A Systematic Review of Mammography Educational Interventions for Low-Income Women

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Source Publication

American Journal of Health Promotion

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We conducted a systematic review to examine the effectiveness of educational interventions in increasing mammography screening among low-income women.

Data Sources

Bibliographic databases, including MEDLINE, The Cochrane Central Register of Controlled Trials, The Cochrane Database of Systematic Reviews, and the ISI Web of Science, were searched for relevant articles.

Study Inclusion and Exclusion Criteria

Randomized, community-based trials targeting low-income women and published between January 1980 and March 2003 were included.

Data Extraction

The search yielded 242 studies; 24 met all inclusion criteria.

Data Synthesis

Three studies used mammography vans, three used low-cost vouchers or provided free mammograms, three used home visits, one used community education alone, one provided referrals, five incorporated multiple intervention strategies, two used phone calls, one used videos and print material, and five used primarily print material.


Of nine studies that reduced barriers to care via mammography vans, cost vouchers, or home visits, eight showed statistically significant increases in mammography screening. Seven of the eight studies that used peer educators had significant increases in screening, as did four of the five studies that used multiple (intervention) components.


Interventions that used peer educators, incorporated multiple intervention strategies, or provided easy access via vans, cost vouchers, or home visits were effective in increasing screenings. Mailed letter or telephone reminders were not effective in trials involving low-income women, which is contrary to findings from middle/upper-income studies.


American Journal of Health Promotion, Vol. 20, No. 2 (November 2005): 96-107. DOI.

Kimberlee Gretebeck was affiliated with the University of Michigan at the time of publication.