Satisfaction of attenders during the establishment of an Australian mammography screening program.

We aimed to examine the satisfaction and the predictors of reported satisfaction with the service offered by a pilot mammography screening service. Information was collected from 481 attenders at the screening clinic and from 318 consecutive attenders at the recall clinic using two different standard self-administered questionnaires covering respectively six and five dimensions of satisfaction. For the screening clinic attenders, mean scores on most subscales indicated quite high levels of satisfaction. There were no significant differences among different samples over time for the perceptions of technical competence of the staff. Decreases in reported level of satisfaction were found for subscales measuring interpersonal skills, information giving, physical surroundings, convenience and accessibility, and general satisfaction. Waiting times, age and marital status were predictors in most satisfaction subscales. For those attending the recall clinic, mean satisfaction scores for most scales were high, except for the scale measuring satisfaction with the way the results were received. The median time between screening and recall visits for women in this study was 27 days (range 3 to 112 days). Attenders were most dissatisfied with the delay in getting results, an area where the service might improve.

Effectiveness, costs, and cost-effectiveness of recruitment strategies for a mammographic screening program to detect breast cancer.

BACKGROUND AND PURPOSE: Since effective and affordable recruitment methods are essential for the widespread implementation of mammographic screening for detection of breast cancer, we studied the effectiveness, the costs, and the cost-effectiveness of various recruitment strategies in the population targeted by a pilot Australian program that offered free mammography screening between 1988 and 1990. METHODS: We evaluated three public recruitment strategies--local newspaper articles, community promotion, and promotion to physicians--and five personal strategies--invitation letters with or without specified appointment times, either alone or with a follow-up letter, or telephone call to nonattenders. The effectiveness of public recruitment strategies was estimated from monthly attendance rates by Poisson regression analysis, while the probability of attendance in response to personal strategies was calculated using logistic regression analysis. Costs were determined by resource usage studies. The cost-effectiveness ratios for personal strategies were determined using decision analysis. RESULTS: The costs in 1988-1989 Australian dollars per woman recruited were $22 for local newspaper articles and $106 for community promotion. No detectable increase in attendance resulted from promotion to physicians. When the cost of reserving an appointment was considered, the most cost-effective personal recruitment strategy was an invitation letter without a specified appointment time, followed by a second letter to nonattenders. This strategy recruited 35.6% of women in the sample targeted and cost $10.52 per attendee. In comparison, the most effective personal recruitment strategy was a letter with a specified appointment time followed by a second letter to nonattenders, which recruited 44.1% of women at an average cost of $19.99 and a marginal cost of $59.71 per additional attendee. CONCLUSIONS: Personal recruitment strategies were more cost-effective than public strategies. The most cost-effective personal strategy was an invitation letter without a specified appointment time, followed by a second letter to nonattenders.