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Impact of an HMO-based intervention to increase mammography utilization
Summary
A health program significantly boosted mammography use in HMO members. However, the intervention
Area of Science:
- Public Health
- Preventive Medicine
- Health Services Research
Background:
- Breast cancer screening is crucial for early detection and improved outcomes.
- Health Maintenance Organizations (HMOs) can implement targeted programs to enhance screening rates.
- Understanding intervention effectiveness across diverse socioeconomic and racial groups is vital.
Purpose of the Study:
- To evaluate a multistage intervention designed to increase breast cancer screening via mammography within an HMO.
- To assess the impact of the intervention on mammography utilization among women aged 50-74.
- To examine how socioeconomic status and race modify the intervention's effectiveness.
Main Methods:
- A quasiexperimental design comparing an HMO intervention group with a geographically matched control group.
- Annual surveys from 1988-1990 of 450 women (aged 50-74) in each group regarding screening practices.
- Analysis of self-reported mammography utilization, calculating rate ratios (RR) and assessing effect modification.
Main Results:
- Mammography utilization increased from 41% to 68% in the intervention group versus 39% to 49% in the control group.
- The overall intervention yielded a rate ratio (RR) of 1.4 for mammography use.
- Intervention effectiveness varied significantly by income and race; higher income women showed minimal benefit, while lower income white women experienced the greatest increase.
Conclusions:
- The HMO-based intervention successfully increased mammography screening rates.
- The intervention's impact on screening utilization was not uniform, being significantly influenced by income and race.
- Tailored strategies may be necessary to ensure equitable improvements in breast cancer screening across all demographic groups.