Assessing delivery of and attitudes toward a randomized intervention to increase mammography uptake among childhood cancer survivors: A report from the Childhood Cancer Survivor Study.

OBJECTIVE: This study characterizes utilization of, and attitudes toward, a two-part intervention of (1) mailed materials, including educational laminated cards for patients and healthcare providers, and (2) telephone counseling, that aimed to increase screening mammography uptake among adult female survivors of childhood cancer compared to attention controls. METHODS: Participants (n = 136, median age 35 years, range 25-49 years) were diagnosed with cancer between 1976 and 1999 before age 21 years and had been treated with chest radiation. At study end, participants completed a questionnaire asking about their use of and attitudes toward the intervention components. Fisher's exact tests assessed associations. RESULTS: Among 130 survivors who completed the survey, 45 (35%) received a mammogram. Eighty-five (65%) survivors recalled receiving both intervention components; about half (n = 73, 56%) found the laminated cards helpful and/or described the telephone counseling as positive or activating (n = 81, 62%). Of the 96 women who provided responses, approximately two-thirds (n = 64, 67%) reported little to no fear/anxiety regarding the intervention. Women were more likely to obtain a mammogram if they remembered receiving both intervention components compared to women who reported receiving one or no components (45% vs. 24%, p = 0.050), reported using the laminated card to discuss screening with a healthcare provider (72% vs. 51%, p = 0.086), or found the telephone counseling motivational (61% vs. 30%, p = 0.003). CONCLUSIONS: In summary, the two-part intervention was well-received and elicited minimal fear/anxiety. Receiving intervention messaging in multiple forms and sharing it with a healthcare provider was associated with intervention efficacy.

Duke Scholars

Author Kevin Charles Oeffinger Medicine, Medical Oncology