• Article

Comparative effectiveness of mailed reminder letters on mammography screening compliance


Romaire, M., Bowles, E. J., Anderson, M. L., & Buist, D. S. (2012). Comparative effectiveness of mailed reminder letters on mammography screening compliance. Preventive Medicine, 55(2), 127-130. DOI: 10.1016/j.ypmed.2012.05.009


Objective. Reminder letters are effective at prompting women to schedule mammograms. Less well studied are reminders addressing multiple preventive service recommendations. We compared the effectiveness of a mammogram-specific reminder sent when a woman was due for a mammogram to a reminder letter addressing multiple preventive services and sent on a woman's birthday on mammography receipt.

Methods. The study included 48,583 women 52-74years enrolled in Group Health Cooperative, a health plan in Washington State. From 2005 to 2009, women were mailed 88,605 mammogram-specific or birthday letters. In this one group pretest-posttest study, we modeled the odds of obtaining a screening mammogram after receiving a letter by reminder type using logistic regression, controlling for demographic and healthcare use characteristics and stratifying by whether women were overdue or up-to-date with mammography at the mailing.

Results. Among women up-to-date with screening, birthday letters were negatively associated with mammography receipt compared to mammogram-specific letters (birthday letters with 1-2 recommendations: OR=0.73; 95% CI:0.68-0.79; 3 recommendations: OR=0.74; 95% CI:0.69-0.78; 4-8 recommendations: OR=0.62 95% CI:0.55-0.68) after. Among overdue women, birthday letters with 4-8 recommendations were negatively associated with mammography receipt.

Conclusions. Transitioning from mammogram-specific reminder letters to multiple preventive service birthday letters was associated with decreased mammography receipt