University of Missouri Kansas City School of Medicine, Kansas City, MO, USA.
University Health/Formerly Truman Medical Center, Kansas City, MO, USA.
Ann Surg Oncol. 2022 Oct;29(10):6199-6205. doi: 10.1245/s10434-022-12130-x. Epub 2022 Aug 17.
The low mammography rates at the authors' safety-net hospital (SNH) are associated with higher rates of late-stage disease. Previously, they showed that a phone call-based intervention with reminder and scheduling components significantly increased mammography uptake by 12% in their population, but implementation was resource-heavy. This study analyzed whether a text-based intervention with reminder and scheduling components could increase mammography uptake at 3 months compared with usual care.
This randomized controlled study analyzed 1277 women ages 50 to 65 years who were overdue for a mammogram but had established care at a primary-care clinic within an urban SNH. The patients received intervention 1 (a text reminder with specific scheduling options), intervention 2 (a text reminder with open-ended scheduling options), or usual care (control). Differences in the percentage of mammography uptake at 3 months were compared between the intervention and control groups using a two-tailed chi-square test.
The patients receiving a text-based reminder and scheduling opportunity were significantly more likely to receive mammograms within 3 months than those in the usual-care control group (10.2% vs 6.2%; χ = 5.6279; p = 0.03). In the intervention group, 10.3% of the participants scheduled an appointment for a mammogram via text, and 63% of these participants received a mammogram. Finally, mammography compliance did not differ by the type of scheduling offered (specific vs general) or by primary care clinic.
Leveraging technology for reminders and scheduling via two-way text messaging is effective in increasing mammography uptake in an urban safety-net setting and may be used as part of a multi-tiered intervention to increase breast cancer screening in a safety-net setting.
作者所在的保障医院（SNH）的乳房 X 光检查率较低，与晚期疾病的发病率较高有关。此前，他们发现基于电话的干预措施，其中包括提醒和预约部分，可以将他们人群中的乳房 X 光检查率提高 12%，但实施起来资源密集。本研究分析了基于提醒和预约部分的文本干预措施是否可以与常规护理相比，在 3 个月时增加乳房 X 光检查率。
这项随机对照研究分析了 1277 名年龄在 50 至 65 岁之间、需要进行乳房 X 光检查但在城市 SNH 内的初级保健诊所建立了常规护理的女性。患者接受干预 1（带有特定预约选项的文本提醒）、干预 2（带有开放式预约选项的文本提醒）或常规护理（对照组）。使用双侧卡方检验比较干预组和对照组在 3 个月时乳房 X 光检查率的差异。
与常规护理对照组相比，接受基于文本的提醒和预约机会的患者在 3 个月内接受乳房 X 光检查的可能性显著更高（10.2%比 6.2%；χ²=5.6279；p=0.03）。在干预组中，有 10.3%的参与者通过文本预约了乳房 X 光检查，其中 63%的参与者接受了乳房 X 光检查。最后，乳房 X 光检查的合规性不因提供的预约类型（具体预约与一般预约）或初级保健诊所而异。
利用双向文本消息传递进行提醒和预约的技术在提高城市保障环境中的乳房 X 光检查率方面是有效的，并且可以作为增加保障环境中乳腺癌筛查的多层面干预措施的一部分。
