A cue-to-action pilot project to increase screening mammography

Screening mammography is a preventive exam used to detect breast cancer in asymptomatic women. This cue-to-action pilot project sought to determine if outreach, education, and incentive would increase uptake of screening mammography among women aged 52 to 74 years who are members of a community-based health insurance plan.

Cohort study design with retrospective and prospective components.

Women were eligible to participate in accordance with the CMS Quality Rating System technical specification for breast cancer screening. Eligible women with no documented screening for a mammogram from January 1, 2016, through November 7, 2017, were invited to participate in a campaign that included outreach about screening mammography as a no-cost covered benefit, education about screening mammography to detect asymptomatic disease, and a gift card to a local grocery merchant if the member obtained screening mammography by December 31, 2017.

During December 2017, 20.8% (27/130) of eligible women obtained a screening mammogram compared with 7.8% (5/64) of eligible women during the nonintervention reference period of December 2016. Mammography screening increased by 170% during the study period in comparison with the reference period of a year earlier (prevalence ratio [PR], 2.7; 95% CI, 1.1-6.6; P = .02).

A one-time, time-limited cue-to-action pilot project consisting of outreach, education, and incentive increased uptake of screening mammography by women enrolled in a community health insurance plan providing health insurance coverage as part of the Affordable Care Act. This increase is statistically significant in the intervention period compared with the reference period (PR, 2.7; 95% CI, 1.1-6.6; P = .02). Despite a small sample size, the magnitude of the effect for this pilot study is encouraging and warrants future studies in a larger population.