Purpose: The October 2001 publication of a meta-analysis questioning the scientific basis for recommending screening mammography sparked yet a new flame of controversy about this issue. We conducted a national survey in March 2002 to provide information about women's perspectives on the issues, including the evidence regarding the efficacy of mammography and, ultimately, their intentions to continue screening.Methods: We added 12 questions to a national telephone omnibus survey in March 2002 to assess women's reactions to the ongoing debate. Responses were collected over three waves of the twice-weekly survey to obtain data from 733 women between the ages of 40 and 69. The sample was weighted to the U.S. population for census region, age, race, ethnicity, and educational attainment.Results: Consistent with prior studies, most women were getting regular mammograms (78%) (95% confidence interval [CI] 75%-81%), >90% believed that mammography is effective in detecting breast cancer (95%) (95% CI 93%-97%) and in reducing breast cancer mortality (93%) (95% CI 91%-96%), and only about 22% (95% CI 19%-25%) said they were confused. Logistic regression analyses revealed sociodemographic differences among women who had heard about the controversy and who reported some confusion about mammograms. Women with lower levels of education, younger women, and those residing in nonmetropolitan areas were significantly less likely to be aware of the controversy. Although a majority of women said they were not confused about mammography, minority women and women with lower education levels were more likely to report being confused. There were no significant demographic differences in intentions to get future mammograms. Women who were concerned about getting breast cancer were much more likely to be planning to have future mammograms than women who were not at all concerned (odds ratio [OR] 3.63; 95% CI 2.37, 5.56). Likewise, respondents who said that they had enough information to make decisions whether to get future mammograms were much more likely to plan on getting screened than women who said they did not have enough information (OR 2.47; 95% CI 1.14, 5.40).Conclusions: These results do not suggest that controversy leads to lower rates of adherence. They do indicate that some women lack the information needed to make informed decisions about mammography.

OBJECTIVE:In the wake of the premature end of the Women's Health Initiative (WHI) study, we sought to assess women's knowledge of and attitudes about hormone therapy (HT) study findings and to appraise women's responses and intentions.METHODS:Between July 26 and August 6, 2002 a national random-digit-dialing telephone survey was conducted in a sample of households that included women 40 to 79 years old.RESULTS:Sixty-four percent of the 819 women interviewed had heard something about HT study results from the media or from talking with others, and 74% were confused about HT use. Another 57% were worried about how the findings might affect them, and 79% were interested in obtaining additional information about HT Only 24% of those who had heard something had actually sought additional information. Logistic regression findings suggested that women currently taking HT were most likely to be aware and informed. They also were more likely to be confused, worried, or to need or to seek additional information. Older women were less likely to be confused or worried or to need or seek additional information. More highly educated women were more likely to be aware and less likely to be confused or uninformed, but were more likely to have sought additional information.CONCLUSION:The Women's Health Initiative study provided a clear message about health risks and benefits of HT use. An important next step is to continue to convey accurate information to women, health providers, and the media so that women can make informed decisions about HT.

ABSTRACT Background: Compared to younger women, women 65+ will experience the greatest increase in new breast cancer cases. In 1991, Medicare began offering partial reimbursement for screening mammography every 2 years. Methods: In 1999, the National Cancer Institute (NCI) conducted a telephone survey on breast cancer, mammography, and Medicare reimbursement with a sample of households containing women ages 65+ using random-digit-dialing. Results were weighted to provide nationally representative estimates of U.S. women 65+. NCI compared 1999 results with similar data from a 1992 AARP survey. Results: Of the 814 women surveyed, 88% had had at least one mammogram in their lifetime; within this group, 80% had received their most recent mammogram 2 years ago or less. Only 57%, however, knew about recommendations to have a mammogram every 1–2 years. Approximately one-third indicated that they were not as concerned about getting breast cancer as when they were younger, and/or that women without risk factors could be less vigilant about mammograms. More than 75% were aware of Medicare coverage, but only 58% had used Medicare to help pay for their last mammogram. Minority women were almost twice as likely to be unaware of Medicare coverage. Recommendations: (1) Highlight that breast cancer risk increases with age (and does not decline in the absence of risk factors) and communicate the correct frequency for having mammograms; (2) expand primary care physicians' roles in promoting mammography screening for women 65+; and (3) provide Medicare coverage information to older women, particularly those not taking advantage of this benefit.

Background. Focus groups conducted by the National Cancer Institute in 1990 revealed that a multitude of fears, anxieties, and negative perceptions underlie the attitudes and behaviors of older Americans with respect to cancer. This central finding suggested that a communications approach aimed at encouraging cancer screening and early detection behavior among older Americans would need to consider the pervasiveness of these fears and not focus on health benefits alone.Methods. To explore consumer reactions to a new fear acknowledgment/self-empowerment communications strategy, three alternative positioning ads (or concepts) reflecting the strategy were prepared and evaluated through 29 in-depth interviews with members of the target audience.Results. Results confirmed the underlying fear of cancer found in earlier focus groups, a step which was critical for assessing the general strategic approach embodied in the ads. The idea that older people operate from a base of widespread fear and need to be empowered to take charge of their health resonates with and makes sense to the intended audience. A single ad concept was developed from the original three that reflects the feedback of the interviewees.Conclusions. Using the approach of fear acknowledgment/self-empowerment with older Americans is likely to affect the target audience positively. As a whole, respondents in the study considered the ads that embodied this strategy to be empathetic, helpful, and easy to relate to.

BACKGROUND:Focus groups conducted by the National Cancer Institute in 1990 revealed that a multitude of fears, anxieties, and negative perceptions underlie the attitudes and behaviors of older Americans with respect to cancer. This central finding suggested that a communications approach aimed at encouraging cancer screening and early detection behavior among older Americans would need to consider the pervasiveness of these fears and not focus on health benefits alone.METHODS:To explore consumer reactions to a new fear acknowledgment/self-empowerment communications strategy, three alternative positioning ads (or concepts) reflecting the strategy were prepared and evaluated through 29 in-depth interviews with members of the target audience.RESULTS:Results confirmed the underlying fear of cancer found in earlier focus groups, a step which was critical for assessing the general strategic approach embodied in the ads. The idea that older people operate from a base of widespread fear and need to be empowered to take charge of their health resonates with and makes sense to the intended audience. A single ad concept was developed from the original three that reflects the feedback of the interviewees.CONCLUSIONS:Using the approach of fear acknowledgment/self-empowerment with older Americans is likely to affect the target audience positively. As a whole, respondents in the study considered the ads that embodied this strategy to be empathetic, helpful, and easy to relate to.

Abstract : The report describes the first study in a program of research dealing with the relationships between the characteristics of human tasks and the abilities required for task performance. The goal of the program is to generate principles which can be used to identify ability requirements from knowledge of the characteristics of a task and of variations in the conditions of task performance. Such knowledge has important implications for both selection and training of personnel. The study investigated the relationship between variations in an auditory signal identification task and consequent changes in the abilities related to identification performance. (Modified author abstract)