Theory-based interventions need to be developed, tested, and disseminated to increase screening utilization among women who have never been screened and to facilitate regular screening among all women. Qualitative and quantitative research is needed to identify specific barriers and to develop interventions appropriate for this population. Research on mammography and related areas suggests that combinations of inreach and outreach strategies may be especially effective.
Authors should report sufficient detail about their interventions to enable readers to understand what was actually done. Where journal limitations preclude this, we encourage authors to put descriptive materials, including intervention descriptions, materials, and/or instruments, onto accessible Web sites.
We advocate the use of standardized, validated measures for breast cancer screening behaviors that will permit meaningful comparisons of outcomes across studies. This would include use of standardized mammography utilization questions from the National Health Interview Survey and the Behavioral Risk Factor Surveillance Survey.
Effective interventions should be widely disseminated. Practitioners are strongly encouraged to use previously validated, evidence-based interventions. The cancer screening chapter in the CDC-led Guide to Community Preventive Services should be a great advance in this regard (http://www.thecommunityguide.org).
Future research must be directed toward studies that are adequately powered to permit subgroup analyses of potential differential impact of intervention activities.