April 7-9, 2022 • Hyatt Regency • Lexington, KY
Communication Strategies to Promote Comprehensive Well-being
Communication Strategies to Promote Comprehensive Well-being
Abstract: Improving Communication to Increase Uptake of High Risk Breast Cancer Prevention Appointments
It's estimated that about one-third of breast cancer cases in the US are due to modifiable risk factors (e.g., alcohol consumption, body fat, physical inactivity; Tamimi et al., 2016). In addition, enhanced breast cancer surveillance and preventative medications can improve breast cancer detection and incidence in patients at high risk. To address this, a Midwest comprehensive cancer center developed a prevention program seeking to identify high-risk patients, and encourage visits with a breast cancer prevention specialist. Women presenting for mammography undergo risk assessments; “high risk” patients are mailed letters informing them they are high-risk and may benefit from the services the prevention program offers. However, in November 2018, the health center was only able to attribute 7 visits, 3.4% of the 204 letters sent that month, to the letters. The mailing failed to address many constructs necessary to motivate patients to take preventive health actions as identified in the Health Belief Model (e.g., increasing perceived benefits, reducing perceived barriers, increasing self-efficacy; Rosenstock, 1974). Formative research was conducted to assess recipients’ perceptions of the letter, and find ways to improve it with the aim of converting more patient letters into actual patients. Methods: Data were collected from 136 women via a recruitment prompt mailed within the letter, asking women to visit a Qualtrics survey. After survey completion, participants were emailed a $10 Amazon gift code. Results: Women generally already felt breast cancer is a severe disease. However, they felt less confident in their abilities to make an appointment (i.e., self-efficacy), and did not have high levels of perceived susceptibility (e.g., that it’s likely they might get breast cancer later in life). Most importantly, women’s perceptions of response efficacy – that an appointment with the prevention program would be helpful in averting a future breast cancer diagnosis – were not significantly different than the scale’s midpoint. Results also indicated key knowledge deficits, with about 66% not knowing whether their appointment would be covered by insurance, and many more uncertain how long/short a visit would be. The majority responded neutrally, or on the disagree side of the scale, indicating their lack of intentions to 1) make appointments in the next 6 months or 2) talk to their primary care provider about making appointments. Recommendations: 1) Response efficacy needs to be a top priority. In other words, information needs to be provided showcasing that visiting the prevention program will help to reduce breast cancer risk. 2) Perceived susceptibility must also be strengthened. Many women indicated they did not plan to visit because their mammograms were clear. However, a clear mammogram is not an indication of future risk. 3) Self efficacy can be boosted by addressing costs - both time and monetary. The letter should clearly indicate whether insurance that provides “free” preventive visits covers the visit. The average amount of time (both minutes, and number of visits needed) should also be provided. Revisions are currently being undertaken with the letter, with additional evaluation of the revised letter’s efficacy within the next year.