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A clinic-based mammography intervention targeting inner-city women.
Taylor, V; Thompson, B; Lessler, D; Yasui, Y; Montano, D; Johnson, K M; Mahloch, J; Mullen, M; Li, S; Bassett, G; Goldberg, H I.
Afiliação
  • Taylor V; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Wash 98109, USA.
J Gen Intern Med ; 14(2): 104-11, 1999 Feb.
Article em En | MEDLINE | ID: mdl-10051781
OBJECTIVE: The objective was to evaluate the effect of a clinic-based intervention program on mammography use by inner-city women. DESIGN: A randomized controlled trial employing firm system methodology was conducted. SETTING: The study setting was a general internal medicine clinic in the university-affiliated county hospital serving metropolitan Seattle. PARTICIPANTS: Women aged 50 to 74 years with at least one routine clinic appointment (when they were due for mammography) during the study period were enrolled in the trial (n = 314). INTERVENTIONS: The intervention program emphasized nursing involvement and included physician education, provider prompts, use of audiovisual and printed patient education materials, transportation assistance in the form of bus passes, preappointment telephone or postcard reminders, and rescheduling assistance. Control firm women received usual care. MEASUREMENTS AND MAIN RESULTS: Mammography completion within 8 weeks of clinic visits was significantly higher among intervention (49%) than control (22%) firm women (p < .001). These effects persisted after adjustment for potential confounding by age, race, medical insurance coverage, and previous mammography experience at the hospital (odds ratio 3.5; 95% confidence interval 1.9, 6.5). The intervention effect was modified by type of insurance coverage as well as prior mammography history. Process evaluation indicated that bus passes and rescheduling efforts did not contribute to the observed increases in screening participation. CONCLUSIONS: A clinic-based program incorporating physician education, provider prompts, patient education materials, and appointment reminders and emphasizing nursing involvement can facilitate adherence to breast cancer screening guidelines among inner-city women.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Avaliação de Processos e Resultados em Cuidados de Saúde / Neoplasias da Mama / Mamografia / Programas de Rastreamento / Educação em Saúde Tipo de estudo: Clinical_trials / Guideline / Prognostic_studies / Screening_studies Limite: Adult / Aged / Female / Humans / Middle aged País/Região como assunto: America do norte Idioma: En Revista: J Gen Intern Med Assunto da revista: MEDICINA INTERNA Ano de publicação: 1999 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Avaliação de Processos e Resultados em Cuidados de Saúde / Neoplasias da Mama / Mamografia / Programas de Rastreamento / Educação em Saúde Tipo de estudo: Clinical_trials / Guideline / Prognostic_studies / Screening_studies Limite: Adult / Aged / Female / Humans / Middle aged País/Região como assunto: America do norte Idioma: En Revista: J Gen Intern Med Assunto da revista: MEDICINA INTERNA Ano de publicação: 1999 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos