DESCRIPTION (provided by applicant): This 2-year cohort study will evaluate the implementation of a large-scale screening mammography patient reminder program that began in January 2006. This real-world case study will be used to refine the "FICS-it" conceptual model for implementation of cancer screening reminder systems ("Forging Implementation of Cancer Screening"). The FICS-it model considers the external environment, intervention design, dissemination-implementation infrastructure, and adopting organization (with particular emphasis on the health care team) and its patients. Our work will provide recommendations to improve mammography screening reminder program Reach, Effectiveness, Adoption, Implementation, and Maintenance (the RE-AIM evaluation framework). Findings from this exploratory study will be used to develop and evaluate improved implementation methods for cancer screening reminder programs. Among women health plan members aged 40 or older who are due for a repeat screening mammogram (n= 32,500) and their health care teams and other key staff, primary aims are to: 1. Evaluate using quantitative methods: a) the degree of overall effectiveness and maintenance of a patient reminder program to improve repeat mammography screening and b) the impact of health care team implementation work practices on overall program effectiveness and maintenance. 2. Describe and explain the mammography patient reminder program Reach, Effectiveness, Adoption, Implementation, and Maintenance using mixed methods and multiple perspectives guided by a comprehensive conceptual framework. 3. Recommend improved methods to enhance Reach, Effectiveness, Adoption, Implementation, and Maintenance of screening mammography patient reminder programs, and refine the conceptual framework and research instruments for future research based on the findings from aims 1 and 2.
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