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Health Serv Res. 1998 April; 33(1): 11–28.
PMCID: PMC1070244

Do vouchers improve breast cancer screening rates? Results from a randomized trial.

Abstract

OBJECTIVE: To determine the effect of a voucher for free mammography on compliance with recommended mammography screening guidelines. STUDY DESIGN: Vouchers for free mammography distributed to a random sample of women over the age of 50 in two rural southern Minnesota counties. The vouchers were good for one year. Baseline and follow-up data were collected and rates of compliance with current mammography guidelines were observed for the voucher group and a control group of women living in the same counties. METHODS: Logistic regression models were used to estimate the effect of the voucher on compliance with mammography guidelines and the impact of factors potentially influencing the effectiveness of the voucher. PRINCIPAL FINDINGS: The voucher improved mammography rates primarily through increasing screening among women who were out of compliance at baseline. CONCLUSIONS: Vouchers, even when distributed randomly within a population of rural Midwestern women, can significantly improve compliance rates. Vouchers are no less effective a means of increasing screening among vulnerable women than among other women.

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Selected References

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  • Adelson P, Irwig L, Turnbull D. Evaluating the impact of a promotional campaign for screening mammography: who attends? Aust J Public Health. 1992 Mar;16(1):66–71. [PubMed]
  • Blustein J. Medicare coverage, supplemental insurance, and the use of mammography by older women. N Engl J Med. 1995 Apr 27;332(17):1138–1143. [PubMed]
  • Breen N, Kessler L. Changes in the use of screening mammography: evidence from the 1987 and 1990 National Health Interview Surveys. Am J Public Health. 1994 Jan;84(1):62–67. [PubMed]
  • Bryant H, Mah Z. Breast cancer screening attitudes and behaviors of rural and urban women. Prev Med. 1992 Jul;21(4):405–418. [PubMed]
  • Burack RC, Gimotty PA, George J, Stengle W, Warbasse L, Moncrease A. Promoting screening mammography in inner-city settings: a randomized controlled trial of computerized reminders as a component of a program to facilitate mammography. Med Care. 1994 Jun;32(6):609–624. [PubMed]
  • Calle EE, Flanders WD, Thun MJ, Martin LM. Demographic predictors of mammography and Pap smear screening in US women. Am J Public Health. 1993 Jan;83(1):53–60. [PubMed]
  • Carr WP, Maldonado G, Leonard PR, Halberg JU, Church TR, Mandel JH, Dowd B, Mandel JS. Mammogram utilization among farm women. J Rural Health. 1996;12(4 Suppl):278–290. [PubMed]
  • Cordes SM. The changing rural environment and the relationship between health services and rural development. Health Serv Res. 1989 Feb;23(6):757–784. [PMC free article] [PubMed]
  • Dowd B, Feldman R. Note. Evaluating exclusionary interventions. J Health Econ. 1991 Oct;10(3):343–348. [PubMed]
  • Dranove D, Cone K. Do state rate setting regulations really lower hospital expenses? J Health Econ. 1985 Jun;4(2):159–165. [PubMed]
  • Etzi S, Lane DS, Grimson R. The use of mammography vans by low-income women: the accuracy of self-reports. Am J Public Health. 1994 Jan;84(1):107–109. [PubMed]
  • Fletcher SW, Black W, Harris R, Rimer BK, Shapiro S. Report of the International Workshop on Screening for Breast Cancer. J Natl Cancer Inst. 1993 Oct 20;85(20):1644–1656. [PubMed]
  • Fletcher SW, Harris RP, Gonzalez JJ, Degnan D, Lannin DR, Strecher VJ, Pilgrim C, Quade D, Earp JA, Clark RL. Increasing mammography utilization: a controlled study. J Natl Cancer Inst. 1993 Jan 20;85(2):112–120. [PubMed]
  • Fulton-Kehoe D, Burg MA, Lane DS. Are self-reported dates of mammograms accurate? Public Health Rev. 1992;20(3-4):233–240. [PubMed]
  • Gordon NP, Hiatt RA, Lampert DI. Concordance of self-reported data and medical record audit for six cancer screening procedures. J Natl Cancer Inst. 1993 Apr 7;85(7):566–570. [PubMed]
  • Hartley D, Quam L, Lurie N. Urban and rural differences in health insurance and access to care. J Rural Health. 1994 Spring;10(2):98–108. [PubMed]
  • Hurley SF, Huggins RM, Jolley DJ, Reading D. Recruitment activities and sociodemographic factors that predict attendance at a mammographic screening program. Am J Public Health. 1994 Oct;84(10):1655–1658. [PubMed]
  • Kiefe CI, McKay SV, Halevy A, Brody BA. Is cost a barrier to screening mammography for low-income women receiving Medicare benefits? A randomized trial. Arch Intern Med. 1994 Jun 13;154(11):1217–1224. [PubMed]
  • Kralewski JE, Shapiro J, Chan HC, Edwards K, Liu YL. Health insurance coverage of Minnesota farm families. Minn Med. 1990 May;73(5):35–38. [PubMed]
  • Montano DE, Taplin SH. A test of an expanded theory of reasoned action to predict mammography participation. Soc Sci Med. 1991;32(6):733–741. [PubMed]
  • Morrison AS. Screening for cancer of the breast. Epidemiol Rev. 1993;15(1):244–255. [PubMed]
  • O'Leary TJ, deParedes ES, Tritschler J, Barr M. Utilization of screening mammography by primary care physicians. Appl Radiol. 1989 Dec;18(12):28–33. [PubMed]
  • Rakowski W, Rimer BK, Bryant SA. Integrating behavior and intention regarding mammography by respondents in the 1990 National Health Interview Survey of Health Promotion and Disease Prevention. Public Health Rep. 1993 Sep-Oct;108(5):605–624. [PMC free article] [PubMed]
  • Robinson JC, Phibbs CS. An evaluation of Medicaid selective contracting in California. J Health Econ. 1989;8(4):437–455. [PubMed]
  • Roetzheim RG, Vandurme DJ, Brownlee HJ, Herold AH, Pamies RJ, Woodard L, Blair C. Reverse targeting in a media-promoted breast cancer screening project. Cancer. 1992 Sep 1;70(5):1152–1158. [PubMed]
  • Rowland D, Lyons B. Triple jeopardy: rural, poor, and uninsured. Health Serv Res. 1989 Feb;23(6):975–1004. [PMC free article] [PubMed]
  • Sawyer JA, Earp JA, Fletcher RH, Daye FF, Wynn TM. Accuracy of women's self-report of their last Pap smear. Am J Public Health. 1989 Aug;79(8):1036–1037. [PubMed]
  • Shapiro S, Venet W, Strax P, Venet L, Roeser R. Ten- to fourteen-year effect of screening on breast cancer mortality. J Natl Cancer Inst. 1982 Aug;69(2):349–355. [PubMed]
  • Strauss LM, Solomon LJ, Costanza MC, Worden JK, Foster RS., Jr Breast self-examination practices and attitudes of women with and without a history of breast cancer. J Behav Med. 1987 Aug;10(4):337–350. [PubMed]
  • Tabar L, Fagerberg G, Duffy SW, Day NE. The Swedish two county trial of mammographic screening for breast cancer: recent results and calculation of benefit. J Epidemiol Community Health. 1989 Jun;43(2):107–114. [PMC free article] [PubMed]
  • Urban N, Anderson GL, Peacock S. Mammography screening: how important is cost as a barrier to use? Am J Public Health. 1994 Jan;84(1):50–55. [PubMed]
  • Wells BL, Horm JW. Stage at diagnosis in breast cancer: race and socioeconomic factors. Am J Public Health. 1992 Oct;82(10):1383–1385. [PubMed]

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