Using text message reminders to increase mammography rescreening among low-income, uninsured women in Louisiana

Introduction Mammography finds breast cancer before it is symptomatic, and repeat screening further improves its ability to find cancer at early stages. Phone and mail reminders have been shown to increase rescreening rates; a literature search found no information on using text messaging.

Methods Louisiana Breast & Cervical Health Program (LBCHP) is piloting using text message reminders to increase rescreening among participants. The two-year pilot study, which began in September 2009, compares two methods: standard, card sent 11 months after a participant's last mammogram, and new, standard plus additional text message reminders at the 17th and 22nd months if needed.

The study is being conducted with LBHCP participants who have been screened at a rural public hospital and an urban community health center. The women are 50-64 years of age, low-income, uninsured, and predominately African-American. They are assigned to intervention groups by zip code of residence.

Survival analysis will be used to determine and compare mammography adherence rates for the two intervention groups. Logistic regression will be used to determine the relationship between participants' characteristics (location, previous screening result, race/ethnicity) and adherence. Time, effort and material costs for the interventions also will be compared.

Results Based on an initial rate of successful transmitting text messages of 45%, it is estimated that there will be 960 subjects in the new intervention group, and 2304 subjects in the standard group by the end of the study period. A mid-study analysis of data collected through September will be available for presentation at APHA.