• Katrin Hegenscheid, Wolfgang Hoffmann, Sebastian Fochler, Martin Domin, Stefan Weiss, Birgit Hartmann, Ulrich Bick, and Norbert Hosten.
• Department of Diagnostic Radiology and Neuroradiology, Ernst Moritz Arndt University Medical Center Greifswald, Germany. katrin.hegenscheid@uni-greifswald.de
• Am J Prev Med. 2011 Oct 1; 41 (4): 421-7.

BackgroundIn Germany, a mammography-screening program (MSP) was implemented on a national level. It complies with all criteria of the European guidelines for quality assurance in screening mammography; however, the attendance rate is 54%, falling short of the target attendance rate of 70%. The aim of this study was to investigate whether additional telephone counseling improves attendance among nonresponders and the level of satisfaction with telephone counseling.DesignIn a prospective RCT, women identified as nonresponders in the MSP were randomized to a control group that received written reminders or to an intervention group that additionally received telephone counseling. In a follow-up, a subset of the intervention group was contacted by telephone regarding their satisfaction with telephone counseling.Setting/ParticipantsIn 2008, a total of 5477 women aged 50-69 years who were eligible for the German MSP but had not participated up to 6 weeks after the first invitation were included in the study.InterventionsIndividual telephone counseling consisted of scripted calls from a trained counselor who provided information on MSP and answered the woman's questions.Main Outcome MeasuresReport of mammography use provided by the screening unit 3 months after the reminder was sent.ResultsAnalysis was conducted in 2009. Comparison of screening attendance revealed a significantly higher attendance rate in the intervention group compared with controls (29.7% vs 26.1%, p=0.0035). When only women for whom telephone numbers were available were analyzed, attendance was even better (35.5% vs 29.7%, p=0.0004). In the follow-up, 278 of 404 women were actually surveyed. Of those, 33% stated that telephone counseling had influenced their decision, 56% stated that they had undergone screening mammography, and 77% agreed that personal telephone counseling should be used routinely to encourage nonresponders to go for screening.ConclusionsIndividual telephone counseling for nonresponders to a national program for breast cancer screening was well accepted by participants and effective.Trial RegistrationThis study is registered at the Australian New Zealand Clinical Trials Registry ACTRN12611000645954.Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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