Ongoing physician guidance to achieve periodic mammography of women at an urban health center.

The use of a low-cost behavior prompt at an urban, hospital-based health center that encourages physicians to record and act upon cancer screening information is described. Brief audit forms were incorporated into medical records of all women 40+ years of age seen between June 1994 and March 1996 (approximately 4,700 office visits). Audit forms alerted physicians about women's breast and cervical cancer screening histories and encouraged them to note any screening done or recommended during an office visit. Patient attributes did not readily distinguish who was and was not screened with mammography at recommended intervals, nor whether physicians did or did not address those needs for examination. On the other hand, explicit, continuous monitoring in medical records of the cancer screening status of women was associated with outcome variables. Availability of information on prior cancer screening activities significantly increased the odds that women were "on-time" for examinations as well as that physicians addressed the needs of women who were "past due" for mammograms at the time of their office visits.