Sixty-six studies (37 inreach and 29 outreach) with 98 separate interventions were included. Forty-four studies were randomised controlled trials (RCTs) and 12 were concurrently controlled studies.
For the following summary results, positive values favour the intervention (representing the percentage increase in mammography use) and negative findings favour the control (percentage decrease in mammography use).
Behavioural interventions.
Vouchers: the effectiveness of inreach interventions (2 studies, 199 patients) was 45.2% (95% CI: 22.1, 68.2; Q=4.0).
Usual care controls: the effectiveness of inreach interventions (7 studies, 2,421 patients) was 16.4% (95% CI: 9.2, 23.6; Q=37.1).
Single intervention with active controls: the effectiveness of inreach interventions (6 studies, 5,181 patients) was 4.6% (95% CI: -0.3, 9.4; Q=17.3).
Multiple interventions with active controls: the effectiveness of inreach interventions (3 studies, 3,693 patients) was 14.0% (95% CI: 8.7, 19.2; Q=4.9), while that for outreach interventions (3 studies, 469 patients) was 18.7% (95% CI: 4.9, 32.4; Q=5.5).
Cognitive interventions.
Generic education: the effectiveness of inreach interventions (6 studies, 3,280 patients) was 1.4% (95% CI: -3.4, 6.3; Q=12.0), while that for outreach interventions (2 studies, 583 patients) was 1.8% (95% CI: -2.9, 26.5; Q=4.2).
Theory-based education with usual care controls: the effectiveness of inreach interventions (1 study, 101 patients) was 5.7% (95% CI: -12.6, 24.0), while that for outreach interventions (4 studies, 1,979 patients) was 12.7% (95% CI: 6.6, 18.8; Q=7.3).
Theory-based education with usual active (static) controls: the effectiveness of inreach interventions (5 studies, 3,255 patients) was 3.5% (95% CI: -0.5, 7.5; Q=9.1), while that for outreach interventions (2 studies, 2,091 patients) was 2.7% (95% CI: -1.5, 6.8; Q=1.8).
Theory-based education with usual active (interactive) controls: the effectiveness of inreach interventions (9 studies, 5,889 patients) was 10.7% (95% CI: 6.8, 14.7; Q=26.7), while that for outreach interventions (2 studies, 850 patients) was 19.9% (95% CI: 10.6, 29.1; Q=1.6).
Cognitive and behavioural interventions.
Generic education: the effectiveness of inreach interventions (1 study, 178 patients) was -10.3% (95% CI: -23.0, 2.4).
Theory-based education with usual care controls: the effectiveness of inreach interventions (2 studies, 719 patients) was 14.0% (95% CI: 7.9, 20.2; Q=0.50), while that for outreach interventions (2 studies, 575 patients) was 27.3% (95% CI: 14.7, 40.0; Q=3.1).
Theory-based education with active controls: the effectiveness of outreach interventions (5 studies, 3,503 patients) was 2.7% (95% CI: -2.0, 7.4; Q=11.7).
Sociologic interventions: the effectiveness of inreach interventions (3 studies, 2,115 patients) was 10.7% (95% CI: 3.4, 18.0; Q=5.6), while that for outreach interventions (5 studies, 5,367 patients) was 9.1% (95% CI: 1.7, 13.3; Q=9.1).
Sociologic and behavioural interventions: the effectiveness of inreach interventions (1 study, 460 patients) was 22.0% (95% CI: 14.1, 29.9).
Sociologic and cognitive interventions: the effectiveness of outreach interventions (3 studies, 7,690 patients) was 3.2% (95% CI: 1.3, 5.1; Q=1.4).
Sociologic, behavioural and cognitive interventions: the effectiveness of outreach interventions (4 studies, 1,222 patients) was 12.3% (95% CI: 3.1, 21.4; Q=10.0).