FACILITY-BASED INREACH STRATEGIES TO PROMOTE ANNUAL MAMMOGRAMS

Mammography facilities frequently use inreach strategies, such as remi nders, to encourage annual returns by asymptomatic women 50 years of a ge and older. We describe three pilot studies that systematically comp ared various strategies. In each study, patients seen for a screening mammogram during a specified period were randomly assigned to a novel reminder condition or a comparison condition one year later, and retur n rates were monitored. In study 1, return rates for subjects receivin g a standard mailed reminder (36%) and subjects receiving a mailed rem inder plus incentive (32%) were similar. In study 2, return rates for subjects receiving a mailed reminder (44%) and subjects receiving a ph oned reminder (48%) also were similar. However, study 3 focused on a m ailed reminder on the referring physician's letterhead sent by the mam mography facility versus no reminder, and a significant increase in re turn rates resulted (47% versus 19%). We present the implications of t his pattern of findings and discuss the need for a larger trial of the physician-endorsed reminder.