EFFECTIVENESS OF A TELEPHONE OUTCALL INTERVENTION TO PROMOTE SCREENING MAMMOGRAPHY AMONG LOW-INCOME WOMEN

Background. This study evaluated the impact of a telephone outcall int ervention (based on the Transtheoretical Model) on Screening mammograp hy behavior among lower income, older women. Methods. A geodemographic database, INFORUM, was used to identify low-income and minority neigh borhoods throughout the state of Colorado. Residences were assigned ra ndomly to three study groups: (1) control, (2) outcall only, and (3) a dvance ''invitation'' + outcall. Information Specialists of the Cancer Information Service implemented the protocol. Mammography adherence w as assessed in telephone interviews conducted 6 months and 2 years aft er the initial call. Results. Neither intervention had a significant e ffect on the main outcome, receipt of mammography in the 6-month follo w-up period. At 6 months, intentions to have a mammogram were signific antly stronger in the intervention groups compared with the control gr oup, particularly among those who were precontemplators at baseline. T he a-year follow-up indicated a small increase in mammography adherenc e attributable to the advance invitation + outcall, but this effect wa s restricted to those adherent at baseline. Mammography behavior durin g the 6-month follow-up period was predicted strongly by decisional ba lance, intentions, receipt of a physical and clinical breast exam, and previous mammography behavior. Conclusions. The intervention promoted minimal movement in the stages of change for mammography. Outcall int erventions may have promise for encouraging repeat mammography behavio r, but more intensive interventions are likely to be necessary to prom ote behavior change among nonadherent women. (C) 1998 American Health Foundation and Academic Press.