Cancer Screening: Small Media Targeting Clients — Breast Cancer
Findings and Recommendations
The Community Preventive Services Task Force (CPSTF) recommends interventions that use small media based on strong evidence of their effectiveness in increasing breast cancer screening by mammography.
The full CPSTF Finding and Rationale Statement and supporting documents for Cancer Screening: Small Media Targeting Clients — Breast Cancer are available in The Community Guide Collection on CDC Stacks.
Intervention
Small media include videos and printed materials such as letters, brochures, and newsletters. These materials can be used to inform and motivate people to be screened for cancer. They can provide information tailored to specific individuals or targeted to general audiences.
About The Systematic Review
The CPSTF finding is based on evidence from a systematic review of 19 studies (search period 1966–2004). The review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to cancer prevention and control.
Study Characteristics
- Tailored interventions used booklets, personalized letters, or other printed materials
- Untailored interventions used personal checklists or record-keeping booklets, printed information distributed at medical facilities, informational or motivational posters and videos in patient waiting or other areas, letters, or a video with brochures
- Reviewed studies were conducted in both rural and urban communities and among different racial, ethnic, and socioeconomic groups
Summary of Results
Nineteen studies qualified for the systematic review.
- Mammography screening: median increase of 7.0 percentage points (interquartile interval [IQI]: 0.3 to 13.2 percentage points; 21 study arms)
- Interventions were effective when tailored: 7.0 percentage point median increase (IQI: 4.5 to 11.2 percentage points; 7 study arms)
- Interventions also were effective when untailored: 4.7 percentage point median increase (IQI: 0.5 to 13.4 percentage points; 14 study arms)
Summary of Economic Evidence
Five studies qualified for the review and reported a wide range of cost effectiveness estimates based on different metrics and assumptions.
Applicability
Evidence included in this review should be applicable across various settings and populations.
Evidence Gaps
The CPSTF identified several areas that have limited information. Additional research and evaluation could help answer the following questions and fill remaining gaps in the evidence base. (What are evidence gaps?)
Evidence gaps for small media to increase cancer screening are available in the Finding and Rationale Statement.
Implementation Considerations and Resources
- Primary barriers to implementing a small media intervention include limited resources and infrastructure
- Access to effective marketing strategies, educational messages, and instructional materials (particularly for specific subgroups) may be limited by cost and special skills required to develop and test these messages
- Materials libraries (such as those available at National Cancer Institute’s Evidence-Based Cancer Control Programs) are a potential source of high quality, topic- and population-specific messages developed as components of evidence-based programs
- Production and dissemination of tailored messages may be more costly and resource intensive than untailored programs because tailoring generally requires new data collection, development of extensive message libraries with graphics, and computer programming support to ensure appropriate individualization
- Cost effectiveness may improve through economies of scale
- Web-based tailored intervention programs may provide a good solution to both the cost and complexity of developing and delivering tailored interventions to promote cancer screening
- Recruitment, training, and support of community health workers and other interventionists to deliver educational messages may pose substantial barriers in smaller community or free-standing clinical settings
- Regional or other aggregations of populations and services might be considered as strategies to overcome this problem
Crosswalks
Find programs from the EBCCP website that align with this systematic review. (What is EBCCP?)
Healthy People 2030 includes the following objectives related to this CPSTF recommendation.