Department of Business Management, Rovira i Virgili University, Reus, Spain.
Research Group on Statistics, Economic Evaluation and Health (GRAEES), Reus, Spain.
PLoS One. 2023 Feb 3;18(2):e0281454. doi: 10.1371/journal.pone.0281454. eCollection 2023.
The paper has two objectives. The first one examines whether informing women about the benefits and adverse effects of breast cancer screening could have an effect on three variables: their knowledge, the importance women attach to the future consequences of their current decisions (time perspective), and the degree to which women are worried about developing breast cancer (worry). The second one examines whether these three variables affect their intention to participate in the screening, either directly or indirectly through their feeling of regret if they do not attend the screening (anticipated regret); through their values and the support they receive in making their decisions (decisional conflict); and, through the perceived acceptability and benefits of the screening programme (attitude).
Partial least squares-structural equation modelling (PLS-SEM) is used to analyse both objectives and to differentiate between direct, indirect, and moderating effects, due to the incorporation in the model of the three mediating variables (anticipated regret, decisional conflict, and attitude) and a moderating variable (educational level).
Information affects knowledge (objective variable), but not the behavioural variables (time perspective and worry). On the other hand, the level of knowledge has no direct or indirect effect on intention, but behavioural variables do affect it through the mediating variables.
The variables of the planned behaviour theory are relevant to understand women's decisions and to be able to take appropriate health policy measures. Doing so, the processes of personalised screening would improve, or there would be the incorporation of shared decision-making in this context; these being demands associated with the most recent goals achieved in health programmes in many countries.
本文有两个目的。第一个目的是检验告知女性乳腺癌筛查的益处和不良反应是否会对三个变量产生影响：她们的知识、女性对当前决策未来后果的重视程度（时间视角），以及女性对患乳腺癌的担忧程度（担忧）。第二个目的是检验这三个变量是否会通过对未参加筛查的后悔感（预期后悔）、价值观以及在决策过程中获得的支持（决策冲突），以及通过对筛查计划的可接受性和益处的感知（态度），直接或间接地影响她们参与筛查的意愿。
偏最小二乘结构方程模型（PLS-SEM）用于分析这两个目的，并区分直接、间接和调节效应，因为模型中包含了三个中介变量（预期后悔、决策冲突和态度）和一个调节变量（教育水平）。
信息会影响知识（目标变量），但不会影响行为变量（时间视角和担忧）。另一方面，知识水平对意愿没有直接或间接影响，但行为变量会通过中介变量影响意愿。
计划行为理论的变量与理解女性的决策有关，并且能够采取适当的卫生政策措施。这样做，可以改进个性化筛查的过程，或者在这种情况下纳入共同决策；这些都是与许多国家卫生计划最近实现的目标相关的要求。
