Low-income African American women are at relatively high risk for breast cancer mortality, due in part to their limited mammography use. The purpose of the proposed stud is to compare the effect of a tailored interactive computer program with a culturally appropriate video on mammography use. Secondly, this study will assess the effect of a booster tailored interactive computer programed and booster video program that is delivered one year after the initial intervention to improve interval mammography screening. Finally, the cost effectiveness of both delivery methods will be explored. The design for this study contrasts three groups randomly allocated to tailored interactive computer, video, or control. Subjects will include 625 African American women ages 41 to 75 years and at 150% poverty or below who have not had a mammogram in the last 18 months. A network of multi service centers located in the poorest areas of a large metropolitan are will serve as resources for recruitment and intervention delivery. The interactive computer and video programs will build on concepts found to be predictive of mammography in prior work. The intervention will be delivered to appropriate groups after a baseline interview and again at 12 months for women who are randomly assigned to receive a booster intervention. Only have of the women initially assigned to receive the interactive computer program or video will receive the booster in order to compare the women receiving the booster intervention with women who receive only the initial intervention. Baseline interviews prior to intervention) will take place in the multi service center and telephone interviews will take place a three times following intervention delivery. l. Women will receive $25.00 following each interview, for a total of $100. This study is developed to have 90% power to detect overall differences in compliance at six months and 21 months. Mammography compliance will be measured through self-report and facility verification. Belief variables built into the intervention and measured through validity and reliability. The primary outcomes at six month and 21 months will be tested by a chi-square statistic using logistic regression with two degrees of freedom. Cost effectiveness analysis is planned for the third aim.
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