Physicians' recommendations for mammography: do tailored messages make a difference?

OBJECTIVES Message tailoring, based on individual needs and circumstances, is commonly used to enhance face-to-face patient counseling. Only recently has individual tailoring become feasible for printed messages. This study sought to determine whether printed tailored recommendations addressing women's specific screening and risk status and perceptions about breast cancer and mammography are more effective than standardized printed recommendations. METHODS Computer-assisted telephone interviews were conducted with 435 women, aged 40 to 65 years, who had visited family practice groups within the previous 2 years. Subjects were randomly allocated to receive individually tailored or standardized mammography recommendation letters mailed from physicians to patients' homes. Follow-up interviews were conducted 8 months later. RESULTS Tailored letter recipients were more likely to remember and to have read more of their letters than standardized version recipients. After controlling for baseline status, tailored letter receipt was associated with more favorable follow-up mammography status for women with incomes below $26,000 and for Black women. CONCLUSIONS Tailored messages are a more effective medium for physicians' mammography recommendations; tailoring may be especially important for women of low socioeconomic status.

[1]  Stefano Ciatto,et al.  A case‐control study of the efficacy of a non‐randomized breast cancer screening program in florence (Italy) , 1986, International journal of cancer.

[2]  J. Hendriks,et al.  The predictive value of positive test results in screening for breast cancer by mammography in the Nijmegen programme. , 1987, British Journal of Cancer.

[3]  W F Velicer,et al.  A decisional balance measure and the stages of change model for weight loss. , 1988, The International journal of the addictions.

[4]  S. Hughes,et al.  Stages of change profiles in outpatient alcoholism treatment. , 1990, Journal of substance abuse.

[5]  J. Dolovich,et al.  The need for extended treatment of anaphylaxis. , 1980, Canadian Medical Association journal.

[6]  Edwin Silverberg,et al.  Survival experience in the breast cancer detection demonstration project , 1987, CA: a cancer journal for clinicians.

[7]  D. Rutledge,et al.  Exploration of factors affecting mammography behaviors. , 1988, Preventive medicine.

[8]  R. Hayward,et al.  Preventive Care Guidelines: 1991 , 1991 .

[9]  L. Tabár,et al.  REDUCTION IN MORTALITY FROM BREAST CANCER AFTER MASS SCREENING WITH MAMMOGRAPHY Randomised Trial from the Breast Cancer Screening Working Group of the Swedish National Board of Health and Welfare , 1985, The Lancet.

[10]  Morrison Breast Cancer Incidence and Mortality in the Breast Cancer Detection Demonstration , 1988 .

[11]  J. Hendriks,et al.  REDUCTION OF BREAST CANCER MORTALITY THROUGH MASS SCREENING WITH MODERN MAMMOGRAPHY First Results of the Nijmegen Project, 1975 - 1981 , 1984, The Lancet.

[12]  A. Stoddard,et al.  Breast cancer screening by mammography: utilization and associated factors. , 1989, American journal of public health.

[13]  B. Crabtree,et al.  Effects of Age, Education, and Physician Advice on Utilization of Screening Mammography , 1989, Journal of the American Geriatrics Society.

[14]  S. Shapiro,et al.  Evidence on screening for breast cancer from a randomized trial , 1977, Cancer.

[15]  Robert A. Smith,et al.  Barriers to screening for breast cancer , 1992, Cancer.

[16]  N. Day,et al.  EVALUATION OF SCREENING FOR BREAST CANCER IN A NON-RANDOMISED STUDY (THE DOM PROJECT) BY MEANS OF A CASE-CONTROL STUDY , 1984, The Lancet.

[17]  S. Moss,et al.  Explaining attendance at a breast-screening clinic. , 1985, Patient education and counseling.

[18]  S. Shapiro,et al.  Ten- to fourteen-year effect of screening on breast cancer mortality. , 1982, Journal of the National Cancer Institute.

[19]  R. Burack,et al.  The acceptance and completion of mammography by older black women. , 1989, American journal of public health.

[20]  U. Maclean,et al.  Women who decline breast screening. , 1984, Journal of epidemiology and community health.

[21]  Assessing elements of women's decisions about mammography. , 1992 .

[22]  Wolosin Rj The experience of screening mammography. , 1989 .

[23]  Robert F. DeVellis,et al.  Evaluation of a problem-solving intervention for patients with arthritis , 1988 .

[24]  L. Tabár,et al.  What is the optimum interval between mammographic screening examinations? An analysis based on the latest results of the Swedish two-county breast cancer screening trial. , 1987, British Journal of Cancer.