Tailored Messages Motivate Women to Get Mammograms

WASHINGTON—In motivating women to get timely mammograms, discussions tailored to individuals’ particular reasons for not getting mammograms are far more effective than general recommendations, said Diane Ruth Lauver, PhD, RN, professor of women’s health, University of Wisconsin, Madison. Speaking at the American Psychological Association Conference on Enhancing Outcomes in Women’s Health, she reported on a study of motivational messages given to 797 Midwestern women, age 51 to 80, who had not had a mammogram in the past 13 months.

A third of the subjects, the control group, received no discussions about mammograms. A second third received telephone calls from advanced practice nurses who offered a standard message about recommendations for mammography. For the last third, the nurses’ calls included both standard recommendations and tailored discussions about the woman’s beliefs, feelings, and external barriers regarding mammography.

The nurses "tailored" the messages, by assessing each woman’s beliefs and feelings about mammography, and any external barriers to getting a mammogram—such as lack of affordability or accessibility—and then using a "message library" of relevant points. If, for example, a woman stated that she didn’t need a mammogram because she had no symptoms of breast cancer, the nurse would reply that having no breast problems was excellent, but that "mammograms are most useful in finding a problem, if it is there, before either the woman or the doctor could see or feel it."

The standard and the tailored messages were about equally effective in motivating women to get screening in the short term—3 months following the calls—and both worked better than no message.

But a year later, more of the women who received the tailored message had gotten a second mammogram than had the women in the other groups.