Grant Details
Grant Number: |
5R01CA062246-03 Interpret this number |
Primary Investigator: |
Harrison, Richard |
Organization: |
University Of Michigan At Ann Arbor |
Project Title: |
Increasing Mammography-Older, Minority and Rural Women |
Fiscal Year: |
1998 |
Abstract
The proposed project develops and tests innovative methods to assess and
increase the use of screening mammography for the early detection and
treatment of breast cancer in older women in accordance with the
recommendations of the National Cancer Institute and other national
organizations. The project uses two methodologies: (a) the assessment of
older women and of physicians regarding utilization of mammography through
the analysis of Medicare claims data and (b) changing the behavior of
older women who have not recently utilized mammography through the use of
personal communications. These studies are performed in populations of
older women in general, older African American women, and older women
living in rural areas. The methods should be cost-effective: they use data
already collected by Medicare; the intervention targets only individuals
needing to change, communicating the need to change in inexpensive
personal letters.
The major study targets older women directly. In the first (assessment)
component of this study, Medicare claims for older women are analyzed to
identify women who have and who have not had a recent mammogram. The
second (intervention) component is a randomized controlled trial focusing
on older women who have not had a recent mammogram. Those assigned to an
intervention group will be sent a personalized letter noting they have not
had a recent mammogram and encouraging them to obtain one. The
programmatic effectiveness and cost effectiveness of the intervention will
be assessed. The third (associated factors) component examines the
relationship of beneficiary characteristics to whether or not women
originally had a mammogram and to whether or not women in the randomized
controlled trial obtained a mammogram. All three components are performed
on a representative population of older women and on representative
subpopulations of older African American women and of older women living
in rural areas.
An additional study targets primary care physicians. In the first
(assessment) component, Medicare data are used to identify the percent of
a physician's Medicare patients who have had a recent mammogram. A second
(associated factors) component examines relationships between physician
characteristics (obtained from existing data sets) to a physician's score
on percent of their patients screened. Both components are performed on a
representative population of primary care physicians and on physicians
treating higher than average proportions of older African American women
and older women living in rural areas. When the first (assessment)
component is successfully completed, randomized controlled interventions
will be proposed that will use personalized letters sent to physicians
with a low percent of screened older women patients.
This project's methods can be applied to female Medicare beneficiaries and
their physicians throughout the United States to assess and increase use
of screening mammography. Additionally, the methods provide models for
using Medicare claims to improve surveillance and dissemination regarding
use of other services.
Publications
Characteristics of primary care physicians and their practices associated with mammography rates for older women.
Authors: Van Harrison R.
, Janz N.K.
, Wolfe R.A.
, Tedeschi P.J.
, Stross J.K.
, Huang X.
, McMahon L.F.
.
Source: Cancer, 2003-11-01 00:00:00.0; 98(9), p. 1811-21.
PMID: 14584062
Related Citations
5-Year mammography rates and associated factors for older women.
Authors: Harrison R.V.
, Janz N.K.
, Wolfe R.A.
, Tedeschi P.J.
, Huang X.
, McMahon L.F.
.
Source: Cancer, 2003-03-01 00:00:00.0; 97(5), p. 1147-55.
PMID: 12599219
Related Citations
Personalized targeted mailing increases mammography among long-term noncompliant medicare beneficiaries: a randomized trial.
Authors: Harrison R.V.
, Janz N.K.
, Wolfe R.A.
, Tedeschi P.J.
, Chernew M.
, Stross J.K.
, Huang X.
, McMahon L.F.
.
Source: Medical Care, 2003 Mar; 41(3), p. 375-85.
PMID: 12618641
Related Citations