Although there have been impressive increases in the proportion of U.S. women who report ever having had mammograms, most women are not following screening guidelines. The overall goal of this Phase III/IV study is to increase adherence of CIS callers to NCI-approved screening mammography guidelines. This will be accomplished by implementing and evaluating a proactive telephone counseling protocol and a repeat mammogram notification registry within the CIS network. The proactive telephone counseling protocol and repeat mammogram notification registry will be evaluated using a randomized three-group design (control vs. proactive counseling vs. proactive counseling + registry, with the week of the CIS call serving as the unit of randomization. Independent random samples of Year 2 subjects (intervention and control) will be interviewed at 6 and 18 months follow-up to obtain adherence to screening mammography guidelines (N= 1,800 per group). Major elements in the proactive counseling protocol include interactive """"""""barriers counseling,"""""""" referrals to local facilities, updated summaries of Medicare benefits for Women 65+ years of age, and a follow-up mailout to reinforce the counseling and to serve as a cue to action. Eligible callers assigned to receive the registry will be invited by CIS telephone counselors to enroll in the registry at the end of the counseling protocol. The names, addresses, and telephone numbers of participating as CIS callers will then be mailed to the centralized registry office located at the AMC Cancer Research Center, for protocol implementation. The impact of the registry on adherence to screening mammography guidelines will be assessed using the 18-month follow-up interviews.
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