Using physician correspondence and postcard reminders to promote mammography use

Am J Public Health. 1994 Apr;84(4):571-4. doi: 10.2105/ajph.84.4.571.


Objectives: In a health maintenance organization that mails letters to women recommending that they schedule mammograms, we conducted a randomized trial to evaluate simple methods of increasing the use of screening mammography.

Methods: Using a 2 x 2 factorial design, we tested the effects of (1) mailing the recommendation letter from each woman's primary care physician rather than from the program director and (2) sending a subsequent reminder postcard.

Results: Sending a reminder postcard nearly doubled the odds that women would get mammograms within 1 year (participate). The letter from the woman's personal physician had no effect. Attending a clinic more than 45 minutes from the screening center, being a current smoker, or being in fair or poor health were negatively associated with subsequently obtaining a mammogram. The odds of participation doubled if women had had previous mammograms.

Conclusions: When preceded by written recommendations to schedule mammograms, reminder postcards effectively increased participation. Future randomized trials to promote use of screening mammography should compare interventions with a reminder condition.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Appointments and Schedules
  • Female
  • Health Maintenance Organizations / statistics & numerical data
  • Health Promotion / methods*
  • Humans
  • Mammography / statistics & numerical data*
  • Middle Aged
  • Patient Compliance
  • Postal Service
  • Reminder Systems*
  • Washington