Tailored interventions for screening mammography among a sample of initially non-adherent women: When is a booster dose important?

Objective: To assess added value of a booster dose of a tailored mammography intervention. Methods: Participants, non-adherent at baseline, were randomly assigned to usual care or one of three tailored interventions. Intervention group members (n = 657) were further randomly assigned to receive/not receive a booster intervention dose. Electronic record mammography data were collected following initial intervention and at 6 and 15 months post-booster. Results: Booster had no effect among women not screened after first intervention dose (n = 337). Among women screened after initial dose (n = 320), booster predicted re-screening at 6 but not 15 months. A booster × race interaction showed a booster effect at 6 months for African Americans (OR = 4.66, p = .0005) but not Caucasians (OR = 0.74, p = .44). Conclusions: Findings suggest if a first-dose intervention does not facilitate screening, neither will a booster dose. However, among women for whom a first dose is effective, boosters can facilitate timely repeat adherence, especially among African Americans. At 6 months booster recipients were less likely to be off-schedule but, by 15 months, the groups were similar. Practice implications: Boosters may effect when, but not whether, women continue screening.