Promoting mammography adherence in underserved women: The telephone coaching adherence study

Abstract

Background Despite interventions to promote regular mammography, underserved women face barriers to mammography. This is evident in high no-show appointment rates in community-based clinics. Understanding why women fail to follow-through with appointments may help improve adherence. Objectives We conducted a focus group with women who were non-adherent to mammograms to evaluate psychosocial and structural barriers and design intervention messages. In phase two we conducted a small randomized controlled trial (RCT) to pilot test a brief telephone coaching adherence intervention (vs. control) to address barriers. Method Eligible women were non-adherent to their mammography screening appointment at a community-based setting. Psychosocial factors and perceptions of barriers were measured via a baseline survey and used to tailor the telephone coaching session. In the RCT, the primary outcome was whether women rescheduled and kept their appointment (yes vs. no). Descriptive statistics were used to summarize the results. Results Fifty-four women participated in the study (17 in phase 1 and 31 in phase 2); 89% were Black and 11% were Latina. Overall, prior to the intervention, women had low perceptions of risk (m=4.2; SD=2.4) and cancer worry (m=4.2; SD=2.6) and these characteristics informed the telephone coaching. After the intervention, most women (94.5%) rescheduled their missed appointment. More women in the intervention group kept their appointment (54%) than those in the usual care group (46%). Conclusion It appears feasible to implement a RCT in non-adherent underserved women. Addressing psychosocial and structural barriers in a brief telephone intervention may reduce non-adherence. Future studies that will test the efficacy of this approach are warranted.

What Black Women Know and Want to Know About Counseling and Testing for BRCA1/2

“…Community-based outreach and intervention strategies have proven to be successful in improving Black women’s uptake of mammography [73–76]. Culturally tailored outreach and education activities are needed in the Black community, as Blacks and other minorities have been “left behind” in the important genomic revolution [57, 58, 77].…”

Motivos Da Não Realização Da Mamografia Por Mulheres Com Idades Entre 60 E 69 Anos

“…Estudo conduzido em Washington (EUA), com mulheres de baixa renda, que participaram de um GF, mostrou que as participantes também sugeriram a necessidade de mais incentivos, para facilitar a adesão ao rastreamento do CM, destacando a necessidade de maiores informações sobre a importância da mamografia e lembretes para a realização do exame por meio de contato telefônico. 17 Ressalta-se a importância de o profissional de saúde abordar a mulher idosa, de modo integral, durante o atendimento, aproveitando a presença dela nos serviços de saúde para, entre outras ações de saúde, oferecer informações sobre o câncer e o rastreamento das neoplasias da mama. Estudo com 446 mulheres turcas, com idade entre 50 e 69 anos, evidenciou os seguintes dados: 47,2% delas relataram ter ouvido ou lido sobre o CM; 51,4% tinham algum conhecimento sobre esse agravo à saúde; a maioria das participantes citou os profissionais de saúde como a principal fonte de informações sobre CM.…”

“…Esse mesmo resultado foi encontrado em estudo conduzido com mulheres participantes de um grupo focal em Washington (EUA). 17 Na Turquia evidenciou-se que entre as mulheres que consideravam a mamografia dolorosa a chance de não serem aderentes à triagem do câncer de mama era duas vezes maior. 18 Superar as dificuldades de acesso aos serviços de saúde e, especialmente, superar as barreiras relacionadas às crenças e sentimentos acerca do CM e mamografia constitui-se um desafio a ser enfrentado pelos profissionais de saúde com vistas a estimular o rastreamento da doença em mulheres sexagenárias.…”

Chronic Obstructive Pulmonary Disease Readmissions at Minority-serving Institutions

“…Peer coaching (i.e., delivery of an intervention through trained lay-individuals who are affected by the same condition as the patients they coach) has recently gained attention as a cost-effective way to disseminate health information. Based on the social cognitive theory, which focuses on providing the knowledge and skills to promote self-efficacy (i.e., the confidence to carry out the recommended behavior) and positive outcome expectancy (i.e., the belief that the benefits outweigh the harms of the recommended behavior), a recently published pilot clinical trial demonstrated that telephone-based coaching can improve adherence to screening mammography in underserved patient populations (31% women; 89% African American; 11% Hispanic) (42). Likewise, telephone-based coaching appears to be effective in promoting adherence to physical activity recommendations in nonadherent patients after cardiac rehabilitation (43) and in improving self-care and quality of life among patients with heart failure (44).…”