Abnormal mammogram follow-up

A pilot study in women with low income

Kathleen Ell, Deborah Padgett, Betsy Vourlekis, Jan Nissly, Diana Pineda, Olga Sarabia, Virginia Walther, Susan Blumenfield, Pey Jiuan Lee

Research output: Contribution to journalArticle

Abstract

PURPOSE: The purpose of this study was to test an intervention (the Screening Adherence Follow-up Program [SAFe]) that was designed to reduce the number of known barriers to diagnostic follow-up adherence and initiation of treatment among women with low incomes who had abnormal mammogram findings. DESCRIPTION OF PROGRAM: The investigators developed and implemented a highly structured, theory- and evidence-based intervention that combined health education, counseling, and systems navigation, which was delivered by a team consisting of a peer counselor and a social worker who held a masters degree. A scripted baseline telephone interview identified potential barriers to follow-up adherence and provided counseling interventions for each patient. Patients were assigned to different service intensities based on the level of risk for nonadherence. Patients with significant mental health symptoms, psychosocial stressors, or who had received a diagnosis of cancer were referred to the team social worker for further assessment and intervention. Patients also received reinforcing telephone follow-up calls at 6 and 12 months. RESULTS: An observational pilot study of SAFe (N = 605) in two large urban diagnostic centers showed that 71% of women receiving SAFe were Hispanic, 18% were Black, and 11% were from other ethnic backgrounds. Adherence rates through diagnostic resolution and the initiation of treatment for women who had received a diagnosis of cancer were 93% and 90%, respectively, at the two study sites. Rates of adherence among women who could not be located or who refused study consent were significantly lower (72% and 69%, respectively). The rate of timely adherence was also higher among the women served. Patient satisfaction with SAFe was generally high. CLINICAL IMPLICATIONS: Study results support the combining of interventions and the practical utility of a clinical decision-making algorithm to determine individualized nonadherence risk and to assign service intensity based on individual need. Problems in locating women for enrollment were experienced.

Original languageEnglish (US)
Pages (from-to)130-138
Number of pages9
JournalCancer Practice
Volume10
Issue number3
DOIs
StatePublished - 2002

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Counseling
Patient Satisfaction
Health Education
Hispanic Americans
Telephone
Observational Studies
Neoplasms
Mental Health
Research Personnel
Interviews
Therapeutics
Social Workers
Clinical Decision-Making
Counselors

Keywords

  • Adherence
  • Breast cancer
  • Follow-up
  • Intervention
  • Screening

ASJC Scopus subject areas

  • Oncology
  • Nursing(all)

Cite this

Ell, K., Padgett, D., Vourlekis, B., Nissly, J., Pineda, D., Sarabia, O., ... Lee, P. J. (2002). Abnormal mammogram follow-up: A pilot study in women with low income. Cancer Practice, 10(3), 130-138. https://doi.org/10.1046/j.1523-5394.2002.103009.x

Abnormal mammogram follow-up : A pilot study in women with low income. / Ell, Kathleen; Padgett, Deborah; Vourlekis, Betsy; Nissly, Jan; Pineda, Diana; Sarabia, Olga; Walther, Virginia; Blumenfield, Susan; Lee, Pey Jiuan.

In: Cancer Practice, Vol. 10, No. 3, 2002, p. 130-138.

Research output: Contribution to journalArticle

Ell, K, Padgett, D, Vourlekis, B, Nissly, J, Pineda, D, Sarabia, O, Walther, V, Blumenfield, S & Lee, PJ 2002, 'Abnormal mammogram follow-up: A pilot study in women with low income', Cancer Practice, vol. 10, no. 3, pp. 130-138. https://doi.org/10.1046/j.1523-5394.2002.103009.x
Ell, Kathleen ; Padgett, Deborah ; Vourlekis, Betsy ; Nissly, Jan ; Pineda, Diana ; Sarabia, Olga ; Walther, Virginia ; Blumenfield, Susan ; Lee, Pey Jiuan. / Abnormal mammogram follow-up : A pilot study in women with low income. In: Cancer Practice. 2002 ; Vol. 10, No. 3. pp. 130-138.
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