IDEAS home Printed from
   My bibliography  Save this article

Cost-effectiveness of targeted versus tailored interventions to promote mammography screening among women military veterans in the United States


  • Lairson, David R.
  • Chan, Wen
  • Chang, Yu-Chia
  • del Junco, Deborah J.
  • Vernon, Sally W.


Objective We conducted an economic evaluation of mammography promotion interventions in a population-based, nationally representative sample of 5500 women veterans.Methods Women 52 years and older were randomly selected from the National Registry of Women Veterans and randomly assigned to a survey-only control group and two intervention groups that varied in the extent of personalization (tailored vs. targeted). Effectiveness measures were the prevalence of at least one self-reported post-intervention mammogram and two post-intervention mammograms 6-15 months apart. Incremental cost-effectiveness ratios (ICERs) were the incremental cost per additional person screened. Uncertainty was examined with sensitivity analysis and bootstrap simulation.Results The targeted intervention cost $25 per person compared to $52 per person for the tailored intervention. About 27% of the cost was incurred in identifying and recruiting the eligible population. The percent of women reporting at least one mammogram were .447 in the control group, .469 in the targeted group, and .460 in the tailored group. The ICER was $1116 comparing the targeted group to the control group (95% confidence interval (CI)Â =Â $493 to dominated). The tailored intervention was dominated (more costly and less effective) by the targeted intervention.Conclusion Decision-makers should consider effectiveness evidence and the full recruitment and patient time costs associated with the implementation of screening interventions when making investments in mammography screening promotion programs. Identification and recruitment of eligible participants add substantial costs to outreach screening promotion interventions. Tailoring adds substantial cost to the targeted mammography promotion strategy without a commensurate increase in effectiveness. Although cost-effectiveness has been reported to be higher for some in-reach screening promotion interventions, a recent meta-analysis revealed significant heterogeneity in the effect sizes of published health-plan based intervention studies for repeat mammography (i.e., some studies reported null effects compared with control groups).

Suggested Citation

  • Lairson, David R. & Chan, Wen & Chang, Yu-Chia & del Junco, Deborah J. & Vernon, Sally W., 2011. "Cost-effectiveness of targeted versus tailored interventions to promote mammography screening among women military veterans in the United States," Evaluation and Program Planning, Elsevier, vol. 34(2), pages 97-104, May.
  • Handle: RePEc:eee:epplan:v:34:y:2011:i:2:p:97-104

    Download full text from publisher

    File URL:
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    1. Andrew H. Briggs & Bernie J. O'Brien, 2001. "The death of cost-minimization analysis?," Health Economics, John Wiley & Sons, Ltd., vol. 10(2), pages 179-184.
    Full references (including those not matched with items on IDEAS)


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:epplan:v:34:y:2011:i:2:p:97-104. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.