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Effectiveness, costs, and cost-effectiveness of recruitment strategies for a mammographic screening program to detect breast cancer

Hurley, Susan F., Jolley, Damien J., Livingston, Patricia M., Reading, Dorothy, Cockburn, Jill and Flint-Richter, Delia 1992, Effectiveness, costs, and cost-effectiveness of recruitment strategies for a mammographic screening program to detect breast cancer, Journal of the National Cancer Institute, vol. 84, no. 11, pp. 855-863, doi: 10.1093/jnci/84.11.855.

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Title Effectiveness, costs, and cost-effectiveness of recruitment strategies for a mammographic screening program to detect breast cancer
Author(s) Hurley, Susan F.
Jolley, Damien J.
Livingston, Patricia M.
Reading, Dorothy
Cockburn, Jill
Flint-Richter, Delia
Journal name Journal of the National Cancer Institute
Volume number 84
Issue number 11
Start page 855
End page 863
Total pages 9
Publisher Oxford Journals
Place of publication Oxford, Eng.
Publication date 1992-06-03
ISSN 0027-8874
Summary BACKGROUND AND PURPOSE: Since effective and affordable recruitment methods are essential for the widespread implementation of mammographic screening for detection of breast cancer, we studied the effectiveness, the costs, and the cost-effectiveness of various recruitment strategies in the population targeted by a pilot Australian program that offered free mammography screening between 1988 and 1990. METHODS: We evaluated three public recruitment strategies--local newspaper articles, community promotion, and promotion to physicians--and five personal strategies--invitation letters with or without specified appointment times, either alone or with a follow-up letter, or telephone call to nonattenders. The effectiveness of public recruitment strategies was estimated from monthly attendance rates by Poisson regression analysis, while the probability of attendance in response to personal strategies was calculated using logistic regression analysis. Costs were determined by resource usage studies. The cost-effectiveness ratios for personal strategies were determined using decision analysis. RESULTS: The costs in 1988-1989 Australian dollars per woman recruited were $22 for local newspaper articles and $106 for community promotion. No detectable increase in attendance resulted from promotion to physicians. When the cost of reserving an appointment was considered, the most cost-effective personal recruitment strategy was an invitation letter without a specified appointment time, followed by a second letter to nonattenders. This strategy recruited 35.6% of women in the sample targeted and cost $10.52 per attendee. In comparison, the most effective personal recruitment strategy was a letter with a specified appointment time followed by a second letter to nonattenders, which recruited 44.1% of women at an average cost of $19.99 and a marginal cost of $59.71 per additional attendee. CONCLUSIONS: Personal recruitment strategies were more cost-effective than public strategies. The most cost-effective personal strategy was an invitation letter without a specified appointment time, followed by a second letter to nonattenders.
Language eng
DOI 10.1093/jnci/84.11.855
Field of Research 1112 Oncology And Carcinogenesis
Socio Economic Objective 920102 Cancer and Related Disorders
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©1992, Oxford Journals
Persistent URL http://hdl.handle.net/10536/DRO/DU:30081875

Document type: Journal Article
Collection: PVC's Office - Health
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