adherence to screening mammography and follow-up. Post intervention surveys will be used to determine the impact of the interventions on adherence, as well as on knowledge, health beliefs and coping variables. Medical and radiology records will be utilized to verify self-report data on mammography adherence and follow-up. The proposed intervention was chosen for its potential efficacy and ease of replication. If effective, it can be applied to diverse problems of cancer control, such as promoting continued adherence and follow-up among persons with positive stool blood tests or Pap smears.
| Lerman, C; Ross, E; Boyce, A et al. (1992) The impact of mailing psychoeducational materials to women with abnormal mammograms. Am J Public Health 82:729-30 |
