Grant Number:	5R01CA105786-05 Interpret this number
Primary Investigator:	Rimer, Barbara
Organization:	Univ Of North Carolina Chapel Hill
Project Title:	Finding the M.i.n.c. for Mammography Maintenance
Fiscal Year:	2007

DESCRIPTION (provided by applicant): Data from the 2000 NHIS show that only about half the age-eligible women in the U.S. are in maintenance for mammography--getting regular mammograms. Regular mammography use is required to reduce the population burden of breast cancer, resulting in earlier detection of breast cancer and lower disease mortality. We aim to increase maintenance among 4040 initially adherent women who are members of the North Carolina Teachers' and State Employees' Comprehensive Major Medical Plan (SHP), a very large population of women, representing women of diverse occupations and backgrounds. The SHP is administered by Blue Cross and Blue Shield of North Carolina (BCBSNC), which also was the administrator of the health plans that were part of the study on which this one is built-- PRISM, Personally Relevant Information about Screening Mammography. The proposed research is PRISM2. Our goal is to identify the M.I.N.C., Minimum Intervention Needed for Change. We propose to refine an adaptive intervention system, based on our previous work using stepped care models and tailored interventions. Following the adaptive model, all women annually will receive one of three kinds of mammography reminders--Usual Care, which represents the kinds of reminders women usually receive, compared to Enhanced Letter or Automated Telephone Reminders based on persuasive communication principles and designed to increase the efficacy of reminders by treating them as brief persuasive communications. Women who do not respond to these brief interventions within 6 months in any intervention year will receive step 2, a brief telephone counseling intervention that focuses either on overcoming barriers or supplementing this by encouraging women to also elaborate either on the positive consequences of getting mammograms or the negative consequences of not getting them. A control condition for the call will help us assess the incremental impact of telephone counseling following reminders. We will conduct baseline telephone interviews prior to intervention and follow-up interviews by telephone 12, 24, 36 and 48 months from first reminders. We are working at the level of both individual women and SHP. We hypothesize that enhanced reminders will be more likely to lead to adherence and maintenance than usual care reminders. Women who receive barriers calls with elaboration of consequences will be most likely to return to adherence. Our interventions are informed by the Health Belief Model, Theory of Reasoned Action, Model of Goal- Directed Behavior and theories appropriate to study maintenance as well as the Elaboration Likelihood Model, a theory that addresses how people process health information. Understanding both behavioral processes and information processing is important. We have a highly experienced team of researchers and support staff at The University of North Carolina at Chapel Hill and Duke University and an outstanding group of consultants and collaborators. This research has the potential to dramatically increase mammography maintenance. We have designed for dissemination so that, if effective, the interventions will be adopted.




Tables or bar graphs? Presenting test results in electronic medical records.
Authors: Brewer N.T. , Gilkey M.B. , Lillie S.E. , Hesse B.W. , Sheridan S.L. .
Source: Medical Decision Making : An International Journal Of The Society For Medical Decision Making, 2012 Jul-Aug; 32(4), p. 545-53.
PMID: 22472914
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It's the amount of thought that counts: when ambivalence contributes to mammography screening delay.
Authors: O'Neill S.C. , Lipkus I.M. , Gierisch J.M. , Rimer B.K. , Bowling J.M. .
Source: Women's Health Issues : Official Publication Of The Jacobs Institute Of Women's Health, 2012 Mar; 22(2), p. e189-94.
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Authors: Gierisch J.M. , Reiter P.L. , Rimer B.K. , Brewer N.T. .
Source: American Journal Of Health Behavior, 2010 Nov-Dec; 34(6), p. 669-79.
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Finding the minimal intervention needed for sustained mammography adherence.
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Source: American Journal Of Preventive Medicine, 2010 Oct; 39(4), p. 334-44.
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Longitudinal predictors of nonadherence to maintenance of mammography.
Authors: Gierisch J.M. , Earp J.A. , Brewer N.T. , Rimer B.K. .
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Factors associated with annual-interval mammography for women in their 40s.
Authors: Gierisch J.M. , O'Neill S.C. , Rimer B.K. , DeFrank J.T. , Bowling J.M. , Skinner C.S. .
Source: Cancer Epidemiology, 2009 Jul; 33(1), p. 72-8.
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Impact of mailed and automated telephone reminders on receipt of repeat mammograms: a randomized controlled trial.
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Public education and cancer control.
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Informed decision making: what is its role in cancer screening?
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