Twenty-four studies (n=92,010) met the inclusion criteria. The types of study designs used were not reported.
Methodological quality: the authors reported that 78% of studies concealed allocation; 26% reported a sample size calculation; 40% achieved greater than 80% follow-up; 52% reported on the characteristics of those who withdrew from the study; 26% reported no details on those who withdrew; and 17% based outcome analyses on intention-to-treat. Blinded outcome assessment was performed in 13% of studies and was not reported in 87%. Most studies (83%) had comparable groups at baseline; 13% reported no information on comparability and 9% noted small differences that were not accounted for in the analysis. Most studies (92%) treated the groups identically apart from the intervention of interest; 9% treated the groups differently.
Logistical assistance: the provision of a van or mobile unit alone (1 study) or in addition to free or low cost vouchers for mammograms (2 studies) was associated with a significant increase in mammography screening. The provision of cost vouchers was also associated with a significant increase in mammography screening (3 studies). Three of these studies used peer-educators or bilingual nurses matched to the target population. Four studies evaluated home visits as the primary intervention, of which three showed significant increases in the uptake of mammography screening.
Community education alone: the use of bilingual health educators to deliver community-based education was not associated with a statistically significant increase in the uptake of mammography screening (1 study).
Referrals: the provision of information on how to obtain mammogram in addition to core education was associated with a statistically significant increase in the uptake of mammography screening (1 study).
Multi-component interventions: of the 5 studies evaluated, four showed a significant increase in the uptake of mammography screening with multi-component interventions.
Telephone calls: of the 2 studies evaluated, one showed a significant increase in the uptake of mammography screening with telephone calls.
Video and printed material: a study that compared four different types of videos with corresponding flyer found that all were associated with a significant increase in the uptake of mammography screening compared with baseline. Multicultural targeting and highlighting the dangers of not obtaining a mammogram were found to be most effective.
Printed materials: of the 5 studies that evaluated print materials as the primary intervention, two were associated with a statistically significant increase in the uptake of mammography screening.
Subgroup analysis: 8 of the 24 studies used peer educators to increase mammography screening, of which seven were associated with a statistically significant increase in the uptake of mammography screening. Of the 16 studies that did not use peer educations, only 5 studies reported a significant increase in the uptake of mammography screening.