Since physician recommendation is a consistent predictor of mammography use, effective methods for improving physician screening behavior are needed to convert underusers in their practice to regular breast cancer screening. Community-based surveys of women aged 50-80 years and their primary care physicians identified non-adherent providers who were assigned using a factorial design to physician intervention or control conditions. 154 control and 128 intervention physicians in 4 Long Island, New York, townships completed pre- and post-intervention surveys (1995 and 1998, respectively). Intervention physicians received a one to two-hour in-office training program and/or a self-study workbook. Physician adherence to breast cancer screening guidelines was measured by self-reports and audits of randomly selected charts of eligible women patients. Educational need (includes office systems to facilitate screening, clinical breast examination (CBE) skills, and knowledge/counseling skills relating to breast cancer) was assessed through self-reports and observational data. Self-reported overall breast cancer screening need improved among more intervention than control physicians, particularly those receiving the in-office intervention (p=0.031). CBE need declined (p=0.010); use of provider reminder systems increased (p=0.021); preparedness to counsel about CBE (p=0.040), and recognition that age is an important risk factor (p=0.023) improved among more intervention than control physicians. Chart audits showed adherence to mammography screening guidelines improved among intervention physicians (p<0.025) but not controls. The intervention appeared to be most effective initiating screening among women who never had a mammogram. This NCI supported project demonstrates the feasibility of a community-based approach to implementing a targeted office-based physician intervention and measuring improved outcomes.
Learning Objectives: Learning objectives: At the conclusion of the session, the participant (learner) in this session will be able to: Describe a community-based approach to identifying physicians in need of breast cancer screening educational interventions. Apply a multi-faceted, targeted continuing medical education program designed to increase mammography screening among older women by increasing the screening practices of their physicians. Assess the effectiveness of a community-based approach to implementing an office-based physician intervention targeted specifically at physicians with breast cancer screening need
Keywords: Breast Cancer Screening, Preventive Medicine
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.