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Am J Manag Care. 2021 Feb 1;27(2):e48-e53. doi: 10.37765/ajmc.2021.88589.
Screening mammography is a preventive exam used to detect breast cancer in asymptomatic women. This cue-to-action pilot project sought to determine if outreach, education, and incentive would increase uptake of screening mammography among women aged 52 to 74 years who are members of a community-based health insurance plan.
Cohort study design with retrospective and prospective components.
Women were eligible to participate in accordance with the CMS Quality Rating System technical specification for breast cancer screening. Eligible women with no documented screening for a mammogram from January 1, 2016, through November 7, 2017, were invited to participate in a campaign that included outreach about screening mammography as a no-cost covered benefit, education about screening mammography to detect asymptomatic disease, and a gift card to a local grocery merchant if the member obtained screening mammography by December 31, 2017.
During December 2017, 20.8% (27/130) of eligible women obtained a screening mammogram compared with 7.8% (5/64) of eligible women during the nonintervention reference period of December 2016. Mammography screening increased by 170% during the study period in comparison with the reference period of a year earlier (prevalence ratio [PR], 2.7; 95% CI, 1.1-6.6; P = .02).
A one-time, time-limited cue-to-action pilot project consisting of outreach, education, and incentive increased uptake of screening mammography by women enrolled in a community health insurance plan providing health insurance coverage as part of the Affordable Care Act. This increase is statistically significant in the intervention period compared with the reference period (PR, 2.7; 95% CI, 1.1-6.6; P = .02). Despite a small sample size, the magnitude of the effect for this pilot study is encouraging and warrants future studies in a larger population.
乳房 X 光筛查是一种用于在无症状女性中检测乳腺癌的预防性检查。本试点项目旨在确定针对参加基于社区的医疗保险计划、年龄在 52 至 74 岁之间的女性开展外展宣传、教育和激励活动是否会增加其乳房 X 光筛查的参与度。
队列研究设计，包含回顾性和前瞻性部分。
根据 CMS 质量评级系统乳腺癌筛查技术规范，女性符合参与条件。符合条件的女性在 2016 年 1 月 1 日至 2017 年 11 月 7 日期间没有接受过乳房 X 光筛查记录，邀请其参加一项活动，该活动包括宣传乳房 X 光筛查作为免费覆盖福利、关于筛查无症状疾病的教育，以及如果成员在 2017 年 12 月 31 日之前接受乳房 X 光筛查，则可获得当地杂货店的礼品卡。
在 2017 年 12 月期间，与 2016 年 12 月非干预参考期的 7.8%（5/64）相比，20.8%（27/130）符合条件的女性接受了乳房 X 光筛查。与一年前的参考期相比，研究期间乳房 X 光筛查增加了 170%（患病率比 [PR]，2.7；95%置信区间，1.1-6.6；P=0.02）。
一项由外展宣传、教育和激励组成的限时一次性试点项目增加了参加提供平价医疗法案医疗保险覆盖范围的社区医疗保险计划的女性接受乳房 X 光筛查的参与度。与参考期相比，干预期的增加具有统计学意义（PR，2.7；95%置信区间，1.1-6.6；P=0.02）。尽管样本量较小，但该试点研究的效果令人鼓舞，值得在更大的人群中进行进一步研究。
