Burhansstipanov 2010.
Methods |
Study design: controlled before‐after (independent samples) Sampling frame: Denver, Colorado; low‐income minority women including Native American, Latina, and African American Sampling method: convenience Collection method: telephone or in‐person interview Description of the community coalition: A coalition of 3 organizations serving low‐income minority women (Native American Cancer Research, La Clinica Tepeyac, and Exempla Saint Joseph Hospital) was formed to implement “Increasing Mammography Adherence among Medically Underserved Women‐MUP,” a National Cancer Institute‐funded project. Data collected before the intervention by the Susan Komen Foundation and the University of Colorado Cancer Center indicated the need for culturally relevant patient navigator support for low‐income minority and white women to increase mammography rescreening among women > 40 years of age. A statewide network, the “Partnership in Cancer Control Among Underserved Populations,” served as the advisory committee for the project. A patient navigator model of care was selected on the basis of previous effectiveness in 2 Native American breast cancer screening studies |
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Participants |
Communities: Denver, Colorado Country: USA Ages included in assessment: women > 39 years, mean age 52.9 years Reasons provided for selection of intervention community: Data (not reported in paper) gathered by the Susan Komen Foundation and the University of Colorado Cancer Center indicated the need Intervention group: (n = 316) women recruited through outreach at 3 coalition settings and community cultural events Comparison group: (n = 200) women in the Colorado Mammography Advocacy Program of similar demographics |
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Interventions |
Name of intervention: Increasing Mammography Adherence among Medically Underserved Women (MUP) Theory: Social Learning Theory Aim: to increase regular mammography rescreening among medically underserved women > 39 years of age Description of costs and resources: Patient navigators were hired and were provided 80 hours of training on patient support and education, breast cancer, cancer screening, and intervention for abnormal mammograms. Each of the 3 coalition organizations hired navigators for patient outreach and follow‐up. Number of patient navigators is not provided and costs are not mentioned Components of the intervention: Culturally appropriate education session, assistance with scheduling mammogram, and follow‐up by phone or visit to document screening were provided; assistance was provided with follow‐up appointment if result was abnormal. Patient navigators followed checklist to document implantation of program components. Control group received usual care Start date: 2001 Duration: 5 years |
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Outcomes |
Outcomes and measures: self report of receipt of mammogram Time points: not reported |
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Notes | High attrition in intervention group due to change in Colorado law disallowing publicly funded services to undocumented Latinas Source of funding: agencies within the coalition |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | High risk | Convenience sample |
Allocation concealment (selection bias) | High risk | Allocation not concealed |
Baseline outcome measurement similar | Low risk | Only enrolled women who had never received repeat screening |
Baseline characteristics similar | High risk | Baseline data not reported |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Blinding not reported |
Incomplete outcome data (attrition bias) All outcomes | High risk | Proportion of missing data higher among intervention group |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Not blinded |
Protection against contamination | Unclear risk | Potential for contamination not described |
Selective reporting (reporting bias) | Low risk | Relevant outcome reported |