Interventions targeted toward patients to increase mammography use

The objective of this study was to determine the effects of patient-based m ammography screening strategies; We performed a meta-analysis and included United States studies that met the following criteria: (a) randomized or co ncurrent control design; (b) defined outcomes; and (c) data available for r eanalysis. Interventions were classified as behavioral, cognitive, or socio logical and further categorized by the type of control group (active versus usual care), number of interventions, and mode of intervention (interactiv e versus static). Data were combined using DerSimonian and Laird random eff ects models to yield summary effect sizes. A total of 63 interventions in 4 3 studies met the inclusion criteria. Behavioral interventions increased sc reening by 13.2% [95% confidence interval (CI), 4.7-21.2] compared with usu al care, and by 13.0% (95% CI, 8.7-17.4) when using multiple strategies and 5.6% (95% CI, 0.6-1.6) when using a single intervention compared to active : controls. Cognitive interventions using generic education strategies had little impact on screening, but those that used theory based education (e.g ., health belief model) increased rates by 23.6% (95% CI, 16.4-30.1) compar ed with usual care. Sociological interventions also increased screening rat es. Interventions using a theoretical framework were the most effective in increasing screening rates. The ability of these interventions to increase screening among subgroups and improve rates of ongoing screening, as well a s the costs of these strategies, is unknown and is an important area for fu ture research.