Abstract

Although mammography is the most effective early detection breast cancer screening technology available, it is underutilized. This study was conducted to test the effectiveness of a loss-framed minimal intervention to increase mammography use. Loss-frame refers to a communication strategy in which messages are framed from the perspective of what a person has to lose by not taking a particular behavioral action. Participants were medically un- and underinsured women 50-64 years old who called one of two urban clinics randomly selected based on demographic statistical equivalency. The women who participated telephoned to inquire about a mammogram during the 6-month study period. The group randomly designated as the experimental group received a loss-framed message conveyed by trained staff telephonically. Members of the comparison group received the "usual" communication, also conveyed telephonically. In the experimental group, 31 of 112 (27%) women who inquired received mammograms, whereas 157 of the 992 (16%) comparison group women who inquired received mammograms. The odds of a mammogram, adjusted for race and breast cancer symptoms, significantly increased for the experimental (odds ratio [OR] = 1.914, chi2 = 7.48, p = .0063, 95% confidence interval [CI] 1.20-3.05) versus comparison group. A loss-framed, in-reach, minimal intervention approach holds promise as a mammography promotion strategy.

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