Authors
Zapka, Jane G.Costanza, Mary E.
Harris, Donald R.
Hosmer, David W.
Stoddard, Anne M.
Barth, Robin S.
Gaw, Victoria P.
UMass Chan Affiliations
Department of Medicine, Division of Preventive and Behavioral MedicineDepartment of Medicine, Division of Hematology/Oncology
Document Type
Journal ArticlePublication Date
1993-01-01Keywords
AgedBreast Neoplasms
Community Health Services
Female
Health Promotion
Humans
Intervention Studies
Mammography
Mass Screening
Massachusetts
Middle Aged
Models, Statistical
Physical Examination
Questionnaires
Life Sciences
Medicine and Health Sciences
Women's Studies
Metadata
Show full item recordAbstract
BACKGROUND. Efforts to detect breast cancer in its early stages are necessary to reduce breast cancer-associated mortality. This study evaluated the impact of a multicomponent intervention implemented between 1987 and 1990 to increase a community's utilization of breast cancer screening by women over 50 years of age. METHODS. The study used a pretest/post-test two-community design, with one community assigned as the intervention community and the other as the comparison. The intervention consisted of a comprehensive physician involvement component and a community education effort. To assess the overall impact of the interventions, we measured women's participation in screening via random digit dial telephone surveys at three time points, each approximately 18 months apart. RESULTS. Over the course of the study, there were dramatic improvements in breast cancer screening participation in both communities. However, the intervention city showed more improvement in selected variables than did the comparison community in the early phases of the project between baseline and midpoint. These included increased advice by physicians to have mammograms, increased awareness that screening is necessary in the absence of symptoms, increased awareness that many women over 50 have mammograms, decreased perception of barriers to clinical breast exam, and an increase in the proportion of women having a clinical breast exam. In addition, significantly fewer women in the intervention city than in the comparison city reported never having had a mammogram at midpoint. CONCLUSIONS. The findings demonstrate limited impact of a community intervention during a period of increasing adoption of mammography screening, in part, due to this rapidly rising secular trend. Additionally, increased activities in the comparison community were documented. Therefore, as incidence of screening increases, targeted activities aimed at population subgroups are warranted, and evaluation designs need to include multiple comparison groups or broader geographic random samples.Source
Prev Med. 1993 Jan;22(1):34-53. Link to article on publisher's siteDOI
10.1006/pmed.1993.1003Permanent Link to this Item
http://hdl.handle.net/20.500.14038/50613PubMed ID
8475011Related Resources
Link to article in PubMedae974a485f413a2113503eed53cd6c53
10.1006/pmed.1993.1003