The proposed research is part of a larger interactive grant to increase
breast screening in underscreened women. The overall aims of the
interactive application are to compare the effectiveness of Barrier-
Specific Telephone counseling in five regions of the country and to
assess the cost-effectiveness of the intervention in increasing
screening.
RAND will compare the effectiveness of two counseling interventions,
telephone and mail, in motivating low income white, black and Hispanic
women to be screened at least once in two out of three years. The
primary intervention (telephone) is based on the Trans-theoretical and
Health Belief models and will stage women to provide stage-based personal
responses. The second intervention (mail expands this staged approach
to anticipate and address barriers most likely in low income women, i.e.,
cost and lack of a regular physician.
A longitudinal cohort design will follow 3240 female religious
organization (ROs) members age 50 and over for three years to compare the
effectiveness and cost-effectiveness of these two interventions on
regular screening and mammography. The cohort will be members of three
RO groups (predominantly white, black, and Hispanic), which will be
randomized into two treatment (48 ROs) and one control (24 ROs) groups.
The interventions will be conducted by trained church members who will
serve as peer counselors. The ROs identified for the study will be
located in a 10 mile radius of the UCLA-County hospital and based in low
income census tracts.
This project focuses on the efficacy of using ROs to deliver health
promotion programs to low income neighborhoods. Because this is a five
site interactive grant, there will be important comparisons possible
across delivery settings and populations. The RAND church-based urban
project focuses entirely on low income women, 2/3 of whom are minorities.
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