RECRUITING HIGH-RISK WOMEN INTO A BREAST-CANCER HEALTH PROMOTION TRIAL

This study sought to identify factors that facilitate or hinder partic ipation in a breast cancer health promotion trial among high-risk wome n. The subjects were 271 women ages 35 years and older who had a famil y history of breast cancer in at least one first-degree relative. All subjects were eligible for participation in a randomized trial which c ompares breast cancer risk counseling with general health counseling. Structured telephone interviews evaluated demographic characteristics, risk factors, risk perceptions, breast cancer concerns, and past scre ening practices. The results showed that education level was a key det erminant of the importance of these factors in participation. Logistic regression modeling indicated that women with a high school education or less were most likely to participate if: (a) their relatives' diag noses had greatly increased their perceptions of their personal risks [OR (OR) = 4.1], particularly if they perceived that risk to be very h igh (OR for interaction = 6.4); and (b) if they were ages 40-49 years versus 35-39 or 50 + years (OR = 2.6). By contrast, among women with e ducation beyond high school, participation was predicted by (a) marita l status (OR = 2.6), (b) employment (OR = 0.03 for employed), (c) numb er of affected relatives (OR = 0.07 for 1 versus 2 first-degree relati ves), and (d) previous biopsy (OR = 0.42). These findings suggest that recruitment strategies that tailor messages to women's educational le vels might be most effective.