School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Health Expect. 2024 Oct;27(5):e70038. doi: 10.1111/hex.70038.
Diagnostic tests carry significant risks, and communications are needed to help lay people consider these. The development of communications has been hindered by poor knowledge about how lay people understand and negotiate testing risks. We examined lay Australians' perceptions of diagnostic testing risks and how these risks are managed.
We completed 12 semistructured online focus groups with 61 Australian adults (18+) between April and June 2022. Participants were divided into younger/older (> 50 years) and male/female groups. Using semistructured discussion and exploring two hypothetical scenarios, we examined attitudes to diagnostic tests, their risks and how test risks were managed. Themes were identified, subanalysed to identify age and gender differences and mapped to the COM-B model of behaviour change.
The six themes provided detailed accounts of how participants considered themselves able, empowered and assertive when negotiating testing risks and of complex ways in which relationships with health workers, personal experiences and structural factors influenced negotiating testing risks. COM-B identified multiple opportunities for leveraging these lay beliefs in health promotion. It also identified barriers, including narrow concepts of testing risks, challenges during shared decision-making and overestimation of personal influence on testing decisions.
Our findings matter because they are a novel, detailed account of testing risk beliefs, linked to a model for behaviour change. This will directly inform development of test risk/benefit communications, which are a research priority.
The study design enabled participants to influence the discussion agenda, and they could comment on the analysis. Participants contributed insights about their needs, beliefs and experiences related to medical testing, and these will be used to shape future patient-centred decision tools.
诊断测试存在重大风险，需要进行沟通，以帮助非专业人士考虑这些风险。由于对非专业人士如何理解和协商测试风险的了解不足，沟通的发展受到了阻碍。我们研究了非专业的澳大利亚人对诊断测试风险的看法，以及如何管理这些风险。
我们在 2022 年 4 月至 6 月期间完成了 12 次半结构化在线焦点小组，参与者为 61 名澳大利亚成年人（18 岁以上）。参与者分为年轻/年长（>50 岁）和男性/女性组。通过半结构化讨论和探索两个假设情景，我们研究了对诊断测试的态度、测试风险及其管理方式。确定了主题，对主题进行了子分析，以确定年龄和性别差异，并将其映射到行为改变的 COM-B 模型。
六个主题详细描述了参与者在协商测试风险时如何认为自己有能力、有权力和有主见，以及健康工作者的关系、个人经历和结构因素如何影响协商测试风险的复杂方式。COM-B 确定了利用这些非专业信念进行健康促进的多种机会。它还确定了一些障碍，包括对测试风险的狭隘概念、在共同决策时面临的挑战以及对个人对测试决策的影响的高估。
我们的发现很重要，因为它们是一种新颖的、详细的测试风险信念描述，与行为改变模型相关。这将直接为测试风险/效益沟通的开发提供信息，这是研究的重点。
研究设计使参与者能够影响讨论议程，并且他们可以对分析发表评论。参与者对与医疗测试相关的需求、信念和经验提供了见解，这些见解将用于塑造未来以患者为中心的决策工具。
