The results of the meta-analysis of mammography interventions for diverse populations show that the past decade’s investment in such interventions has translated into effective interventions for these groups. In general, the interventions for general populations are not so different from those that are effective with diverse populations, with the exception of the importance of access-enhancing interventions. This makes sense because access barriers may exert considerable negative impact for the women characterized here as diverse. But similarly, the interventions that have been effective in general, such as tailored and untailored letters and reminders and various forms of counseling, also are effective for diverse populations. Also encouraging is the fact that interventions aimed at diverse populations had strong effects. However, the results suggest that some interventions—such as social network and media interventions alone—that are widely used for diverse populations may not be sufficiently powerful to justify their use for these groups without additional interventions.
All interventions are not equal. In some cases, combinations of interventions will be needed. For example, mass media interventions can be used to increase awareness, while access-enhancing and individual-directed interventions can be used to overcome individual women’s barriers to getting mammograms. The forthcoming Guide to Community Preventive Services (http://www.thecommunityguide.org/) , led by the Centers for Disease Control and Prevention (CDC), will provide more detailed information on which interventions are most effective.
Further research is necessary to characterize the relationships between the race, ethnicity, and language of women and their health care providers in order to identify factors that contribute to differential patterns of communication and behavior change relevant to screening mammography. Examples of such factors might include social norms of the patient-provider relationship, training of practitioners, and communication norms around issues of breast