Encouraging Attendance at a Screening Mammography Programme: Determinants of Response to Different Recruitment Strategies

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Abstract
To predict attendance at a mammographic screening programme after a community health promotion campaign and attendance after a personal invitation in addition to that campaign. Setting – A pilot mammographic screening programme in Melbourne, Australia. Methods — Attendance was encouraged by a community health promotion campaign and one year later, a personal invitation was sent to all women who had not yet attended. Drawn from two regions of a defined area (close to and distant from the screening centre), 618 women were interviewed before the programme started, and subsequent attendance at the programme was recorded. Over half of the women (58%) in the sample residing close to the screening centre and 44% of women in the more distant sample attended. The personal invitation boosted attendance, particularly in the distal sample where attendance was more than doubled. Overall, attendance was predicted by ease of access to the programme; positive intention to attend; moderate experience of, perceived susceptibility to, concern about, and knowledge of breast cancer; adoption of other preventive health behaviours; having a job; and older age. Proximity to the programme, positive initial intentions, having heard of a mammogram, no concern about radiation from a mammogram, high personal control over health, and belonging to a club were associated with attendance after exposure to only the health promotion campaign. A personal invitation encouraged attendance among women without these characteristics. A personal invitation in addition to a community promotion campaign seems to overcome many barriers to attendance. Attendance may be further increased by informing women of the benefits of early detection and improving access to the screening centre.