Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Ann Behav Med. 2023 Aug 21;57(9):696-707. doi: 10.1093/abm/kaad018.
The US Preventive Services Task Force does not recommend routine annual mammography screening for women aged 40-49 at average risk. Little research has been done to develop theory-based communication interventions to facilitate informed decision-making about reducing potentially low-value mammography screening.
Evaluate the effects of theory-based persuasive messages on women's willingness to consider delaying screening mammography until age 50 or have mammograms biennially.
We conducted a randomized controlled communication experiment online with a population-based sample of U.S. women aged 40-49 (N = 383) who screened to be at average risk for breast cancer. Women were randomly assigned to the following messaging summaries: annual mammography risks in 40s (Arm 1, n = 124), mammography risks plus family history-based genetic risk (Arm 2, n = 120), and mammography risks, genetic risk, and behavioral alternatives (Arm 3, n = 139). Willingness to delay screening or reduce screening frequency was assessed post-experiment by a set of 5-point Likert scale items.
Women in Arm 3 reported significantly greater willingness to delay screening mammography until age 50 (mean = 0.23, SD = 1.26) compared with those in Arm 1 (mean = -0.17, SD = 1.20; p = .04). There were no significant arm differences in willingness to reduce screening frequency. Exposure to the communication messages significantly shifted women's breast cancer-related risk perceptions without increasing unwarranted cancer worry across all three arms.
Providing women with screening information and options may help initiate challenging discussions with providers about potentially low-value screening.
美国预防服务工作组不建议对平均风险的 40-49 岁女性进行常规年度乳房 X 光筛查。针对制定基于理论的沟通干预措施以促进关于减少潜在低价值乳房 X 光筛查的知情决策，相关研究甚少。
评估基于理论的有说服力的信息对女性考虑将乳房 X 光筛查推迟至 50 岁或每两年进行一次的意愿的影响。
我们通过一项基于人群的美国 40-49 岁女性（N = 383）的在线随机对照沟通实验进行了研究，这些女性筛查结果显示为乳腺癌平均风险。女性被随机分配到以下信息摘要中：40 多岁的年度乳房 X 光检查风险（第 1 臂，n = 124）、乳房 X 光检查风险加上基于家族史的遗传风险（第 2 臂，n = 120）和乳房 X 光检查风险、遗传风险和行为替代方案（第 3 臂，n = 139）。实验后通过一组 5 点李克特量表项目评估延迟筛查或减少筛查频率的意愿。
第 3 臂的女性报告说，与第 1 臂的女性相比（平均值 = -0.17，SD = 1.20；p =.04），她们更愿意将乳房 X 光筛查推迟到 50 岁。在减少筛查频率方面，三组之间没有显著的手臂差异。接触沟通信息显著改变了女性的乳腺癌相关风险感知，而在所有三组中均未增加不必要的癌症担忧。
向女性提供筛查信息和选择可能有助于与提供者开始关于潜在低价值筛查的具有挑战性的讨论。
