Recruitment to mammography screening: a randomised trial and meta-analysis of invitation letters and telephone calls
Article first published online: 25 SEP 2007
Australian and New Zealand Journal of Public Health
Volume 30, Issue 2, pages 111–118, April 2006
How to Cite
Page, A., Morrell, S., Chiu, C., Taylor, R. and Tewson, R. (2006), Recruitment to mammography screening: a randomised trial and meta-analysis of invitation letters and telephone calls. Australian and New Zealand Journal of Public Health, 30: 111–118. doi: 10.1111/j.1467-842X.2006.tb00101.x
- Issue published online: 25 SEP 2007
- Article first published online: 25 SEP 2007
- Revision requested: May 2005 Accepted: June 2005
Objectives: To determine the effectiveness of three recruitment strategies to encourage women to attend for an initial mammography screen, and to compare results with similar service studies. Interventions were: (1) an invitation letter; (2) two invitation letters; and (3) an invitation letter plus a follow-up telephone call.
Methods: All women aged 50–54 years in two BreastScreen New South Wales (BSNSW) Screening and Assessment Service catchment areas (n=3,144) were recruited from the Australian Electoral Roll and randomised to the four groups. Response rates for each intervention were compared relative to standard practice (one invitation letter) at 12-weeks follow-up. Marginal cost-effectiveness for each condition was calculated. Other similar randomised trials were also meta-analysed.
Results: The screening rate for two letters was 8.5% (OR=1.61, 95% CI 1.08-2.40) and 7.8% (OR=1.46, 95% CI 0.97-2.18) for one letter plus a telephone call, compared with 5.5% for standard practice (one letter) (OR=1.00). The response rate in the one letter plus a phone call group was 13.3% (OR=2.65, 95% CI 1.76-4.00) for women where a phone number was located.
Conclusion: Initial screening rates after a 12-week follow-up were significantly higher in the women receiving a second invitation letter, compared with standard practice (one letter). Marginal cost-effectiveness favoured the two-letter approach.
Implications: A follow-up invitation letter is more cost-effective than one invitation letter plus a follow-up telephone call in the BSNSW program. However, an invitation letter plus follow-up phone call is more cost-effective in recruiting women to BSNSW only if a phone number is located.