SEARCH · PubMed Health

Results for “Adherence Interventions”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 775 records · Page 43Linked to original sources

PubMed2002

Vascular leukocyte sequestration in decompression sickness and prophylactic hyperbaric oxygen therapy in rats.

BACKGROUND: Evidence for a causal relationship between decompression sickness (DCS) and leukocyte sequestration was assessed in a rat model based on the effects of interventions which impede cell-to-cell adherence, including hyperbaric oxygen therapy (HBO2). HYPOTHESIS: We hypothesized that leukocyte adhesion to vessels may play a role in DCS. METHODS: Rats were subjected to decompression stress and their ability to ambulate on a rotating drum was assessed to quantify functional neurological deficits. Leukocyte adherence in the brain was measured by a myeloperoxidase (MPO) radioimmunoassay. Interventions included infusion of antibodies to render rats neutropenic or to inhibit leukocyte beta2 integrin adhesion molecules. Tissue gas bubbles were imaged and quantified using a transmission ultrasound camera. RESULTS: Decompressed rats manifested a deficit in their ability to ambulate and a five-fold elevation in concentration of MPO in brain. Neutropenic rats, and those infused with antibody fragments to inhibit leukocyte beta2 integrins, did not exhibit brain MPO elevations, nor a deficit in ambulatory function. HBO2 was used in a prophylactic manner to address its ability to inhibit leukocyte beta2 integrin-mediated adherence without reducing the presence of decompression-induced bubbles. Prophylactic HBO2 prevented cerebral leukocyte sequestration and the performance deficit. CONCLUSIONS: The results implicate beta2 integrin-mediated leukocyte adhesion in neurological deterioration after decompression stress, and offer new insight into the therapeutic action of HBO2. Immunomodulatory approaches, including prophylactic HBO2, may improve the safety of decompression procedures in undersea and space exploration.

Animals↗

PubMed2006

Case management to improve major depression in primary health care: a systematic review.

BACKGROUND: Deficits in the care of depression lead to poor medication adherence, which increases the risk of an unfavourable outcome for this care. This review evaluates effects on symptoms and medication adherence of case management in primary health care. METHOD: A systematic literature search was performed. The quality of the studies was rated according to the Cochrane Effective Practice and Organization of Care Group (EPOC) criteria. To conduct a subgroup analysis interventions were classified as either 'standard' or 'complex' case management. RESULTS: Thirteen studies met the inclusion criteria. In a meta-analysis we calculated a standard mean difference/effect size on symptom severity after 6-12 months of -0.40 (95% CI -0.60 to -0.20). Patients in the intervention groups were more likely to achieve remission after 6-12 months [relative risk (RR) 1.39, 95% CI 1.30-1.48]. The relative risk for clinical response was 1.82 (95% CI 1.68-2.05). Patients in intervention groups had better medication adherence than the control group (RR 1.5, 95% CI 1.28-1.86). We found heterogeneous results when assessing effects of different types of intervention. CONCLUSIONS: We conclude that case management improves management of major depression in primary health-care settings.

Case Management↗

PubMed2026

Effectiveness of digital health technologies for post-discharge follow-up and management in older adults: a systematic review.

Older adults (≥65 years) are a rapidly growing population that are experiencing a higher number of hospitalisation admissions, longer hospital stays, and greater hospitalisation-related costs than younger adults. There is an important gap in post-discharge care for older adults, and digital technologies, such as video visits, mobile health apps, and remote patient monitoring, may support follow-up and management after hospital discharge. This systematic review examined the effectiveness, feasibility, acceptability, and impact (ie, effects on rehospitalisation, quality of life, mental health, adherence, and patient satisfaction) of technology-based interventions used for the follow-up and management of older adults after hospital discharge. MEDLINE (via PubMed), Scopus, and Web of Science were searched from database inception to January, 2026. The search identified 1972 records, of which 46 studies met the inclusion criteria: older adult populations (aged ≥65 years), a technology-based intervention, post-discharge follow-up or management, and empirical data. Overall, digital post-discharge interventions were reported to be feasible, with good engagement, adherence, compliance, and retention; low dropout rates; and positive patient satisfaction. However, mixed findings were reported regarding rehospitalisation rates and mental health outcomes for virtual care compared with those for traditional care. Digital health technologies might represent a promising step towards improving post-discharge health care and continuity of care for older adults.

Journal Article↗

PubMed2003

Qualitative and quantitative assessments of HAART adherence of substance-abusing women.

This study was set up to examine factors affecting adherence to highly active antiretroviral therapy (HAART) by substance abusing women and to conduct a pilot study of a reminder device intervention. Three focus groups totaling 24 HIV-positive women developed priority lists of issues affecting adherence. Another group of 24 HIV-positive women received a timer-reminder with structured interviews on adherence at baseline and two monthly follow up intervals. Focus groups described key barriers to HAART adherence as substance abuse, forgetting, feeling ill, others' negative attitudes, obtaining refills and confidentiality. Primary disadvantages to HAART were side effects, pill-taking schedule and burden of taking medications. Facilitators included reminders (e.g. pill boxes) and spirituality. After receiving the reminder, missing a dose was less common (p < 0.05) due to sleeping through dose, being busy and feeling too good while a favourable trend (p = 0.07) was seen for change in daily routine and having too many pills to take. Although well accepted, the reminder did not affect the proportion missing a dose in the past two weeks: baseline (33%), first follow-up (30%) and second follow-up (30%). Forgetting to take HAART was only one of many cited barriers to adherence in these HIV-positive women; well-received reminder devices did not affect adherence. To improve substance-abusing women's adherence, multidimensional interventions are warranted.

Adult↗

PubMed2026

Changes in weight and metabolic health during and after cessation of a time-restricted feeding plus aerobic training in Swiss mice fed a high-fat diet.

Obesity is a chronic disease, representing a significant health problem worldwide. Unhealthy eating habits and sedentarism are key contributors to the development of obesity. Dietary and exercise strategies are the first-line therapies for weight loss or maintenance and have proven effective in controlling weight. However, long-term adherence is challenging, and rapid weight regain often follows intervention cessation. In mice, time-restricted feeding (TRF) and exercise (EXE) independently prevent weight gain and maintain metabolic health, yet weight regain is observed upon cessation. Whether combining TRF and EXE provides longer-lasting benefits remains unclear. Here, we assessed weight and metabolic parameters in Swiss male mice fed with a high-fat diet (HFD) during an 8-wk intervention of TRF (8-h food access in the active phase) or TRF combined with EXE (60-min treadmill running daily) and after cessation and transfer to ad libitum feeding. TRF and EXE interventions successfully mitigate weight gain, improve glycemic homeostasis, and attenuate lipid accumulation in the liver and adipose tissue hypertrophy compared to mice fed HFD ad libitum. However, cessation of both strategies led to rapid weight regain, impaired glycemic control, and increased circulating lipid levels. Although the combination of TRF and EXE led to the lowest body weight and best metabolic health, this group showed no protection against the metabolic impairments observed after TRF cessation alone. In conclusion, TRF and EXE are complementary strategies for managing metabolic health, but cessation of these interventions leads to rapid weight regain and metabolic deterioration, with only partial preservation of select metabolic adaptations. These findings underscore the critical need for sustained adherence to lifestyle interventions in obesity management.NEW & NOTEWORTHY This study demonstrates that combining time-restricted feeding with aerobic training improves weight and metabolic health in Swiss mice fed a high-fat diet. Importantly, we show that most metabolic benefits are lost after intervention cessation. However, insulin sensitivity and aspects of hepatic lipid metabolism are partially maintained after cessation of the intervention. These findings provide new insight into the durability of metabolic improvements induced by lifestyle interventions and highlight the potential of combined dietary and exercise strategies to counteract diet-induced obesity and metabolic dysfunction.

Animals↗

PubMed2005

Evaluating an intervention to reduce fear of falling and associated activity restriction in elderly persons: design of a randomised controlled trial [ISRCTN43792817].

BACKGROUND: Fear of falling and associated activity restriction is common in older persons living in the community. Adverse consequences of fear of falling and associated activity restriction, like functional decline and falls, may have a major impact on physical, mental and social functioning of these persons. This paper presents the design of a trial evaluating a cognitive behavioural group intervention to reduce fear of falling and associated activity restriction in older persons living in the community. METHODS/DESIGN: A two-group randomised controlled trial was developed to evaluate the intervention. Persons 70 years of age or over and still living in the community were eligible for study if they experienced at least some fear of falling and associated activity restriction. A random community sample of elderly people was screened for eligibility; those eligible for study were measured at baseline and were subsequently allocated to the intervention or control group. Follow-up measurements were carried out directly after the intervention period, and then at six months and 12 months after the intervention. People allocated to the intervention group were invited to participate in eight weekly sessions of two hours each and a booster session. This booster session was conducted before the follow-up measurement at six months after the intervention. People allocated to the control group received no intervention as a result of this trial. Both an effect evaluation and a process evaluation were performed. The primary outcome measures of the effect evaluation are fear of falling, avoidance of activity due to fear of falling, and daily activity. The secondary outcome measures are perceived general health, self-rated life satisfaction, activities of daily life, feelings of anxiety, symptoms of depression, social support interactions, feelings of loneliness, falls, perceived consequences of falling, and perceived risk of falling. The outcomes of the process evaluation comprise the performance of the intervention according to protocol, the attendance and adherence of participants, and the participants' and facilitators' opinion about the intervention. Data of the effect evaluation will be analysed according the intention-to-treat and on-treatment principle. Data of the process evaluation will be analysed using descriptive techniques.

Accidental Falls↗

PubMed2005

A randomized controlled trial of psychological interventions for postnatal depression.

OBJECTIVES: First, to establish the efficacy of psychological interventions versus routine primary care for the management of postnatal depression (PND). Secondly, to provide a direct comparison of cognitive-behavioural therapy (CBT) versus counselling and, finally, to compare the relative value of group and individual delivery formats. DESIGN: The study involved 192 depressed women drawn from a large community screening programme in Melbourne, Australia and allocated to cognitive behaviour therapy, counselling, or routine primary care. Baseline and post-intervention measures of depression and anxiety were collected in the form of validated self-report inventories. METHOD: Women were screened in the community and diagnosis of depression confirmed with a standardized psychiatric interview. Interventions were of 12 weeks duration, including three partner sessions, and adhered to a structured manual. RESULTS: Psychological intervention per se was superior to routine care in terms of reductions in both depression and anxiety following intervention. CONCLUSIONS: For those women with PND, psychological intervention is a better option than routine care, leading to clinically significant reduction of symptoms. Counselling may be as effective as group cognitive behaviour therapy. The benefits of psychological intervention may be maximized by being delivered on a one-to-one basis.

Adult↗

PubMed1999

Stepped collaborative care for primary care patients with persistent symptoms of depression: a randomized trial.

BACKGROUND: Despite improvements in the accuracy of diagnosing depression and use of medications with fewer side effects, many patients treated with antidepressant medications by primary care physicians have persistent symptoms. METHODS: A group of 228 patients recognized as depressed by their primary care physicians and given antidepressant medication who had either 4 or more persistent major depressive symptoms or a score of 1.5 or more on the Hopkins Symptom Checklist depression items at 6 to 8 weeks were randomized to a collaborative care intervention (n = 114) or usual care (n = 114) by the primary care physician. Patients in the intervention group received enhanced education and increased frequency of visits by a psychiatrist working with the primary care physician to improve pharmacologic treatment. Follow-up assessments were completed at 1, 3, and 6 months by a telephone survey team blinded to randomization status. RESULTS: Those in the intervention group had significantly greater adherence to adequate dosage of medication for 90 days or more and were more likely to rate the quality of care they received for depression as good to excellent compared with usual care controls. Intervention patients showed a significantly greater decrease compared with usual care controls in severity of depressive symptoms over time and were more likely to have fully recovered at 3 and 6 months. CONCLUSIONS: A multifaceted program targeted to patients whose depressive symptoms persisted 6 to 8 weeks after initiation of antidepressant medication by their primary care physician was found to significantly improve adherence to antidepressants, satisfaction with care, and depressive outcomes compared with usual care.

Antidepressive Agents↗

PubMed1998

A cost-saving algorithm for children hospitalized for status asthmaticus.

OBJECTIVE: To test the ability of an assessment-driven algorithm for treatment of pediatric status asthmaticus to reduce length and cost of hospitalization. DESIGN: Nonrandomized, prospective, controlled trial. SETTING: Tertiary care children's hospital. PATIENTS: Children aged 1 to 18 years hospitalized for status asthmaticus; 104 were treated using the asthma care algorithm (intervention) and 97 using unstructured standard treatment (control). INTERVENTION: Patients were treated using either an assessment-based algorithm or standard care practices. The algorithm group was treated with standard medications (aerosolized albuterol, systemic corticosteroids, epinephrine, ipratropium) administered at a frequency driven by the patient's clinical condition. Specific criteria were outlined for decreasing or augmenting therapy, transferring to intensive care, and discharging to home. A unique patient record containing assessments, algorithm cues, and a treatment record was used. Intervention group patients were interviewed by telephone 1 week after discharge. MAIN OUTCOME MEASURES: Hospital length of stay, cost per hospitalization, relapse rate, protocol adherence. RESULTS: Average hospital stay for intervention patients was significantly shorter than for control patients (2.0 vs 2.9 days, P<.001). Although intervention patients received fewer aerosolized albuterol doses than controls, there was no difference in short-term relapse rate between groups. The intervention saved more than $700 per patient in hospital charges. Adherence to the protocol was excellent, with only 8 variances per patient stay out of more than 150 opportunities. CONCLUSION: An intensive, assessment-driven algorithm for pediatric status asthmaticus significantly reduces hospital length of stay and costs without increasing morbidity.

Adolescent↗

PubMed2002

Patient-perceived barriers to antiretroviral adherence: associations with race.

New antiretroviral (ARV) regimens require strict adherence if optimal suppression of HIV is to be maintained. This study is a theory-based examination of racial differences in patient-perceived barriers and reported ARV adherence. Participants (N=149) completed the Patient Medication Adherence Questionnaire (PMAQ), measuring adherence and perceived barriers to adherence. Adherence was defined as a self-report of 100% adherence in the past four weeks. Odds ratios were calculated to determine the relation of reported barriers to adherence for race and gender groups, and for the sample overall. For every ten-point increase in barrier score, there was an 86% increased risk of being non-adherent (OR=1.86; 95% CI: 1.19, 2.91). Adherence was not different between racial and gender groups, nor was total barrier score. However, individual barriers were differentially endorsed across groups. Rather than relying on demographic predictors, which may be only an indirect marker of adherence, evaluations of adherence should examine the psychological and social barriers to positive adherence outcomes in individual patients. Our findings support the use of theory-based behavioural interventions that address perceived barriers to adherence and other health promotion activities.

Adult↗

PubMed2004

Interventions to improve quality of care: the Kaiser Permanente-alzheimer's Association Dementia Care Project.

OBJECTIVE: To improve quality of dementia care in a Kaiser Permanente service area through rigorous dissemination of practice guidelines and social worker support for physicians and patients. STUDY DESIGN: Pre-post design with practice behavior change assessed by medical record review, and provider and caregiver satisfaction with care assessed by surveys. METHODS: A diagnostic guideline and later a management guideline were adopted for use by Kaiser Permanente physicians in metropolitan Los Angeles. Physicians received training based on the guidelines, and social workers provided ancillary support. Eighty-three community-dwelling dementia patients and their caregivers were referred to the project by primary care physicians and then were assessed and followed by social workers. Data were abstracted from medical records to determine whether these interventions led to improved quality of care as indicated by adherence to key care processes derived from the adopted dementia guidelines. Chi-square and t tests were applied to compare guideline adherence and satisfaction rates before and after the interventions. RESULTS: Compared with baseline, higher rates of provider and caregiver satisfaction with Kaiser's system of dementia care were found at the postintervention follow-up. There also were significantly higher rates of adherence to several practice guideline-based quality measures: assessment of cognitive status; referrals to the Alzheimer's Association; and assessments of activities of daily living, decision-making capacity, depression, and wandering risk. CONCLUSION: Quality of primary care for people with dementia can be improved through guideline implementation with care management support by social workers.

Alzheimer Disease↗

PubMed1993

Adherence and psychological adjustment among women at high risk for breast cancer.

Increasingly, women with a positive family history of breast cancer are being targeted for cancer prevention and control efforts. Two findings have been demonstrated consistently across studies of this high risk population. First, these women often have high levels of psychological distress, as well as persistent and intrusive worries about developing breast cancer. Second, despite their increased risk for developing breast cancer, a substantial proportion of these women do not adhere to recommended breast cancer screening guidelines. There is growing evidence that psychological distress is an important barrier to adherence among high risk women. Despite this, little is known about how to intervene to improve psychological adjustment and adherence in this population. In the present paper, we review the literature on adherence and psychological adjustment in women who are at increased risk for breast cancer because of a positive family history of disease. This review provides the basis for a discussion of potential intervention strategies designed to increase adherence and reduce psychological distress in this population. Finally, we present some of the psychological implications of recent developments in genetic testing for breast cancer susceptibility.

Adult↗

PubMed2000

Interventions for helping patients to follow prescriptions for medications.

BACKGROUND BACKGROUND: Efforts to assist patients with adherence to prescribed, self-administered medications might improve the benefits and efficiency of health care. OBJECTIVES OBJECTIVE: To update an ongoing review summarising the results of randomised controlled trials (RCTs) of interventions to help patients follow prescriptions for medications, focusing on trials that measured both adherence and clinical outcomes. SEARCH STRATEGY: Computerised searches to July 1998 in MEDLINE, CINAHL, The Cochrane Library, International Pharmaceutical Abstracts (IPA), PsychInfo, Sociofile, and HSTAR; bibliographies in articles on patient adherence; articles in the reviewers' personal collections; and contact with authors. SELECTION CRITERIA: Articles were selected if they reported an unconfounded RCT of an intervention to improve adherence with prescribed medications, measuring both medication adherence and treatment outcome, with at least 80% follow-up of each group studied and, for long-term treatments, at least six months follow-up for studies with positive initial findings. DATA COLLECTION AND ANALYSIS: Information on study design features, interventions and controls, and findings were extracted by one reviewer (PM) and a research assistant and confirmed by two of the other reviewers. The studies were too disparate to warrant meta-analysis. MAIN RESULTS: For short-term treatments, one study, of counselling and written information, showed an effect on adherence and clinical outcome. Ten of 19 interventions for long-term treatments reported in 17 RCTs were associated with improvements in adherence, but only nine interventions led to improvements in treatment outcomes. Almost all of the interventions that were effective for long-term care were complex, including combinations of more convenient care, information, counselling, reminders, self-monitoring, reinforcement, family therapy, and other forms of additional supervision or attention. Even the most effective interventions did not lead to large improvements in adherence and treatment outcomes. Two studies showed that telling patients about adverse effects of treatment did not affect their adherence. REVIEWER'S CONCLUSIONS: The full benefits of medications cannot be realised at currently achievable levels of adherence. Current methods of improving adherence for chronic health problems are mostly complex and not very effective. More studies of innovative approaches to assist patients to follow medication prescriptions are needed.

Drug Prescriptions↗

PubMed2006

Contingency management treatments: Reinforcing abstinence versus adherence with goal-related activities.

Contingency management (CM) interventions usually reinforce submission of drug-negative specimens, but they can also reinforce adherence with goal-related activities. This study compared the efficacy of the 2 approaches. Substance-abusing outpatients (N = 131) were randomly assigned to 1 of 3 12-week treatments: standard treatment (ST), ST with CM for submitting negative urine toxicology screens, or ST with CM for completing goal-related activities. CM patients remained in treatment longer and achieved more abstinence than ST patients, but the CM condition that reinforced submission of negative samples resulted in better outcomes than the CM condition that reinforced goal-related activities. Abstinence at 6- and 9-month follow-ups did not differ by group, but longest duration of abstinence achieved during treatment was associated with abstinence posttreatment.

Adult↗

PubMed2000

Adherence to recommendations of community-based comprehensive geriatric assessment programmes.

BACKGROUND: non-adherence to the recommendations of short-term community-based consultative comprehensive geriatric assessment programmes is a threat to the effectiveness of these programmes. OBJECTIVE: to synthesize the literature on patient and physician adherence to recommendations of community-based comprehensive geriatric assessment programmes. METHOD: I identified papers cited by an English language literature search of MEDLINE, Health Star and CINAHL databases from January 1980 to November 1999. This search was supplemented with literature identified from the reference sections of these publications. RESULTS: patient adherence rates ranged from 46 to 76%, which approximates to the rates for the consulting physician adherence (49-79%). I identified many characteristics of patient, treatment, care provider and clinical setting which influenced adherence. Understanding these factors has led to the development of adherence-enhancing strategies. However, without systematic evaluations it is difficult to evaluate the relative effectiveness of these interventions. CONCLUSION: further research which targets more representative samples and uses validated assessment tools and multiple data collection methods is needed to expand our knowledge of patterns and predictors of adherence and to evaluate the relative effectiveness of adherence-enhancing intervention strategies.

Aged↗

PubMed2006

Using digital videos displayed on personal digital assistants (PDAs) to enhance patient education in clinical settings.

OBJECTIVES: To evaluate the effects of using an audiovisual animation (i.e., digital video) displayed on a personal digital assistant (PDA) for patient education in a clinical setting. METHODS: Quasi-experimental study of a prospective technology intervention conducted in an outpatient infectious diseases clinic at an academic medical center. Subjects responded to questions immediately before, immediately after, and 4-6 weeks after watching a digital video on a PDA. Outcome measures include participant knowledge of disease, knowledge of medications, and knowledge of adherence behaviors; attitudes toward the video and PDA; self-reported adherence; and practicality of the intervention. RESULTS: Fifty-one English-speaking adults who were initiating or taking medications for the treatment of HIV/AIDS participated in the study. At visit one, statistically significant improvements in knowledge of disease (p<0.005; paired t-test), knowledge of medications (p<0.005; paired t-test), and knowledge of adherence behaviors (p<0.05; ANOVA) were measured after participants watched the PDA-based video. At visit two (4-6 weeks later), statistically significant improvements in self-reported adherence to the medication regimens (p<0.005; paired t-test) were reported. Participants liked the PDA-based video and indicated that it was an appropriate medium for learning, regardless of their baseline literacy skills. The video education process was estimated to take 25 min of participant time and was viewed in both private and semi-private locations. CONCLUSIONS: Technology-assisted education using a digital video delivered via PDA is a convenient and potentially powerful way to deliver health messages. The intervention was implemented efficiently with participants of a variety of ages and educational levels, and in a range of locations within clinical environments. Additional study of this methodology is warranted.

Adult↗

PubMed2005

Integrating mental health in global initiatives for HIV/AIDS.

A more prominent role is needed for mental health interventions in global HIV/AIDS initiatives -- such as the World Health Organization'3 by 5' Initiative. Significant numbers of infected people have, or develop, mental health problems, and this often adversely impacts on HIV/AIDS treatment and adherence. Integrating psychiatric and psychosocial interventions should benefit both the mental and the physical health of people living with HIV/AIDS.

Delivery of Health Care, Integrated↗

PubMed1999

Patterns of breast cancer screening among lesbians at increased risk for breast cancer.

BACKGROUND: Women with a family history of breast cancer (i.e., in a mother, sister or daughter) are at increased risk for this disease. Previous data also suggest that lesbians are at increased risk for breast cancer. While the screening behaviors of women with a family history have been described, little is known about factors that influence screening behaviors of lesbians with the same risk factor profile. PURPOSE: The purpose of this study was to characterize the perceptions of susceptibility to breast cancer and describe factors that influence adherence to breast cancer screening guidelines in a sample of lesbians with a first-degree relative with a diagnosis of breast cancer. METHODS: Structured telephone interviews were conducted on a sample of 139 self-identified lesbians who had a first-degree relative with a diagnosis of breast cancer, were between the ages of 35 to 75 and had no previous history of cancer. Cross-sectional data obtained, included socio-demographics, breast cancer risk factors, breast cancer screening patterns, breast cancer perceptions, worries, and knowledge, and barriers and access to health care factors. Individual subject characteristics were examined for their association with adherence to mammography guidelines followed by a multivariate analysis to evaluate the most important combinations of factors. Outcome measures were age-specific adherence to ACS guidelines for both mammography and overall adherence (i.e., mammography, clinical breast examination and breast self-examination). RESULTS: The 139 lesbians interviewed for this study were young (mean age = 43), almost exclusively white (94%), highly educated (78% = college graduate and beyond), and partnered (68%). In the bivariate analysis of individual factors, being employed and reporting breast cancer worries were significantly and positively associated with adherence to mammography guidelines. Higher income and insurance type were significantly associated with mammography adherence. No factors were significantly associated with overall adherence. Multivariate logistic regression analyses revealed that only income level and degree of breast cancer worries were significantly and positively associated with mammography adherence. However, since there was a high correlation between income level and employment status, a regression model with employment status and worry was also significantly related to mammography adherence. CONCLUSIONS: In lesbians who are at an increased risk for breast cancer because of family history, breast cancer worries may motivate, rather than deter, adherence for mammography use. High income levels also appear to enable adherence in this population. IMPLICATIONS: Additional studies are needed to validate these findings, identify the prevalence of lesbians in general samples of women at increased risk for breast cancer, and prospectively test lesbian sensitive educational intervention strategies designed to facilitate adherence to mammography screening guidelines in this population.

Adult↗