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A Multi-Level Strategy for De-implementing Mammography Overuse Among Older Women
De-implementation of Overuse of Mammography Screening in Older Racially and Ethnically Diverse Women
Who can join
Ages 18 and older · All sexes · Healthy volunteers welcome
Full eligibility criteria
Patient level criteria Inclusion criteria * English- or Spanish-speaking women based on preferred language in electronic health record * Aged 75 and older at the time of their scheduled primary care visit * Women who have a primary care visit scheduled within the next 2-4 weeks * Women who have not had a screening mammogram 6 months prior to their scheduled primary care visit but have had a screening mammogram 7-18 months prior to their scheduled primary care visit Exclusion Criteria * Women with a history of atypical ductal hyperplasia (ADH) or non-invasive or invasive breast cancer (assessed via ICD 10 code) * Women with dementia (assessed via ICD 10 code) * ICD codes to use across exclusion criteria: F01-F03, Z85.3, G30-G31, N60, C50, or D05 Provider level criteria Inclusion Criteria • Primary care clinicians attributed to the 2 intervention clinics that serve adult patients, including those ≥75 years Exclusion Criteria * Specialists * Primary care clinicians for patients \< 18 years old * Non-clinicians * Physician assistants
About the study
This project aims to advance methodological and theoretical approaches for developing, selecting, refining, and piloting a multilevel de-implementation strategy to reduce the overuse of screening mammography in women aged ≥75 years. Informed by an innovative participatory, stakeholder-driven innovation tournament and a discrete choice experiment, the research team identified, prioritized, and tailored a multilevel de-implementation strategy. The research team will conduct a cluster randomized controlled trial (at the provider level) to test the impact of the provider- and patient-level components of the multilevel strategy on screening mammography use, and secondarily, on provider referrals/orders for screening mammography. The organizational level components of the multilevel strategy will be implemented among all participants, not via random assignment.
What is being tested
- Enhanced Usual Care (EUC) (other)
- Multilevel De-Implementation Strategy (behavioral)
Sponsor: Columbia University · Participants: 500 · Started: Mar 11, 2026
Contact the study team
- Parisa Tehranifar, DrPH · Phone: 212-305-1018
Official record on ClinicalTrials.gov — NCT07511621
Locations in the U.S.
| New York | Columbia University Irving Medical Center, New York |
From ClinicalTrials.gov, data retrieved Oct 1, 2026. Each study sets its own eligibility; the study team decides who can join.