Costs and cost-effectiveness of a church-based intervention to promote mammography screening

Objectives. To evaluate the costs of implementing a church-based, telephone -counseling program for increasing mammography use, and to identify the com ponents of costs and the likely cost-effectiveness in hypothetical communit ies with varying characteristics. Data Sources/Study Setting. An ethnically and socioeconomically diverse sam ple of 1,443 women recruited from 45 churches participating in the Los Ange les Mammography Promotion (LAMP) program were followed from 1995 to 1997. Study Design. Churches were stratified into blocks and randomized into thre e intervention arms-telephone counseling, mail counseling, and control. We surveyed participants before and after the intervention to collect data on mammography use and demographic characteristics. Data Collection/Extraction Methods. We used call records, activity reports, and interviews to collect data on the time and materials needed to organiz e and carry out the intervention. We constructed a standard model of costs and cost-effectiveness based on these data and the Year One results of the LAMP program. Principal Findings. The cost in materials and overhead to the church site was $10.89 per participant and $188 per additional screening. However, when the estimated cost for church volunteers' time was included, the cost of the intervention increased substantially. Conclusions. A church-based program to promote the use of mammography would be feasible for marry churches with the use of volunteer labor and resourc es.