Two sequential randomized trials of community participation to recruit women for mammographic screening

Background. If mammographic screening is to reduce mortality from breast cancer, it is essential that a high proportion of the target population attend for screening. In order to achieve this, effective recruitment strategies are needed. This paper reports two trials of recruitment strategies for mammographic screening involving eight communities in rural New South Wales (NSW), Australia. Methods. Each trial involved two matched pairs of towns in the Hunter Valley region of NSW. Towns were randomly allocated to intervention, receiving either mass media promotion or community participation in Trial 1 and community participation or family physician involvement in Trial 2. Results. In Trial 1, significantly higher attendance rates were observed in the two towns that received the community participation intervention compared with their matched media promotion towns (63% vs 34%, P < 0.001 and 51% vs 34%, P < 0.01). In Trial 2, a significantly higher attendance rate was observed in one town that received the family physician involvement intervention compared with its matched town which received the community participation intervention (68% vs 51%, P ( 0.01). There was no significant difference in attendance in the other pair of towns (68% vs 58%, P = 0.11). Conclusions. Both community participation and family practitioner involvement are more promising strategies for the promotion of attendance at mammographic screening facilities than media promotion alone. (C) 1996 Academic Press, Inc.