Background: Most health promotion trials in cancer screening offer limited evidence of external validity. We assessed internal and external validity in a nationwide, population-based trial of an intervention to promote regular mammography screening.
Methods: Beginning in September 2000, study candidates age 52 years and older (n = 23,000) were randomly selected from the National Registry of Women Veterans and sent an eligibility survey. Consistent with intention-to-treat principles for effectiveness trials, we randomly assigned eligible respondents and nonrespondents to one of five groups. We mailed baseline surveys to groups 1-3 followed by intervention materials of varying personalization to groups 1 and 2. We delayed mailing baseline surveys to two additional control groups to coincide with the mailing of postintervention follow-up surveys to groups 1-3 at year 1 (group 4) and year 2 (group 5). Mammography rates were determined from self-report and Veterans Health Administration records. To assess internal validity, we compared groups on participation and factors associated with mammography screening at each stage. To assess external validity, we compared groups 3, 4, and 5 on mammography rates at the most recent follow-up to detect any cueing effects of prior surveys and at the respective baselines to uncover any secular trends. We also compared nonparticipants with participants on factors associated with mammography screening at the trial's end.
Results: We established study eligibility for 21,340 (92.8%) of the study candidates. Groups 1-3 were similar throughout the trial in participation and correlates of mammography screening. No statistically significant survey cueing effects or differences between nonparticipants and participants across groups were observed. Mammography screening rates over the 30 months preceding the respective baselines were lower in group 5 (82.3% by self-report) than in groups 1-4 (85.1%, P = .024, group 5 vs groups 1-4 combined), suggesting a decline over time similar to that reported for US women in general.
Conclusion: This systematic assessment provides evidence of the trial's internal and external validity and illustrates an approach to evaluating validity that is readily adaptable to future trials of behavioral interventions.
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http://dx.doi.org/10.1093/jnci/djn027 | DOI Listing |
Breast Cancer Res Treat
January 2025
Google Health, 1600 Amphitheatre Pkwy, Mountain View, CA, 94043, USA.
Purpose: Many breast centers are unable to provide immediate results at the time of screening mammography which results in delayed patient care. Implementing artificial intelligence (AI) could identify patients who may have breast cancer and accelerate the time to diagnostic imaging and biopsy diagnosis.
Methods: In this prospective randomized, unblinded, controlled implementation study we enrolled 1000 screening participants between March 2021 and May 2022.
J Med Internet Res
January 2025
Cancer Screening, American Cancer Society, Atlanta, GA, United States.
Background: The online nature of decision aids (DAs) and related e-tools supporting women's decision-making regarding breast cancer screening (BCS) through mammography may facilitate broader access, making them a valuable addition to BCS programs.
Objective: This systematic review and meta-analysis aims to evaluate the scientific evidence on the impacts of these e-tools and to provide a comprehensive assessment of the factors associated with their increased utility and efficacy.
Methods: We followed the 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and conducted a search of MEDLINE, PsycINFO, Embase, CINAHL, and Web of Science databases from August 2010 to April 2023.
Cien Saude Colet
January 2025
Universidade Federal do Ceará. R. Alexandre Baraúna 1115, Rodolfo Teófilo. 60430-160 Fortaleza CE Brasil.
Mammography is one of the main methods available for breast cancer screening in Brazil. However, differences in timely access and performance of the exam can be highlighted based on social determinants of health, considered relevant due to their influence on the health situation of a population. Thus, the present study aimed to identify the social determinants of health associated with access to and performance of mammography in Brazilian women.
View Article and Find Full Text PDFAJR Am J Roentgenol
January 2025
Banner MD Anderson Cancer Center, Division of Diagnostic Imaging, 2946 East Banner Gateway Drive, Gilbert, Arizona 85234.
AJR Am J Roentgenol
January 2025
The University of Alabama at Birmingham, Birmingham, AL 35233.
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