Mammography Adherence in African-American Women: Results of a Randomized Controlled Trial

Abstract

Background: Breast cancer is the second leading cause of cancer mortality among women in the developed world. Mammography screening is especially important for African-Americans because they experience a greater mortality (OR = 1.38) than Caucasians despite having a lower incidence of breast cancer.

Purpose: The purpose of this study was to compare the effects of two interventions with usual care on mammography adherence among African-American women.

Methods: A subsample of African-American women (n = 244) aged 41-65 years who had not had a mammogram in the last 15 months and no history of breast cancer was randomly assigned to receive (1) mailed interactive DVD, (2) computer-tailored telephone counseling, or (3) usual care.

Results: The DVD intervention was five times more effective than usual care for promoting mammography screening at 6 months follow-up among women who earned less than $30,000 (OR = 5.3). Compared to usual care, neither the DVD nor phone produced significant effects for women with household incomes >$30,000.

Conclusion: Use of a mailed DVD for low-income African-American women may be an effective way to increase mammography adherence.

Trial registration: ClinicalTrials.gov NCT00287040.

Keywords: African-American; Controlled trial; Health disparities; Interactive DVD; Mammography adherence; Randomized intervention.

Figures

Fig 1. Consort Flow Diagram for African American Sample obtained from larger study

This diagram shows the number of women who were eligible, those allocated to each intervention group-DVD, Telephone and Usual Care and those who were analyzed. †No race data was collected from those who were eligible; race data is only available for those who consented to participate and enrolled in the study.