Improving access to mammograms through community-based influenza clinics -A quasi-experimental study

Background: It is a national priority to increase breast-cancer screening a mong women aged greater than or equal to 50. Annual influenza clinics may r epresent an efficient setting in which to promote breast-cancer screening a mong older women. To our knowledge, this possibility has not previously bee n explored. Objective: To examine whether offering women attending community-based infl uenza clinics the opportunity to receive a scheduling telephone call from a mammography facility will result in an increase in the number of mammogram s performed over a 6-month period. Methods: We used a quasi-experimental design with 6-month follow-up. A cont emporaneous population-based survey provided a further control group for co mparison. The sample group consisted of a total of 284 women attending nine community-based influenza clinics in a semirural county in Connecticut. Al l women were aged greater than or equal to 50 and reported no mammogram in the preceding 12 months. All women received informational literature on mam mography. Experimental subjects were each asked if a radiology facility cho sen by the subject could call her at home to schedule a mammogram. Mammogra ms performed were determined by hospital record for participants who receiv ed a scheduling call from a radiology facility, and by self-report for all other participants. Results: Mammography use following access through influenza clinics was app roximately twice that of women attending influenza clinics where access to mammography was not offered. Using three different assumptions regarding pa rticipants whose mammography status was unknown, the relative risks ranged between 1.6 and 2.1. For each assumption the results were statistically sig nificant (chi (2)=8.51-12.2; p<0.001) Conclusions: Linking access to mammography at community-based influenza cli nics can significantly increase the use of mammograms among women aged <gre ater than or equal to>50. Further studies should seek to confirm these find ings and determine the degree to which they can be replicated in a variety of communities. Enhancing preventive health practice through the bundling o f services suggests a new strategy to exploit available interventions to im prove health.