Forty-three studies including 40 randomised controlled trials, (RCTs) were included.
Overall there were 63 distinct interventions including 27 behavioural interventions, 21 cognitive interventions, 9 sociological interventions, and 5 interventions that combined behavioural and cognitive strategies. Mammography outcomes were most commonly assessed by self-claim (49%).
Patient targeted behavioural interventions:
With usual care control (7 studies, 5 were included in the meta-analysis): the heterogeneity among studies was not associated with any one study. Interventions increased mammography. Q = 19.3. Effect size = 13.2 (95% CI: 4.7, 21.2).
Active control, single intervention (6 studies, 5 were included in the meta-analysis): overall Q = 33.3. The heterogeneity among studies was associated with one study. When this study was removed, studies were considered homogeneous with Q = 14.3 and interventions increased mammography. Effect size = 5.6 (95% CI: 0.6, 10.6).
Active controls, multiple interventions (5 studies, with 4 included in the meta-analysis): interventions increased mammography. Q = 5.6. Effect size = 13.0 (95% CI: 8.6, 17.4).
Patient targeted cognitive interventions:
Generic patient education (6 studies): interventions were not significantly effective in increasing mammography. Q = 7.3. Effect size = 1.1 (95% CI: -2.4, 4.6). Sensitivity analysis did not alter these findings.
Theory based patient education: usual care controls (2 studies): interventions increased mammography. Q = 4.1. Effect size = 23.6 (95% CI: 16.4, 30.1). Sensitivity analysis did not alter these findings.
Active controls, static intervention (4 studies): interventions were not effective in increasing mammography. Q = 6.3. Effect size = 0.4 (95% CI: -5.4, 6.2). Sensitivity analysis did not alter these findings.
Active controls, interactive intervention (5 studies): interventions increased mammography. Q = 13.0. Effect size = 7.9 (95% CI: 2.3, 13.5).
Patient targeted sociological interventions (9 studies, 8 were included in the meta-analysis): interventions increased mammography. Q = 19.8. Effect size = 12.6 (95% CI: 7.4, 17.9).
Financial incentives (2 studies): both studies led to increases in mammography utilization. No details were presented.
Combined behavioural and cognitive strategies (5 studies): variable effects.