Mammography Adherence in African-American Women: Results of a Randomized Controlled Trial

Background Breast cancer is the second leading cause of cancer mortality among women in the developed world. Mammography screening is especially important for African-Americans because they experience a greater mortality (OR-1.38) than Caucasians despite having a lower incidence of breast cancer. Purpose The purpose of this study was to compare the effects of two interventions with usual care on mammography adherence among African-American women. Methods A subsample of African-American women (n=244) aged 41-65 years who had not had a mammogram in the last 15 months and no history of breast cancer was randomly assigned to receive (1) mailed interactive DVD, (2) computer-tailored telephone counseling, or (3) usual care. Results The DVD intervention was five times more effective than usual care for promoting mammography screening at 6 months follow-up among women who earned less than $30,000 (OR=5.3). Compared to usual care, neither the DVD nor phone produced significant effects for women with household incomes >$30,000. Conclusion Use of a mailed DVD for low-income African-American women may be an effective way to increase mammography adherence.