News Release

Volunteers can help with mammography promotion

Peer-Reviewed Publication

Center for Advancing Health

Volunteers can help promote mammography in rural areas, according to a large study of women from 40 communities in Washington State.

Previous research has indicated that rural residents are screened for cancer less frequently than urban residents. "Despite evidence that regular breast cancer screening significantly reduces breast cancer mortality, many women in the United States do not receive regular screening," said lead author M. Robyn Andersen, PhD.

Andersen and colleagues from the Fred Hutchinson Cancer Research Center and from the University of Washington in Seattle, Washington tested three types of mammography promotion approaches that employed volunteers.

In the first approach, volunteers provided mammography information by telephone. Volunteer counselors reminded women about the value of regular mammography and provided information about local facilities, including those with free and low-cost mammography options. They also addressed issues related to lack of physician referral and helped women address their fears of mammography results and other barriers to mammography use.

A second approach focused on building awareness and support of mammography screening within the community, and the third strategy combined aspects of the first two approaches. Community activities included mammography-theme bingo nights; beauty shop promotions; community newsletters; and distribution of mammography information at local clubs, stores, libraries, and golf courses.

From follow-up interviews three years after initiating the volunteer programs, the researchers found that their efforts had achieved positive, but very modest, improvements in mammography usage among the 6,592 study participants, half of whom were regular users of mammography at the start of the study. The results are consistent with other large community trials that employed similar techniques, according to the researchers.

The three approaches achieved similar results, but the second approach, which focused on community activities, was the most effective. It was the only approach that resulted in statistically significant increases in mammography usage.

This approach increased mammography use among women who were already regular users by 2.9 percent. The community activities approach also led to an increase in mammography among certain groups of women who were not regular users at the beginning of the study, including women in communities without female physicians and women with no health insurance. The study findings are published in the April issue of the American Journal of Preventive Medicine.

The researchers speculated that the volunteers involved with the community approach may have spent more time on the community activities than those asked to do telephone counseling or those asked to do both telephone counseling and community activities.

They also suggested another possibilityÐthat the first, and especially the third, approaches may have been too much of a strain for volunteers. "It is possible to ask too much of volunteers," said Andersen.

Andersen and colleagues described the positive results in communities lacking female physicians as "interesting." "It is possible that female physicians working in rural communities serve as local specialists in areas related to women1s health care or act as local spokespeople promoting mammography use," said Andersen.

"If so, community interventions may be most effective in communities where there aren1t local physicians actively promoting cancer screening. In such communities trained volunteers may serve as credible, trustworthy sources of information," she concluded.

This research was supported by a grant from the National Cancer Institute.

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The American Journal of Preventive Medicine, sponsored by the Association of Teachers of Preventive Medicine and the American College of Preventive Medicine, is published eight times a year by Elsevier Science. The Journal is a forum for the communication of information, knowledge, and wisdom in prevention science, education, practice, and policy. For more information about the journal, contact the editorial office at (619) 594-7344.

Posted by the Center for the Advancement of Health < http://www.cfah.org >. For information about the Center, call Petrina Chong, < pchong@cfah.org > (202) 387-2829.


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