Women's Recall of Recommended Client-Directed Interventions to Promote Breast Cancer Screening: A National Survey

BACKGROUND: Current mammography rates in the U.S. (75%) are below the Healthy People 2020 goal of 81%. The Guide to Community Preventive Services recommends evidence-based client-directed interventions to increase breast cancer screening rates (client reminders (CR); small media (SM); one-on-one (OE) and group education (GE); reduction of out-of-pocket costs (ROPC); and reduction of structural barriers (RSB)). This study examined women's receipt of interventions to promote mammography within the past 12 months. METHODS: In 2010, the Community Supports for Cancer Screening Survey was conducted among women aged 40 -74 using random-digit-dial and a web-based panel. Low-income and minority populations were oversampled. Data were weighted for analysis. Logistic regression was used to identify factors associated with the receipt of interventions adjusting for sociodemographic, health history and health care access. RESULTS: Of 2,514 women surveyed, >90% reported receiving >1 recommended interventions. RSB was most common (79%) followed by OE, CR, SM (43-38%), ROPC (24%) and GE (2%). Screening availability outside of work hours was the most common form of RSB. After adjustment, interventions were significantly less likely reported among women under age 50, between 251-400% of the federal poverty level, and those with no insurance, no provider, or, no family history of cancer. Hispanics were more likely to report receiving an intervention. DISCUSSION: These findings demonstrate that most women aged 40-74 recalled receiving ≥1 recommended interventions to promote mammography screening; however, opportunities exist to further implement evidence-based targeted interventions to increase breast cancer screening.