Journal of Cancer Education

, Volume 26, Issue 3, pp 549–554

A Randomized Controlled Calendar Mail-Out to Increase Cancer Screening Among Urban American Indian and Alaska Native Patients

  • Ardith Z. Doorenbos
  • Clemma Jacobsen
  • Rebecca Corpuz
  • Ralph Forquera
  • Dedra Buchwald


This study seeks to ascertain whether a culturally tailored art calendar could improve participation in cancer screening activities. We conducted a randomized, controlled calendar mail-out in which a Native art calendar was sent by first class mail to 5,633 patients seen at an urban American Indian clinic during the prior 2 years. Using random assignment, half of the patients were mailed a “message” calendar with screening information and reminders on breast, colorectal, lung, and prostate cancer; the other half received a calendar without messages. The receipt of cancer screening services was ascertained through chart abstraction in the following 15 months. In total, 5,363 observations (health messages n = 2,695; no messages n = 2,668) were analyzed. The calendar with health messages did not result in increased receipt of any cancer-related prevention outcome compared to the calendar without health messages. We solicited clinic input to create a culturally appropriate visual intervention to increase cancer screening in a vulnerable, underserved urban population. Our results suggest that printed materials with health messages are likely too weak an intervention to produce the desired behavioral outcomes in cancer screening.


Cancer Prevention Screening American Indians Health disparities Randomized Controlled trial 


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Copyright information

© Springer 2011

Authors and Affiliations

  • Ardith Z. Doorenbos
    • 1
  • Clemma Jacobsen
    • 2
  • Rebecca Corpuz
    • 3
  • Ralph Forquera
    • 3
  • Dedra Buchwald
    • 4
  1. 1.School of NursingUniversity of WashingtonSeattleUSA
  2. 2.Partnerships for Native HealthUniversity of WashingtonSeattleUSA
  3. 3.Seattle Indian Health BoardSeattleUSA
  4. 4.School of MedicineUniversity of WashingtonSeattleUSA

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