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Costs and cost-effectiveness of a church-based intervention to promote mammography screening
S E Stockdale1, E Keeler, N Duan
1RAND, Santa Monica, CA 90407-2138, USA.
Objectives:
To evaluate the costs of implementing a church-based, telephone-counseling program for increasing mammography use, and to identify the components of costs and the likely cost-effectiveness in hypothetical communities with varying characteristics.
Data Sources/Study Setting:
An ethnically and socioeconomically diverse sample of 1,443 women recruited from 45 churches participating in the Los Angeles Mammography Promotion (LAMP) program were followed from 1995 to 1997.
Study Design:
Churches were stratified into blocks and randomized into three intervention arms-telephone counseling, mail counseling, and control. We surveyed participants before and after the intervention to collect data on mammography use and demographic characteristics.
Data Collection/Extraction Methods:
We used call records, activity reports, and interviews to collect data on the time and materials needed to organize and carry out the intervention. We constructed a standard model of costs and cost-effectiveness based on these data and the Year One results of the LAMP program.
Principal Findings:
The cost in materials and overhead to the church site was $10.89 per participant and $188 per additional screening. However, when the estimated cost for church volunteers' time was included, the cost of the intervention increased substantially.
Conclusions:
A church-based program to promote the use of mammography would be feasible for many churches with the use of volunteer labor and resources.
