Background. This randomized trial evaluated the impact of mammography- enhancing interventions implemented in 40 senior citizens' housing facilities in Pennsylvania and North Carolina. Methods. After stratification of the facilities according to the socioeconomic status and racial backgrounds of their residents, they were randomly assigned to one of four groups to receive the following: 1) standard care - a Medicare mammography benefit flier; 2) education the flier and a community education program; 3) access - the flier, mammography appointments, and transportation; 4) combined - all interventions. Telephone surveys, conducted prior to any intervention, identified mammography-eligible women, who were re-surveyed six months later to ascertain mammography use. Results. Logistic regression analyses identified mammography intention, age, and the interaction between ever having had mammography and being in the combined intervention group to be significant predictors of mammography use at six months. However, no significant main effect was found for any of the interventions. Conclusions. These results suggest that the combination of community-directed mammography education and access to mammography appointments encourages mammography use primarily by women who are already predisposed to having mammography. However, individually targeted and tailored interventions may be needed to encourage mammography use among women who have never had mammography and/or express no intention of having it done.
