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Tailored interventions for screening mammography among a sample of initially non-adherent women: when is a booster
Celette Sugg Skinner1, Sarah C Kobrin, Patrick O Monahan
1Department of Surgery, Duke University Medical Center and Program in Prevention, Detection & Control Research, Duke University Comprehensive Cancer, 2424 Erwin Rd, Ste 602, DUMC 2715, Durham, NC 27705, USA. skinn008@mc.duke.edu
Objective:
To assess added value of a booster dose of a tailored mammography intervention.
Methods:
Participants, non-adherent at baseline, were randomly assigned to usual care or one of three tailored interventions. Intervention group members (n=657) were further randomly assigned to receive/not receive a booster intervention dose. Electronic record mammography data were collected following initial intervention and at 6 and 15 months post-booster.
Results:
Booster had no effect among women not screened after first intervention dose (n=337). Among women screened after initial dose (n=320), booster predicted re-screening at 6 but not 15 months. A boosterxrace interaction showed a booster effect at 6 months for African Americans (OR=4.66, p=.0005) but not Caucasians (OR=0.74, p=.44).
Conclusions:
Findings suggest if a first-dose intervention does not facilitate screening, neither will a booster dose. However, among women for whom a first dose is effective, boosters can facilitate timely repeat adherence, especially among African Americans. At 6 months booster recipients were less likely to be off-schedule but, by 15 months, the groups were similar.
Practice Implications:
Boosters may effect when, but not whether, women continue screening.
