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Preconceptions influence women's perceptions of information on breast cancer screening: a qualitative study.

Henriksen MJ, Guassora AD, Brodersen J - BMC Res Notes (2015)

Bottom Line: Screening for breast cancer has been subject to intense debate in recent decades regarding benefits and risks.An isolated framing effect was not found.These expectations compromise the perception of balance between screening benefits and potential harmful effects.

View Article: PubMed Central - PubMed

Affiliation: Research Unit and Section for General Practice, Department of Public Health, University of Copenhagen, Oster Farimagsgade 5, 1014, Copenhagen K, Denmark. mikael.jv.henriksen@gmail.com.

ABSTRACT

Background: Screening for breast cancer has been subject to intense debate in recent decades regarding benefits and risks. Participation in breast cancer screening should be based on informed choice, and most countries approach this by sending information leaflets with invitations to attend screening. However, very little attention has been paid to the decision-making process and how the information leaflets are used and understood by women. The aim of this study is twofold. First, we use a theoretical framework to explore how the framing of information influences the intention to participate in breast cancer screening. Second, we discuss how information and attitudes held prior to receiving the invitation influence the perception of the balance between the benefits and risks harms of screening.

Methods: We used a qualitative design and interviewed six women who were soon to receive their first invitation to participate in the breast screening programme in Denmark. The selected women received a copy of the official information leaflet 1 week before we interviewed them. The six women were interviewed individually using an interview guide based on the theory of planned behaviour. We used meaning condensation for our initial analysis, and further analysis was guided by the theory of cognitive dissonance.

Results: For our participants, the decision-making process was dominated by the attitudes of the women's circle of acquaintances and, to a lesser extent, by the information that accompanied the screening invitation. Information that conflicted with attitudes the women already held was actively disregarded. The risk of overdiagnosis as a potentially harmful effect of participation in mammography screening was unknown to the women in our study. An isolated framing effect was not found.

Conclusion: Women have expectations about breast cancer screening that are formed before they receive information from the screening programme. These expectations compromise the perception of balance between screening benefits and potential harmful effects. They also influence the perception of the information in the breast screening leaflet. The phenomenon of overdiagnosis is unknown to the women.

No MeSH data available.


Related in: MedlinePlus

Topics covered in the interview guide. Legend the topics covered during the semi-structured interviews with the informants
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Fig2: Topics covered in the interview guide. Legend the topics covered during the semi-structured interviews with the informants

Mentions: The interviews were conducted at either the women’s homes or at their workplaces and each interview lasted approximately 90 min. The interview guide included questions on attitudes towards screening after having read the information leaflet, other sources of information, and people in the family or circle of friends who may have had an influence on the decision-making process. Inspired by Tversky, the interview guide provided the women with information about the risk of getting breast cancer and the effects of screening in both a survival frame and a mortality frame. We also presented the numbers in different formats (Fig. 2). Other questions covered the women’s knowledge of the effects of mammography screening and phenomena such as risk of side-effects, including overdiagnosis, by presenting statements about these issues framed in different ways. To optimize the effect of how changes in attitude are sensitive to framings and facts, we chose evidence based information that conflicted somewhat with the information in the official leaflet (Fig. 3). These facts were based on a Cochrane Systematic Review [7], as this was the highest level of evidence available at the time of our study design, and it pre-dates the results of The UK Independent Panel on Breast Cancer Screening.Fig. 2


Preconceptions influence women's perceptions of information on breast cancer screening: a qualitative study.

Henriksen MJ, Guassora AD, Brodersen J - BMC Res Notes (2015)

Topics covered in the interview guide. Legend the topics covered during the semi-structured interviews with the informants
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4557860&req=5

Fig2: Topics covered in the interview guide. Legend the topics covered during the semi-structured interviews with the informants
Mentions: The interviews were conducted at either the women’s homes or at their workplaces and each interview lasted approximately 90 min. The interview guide included questions on attitudes towards screening after having read the information leaflet, other sources of information, and people in the family or circle of friends who may have had an influence on the decision-making process. Inspired by Tversky, the interview guide provided the women with information about the risk of getting breast cancer and the effects of screening in both a survival frame and a mortality frame. We also presented the numbers in different formats (Fig. 2). Other questions covered the women’s knowledge of the effects of mammography screening and phenomena such as risk of side-effects, including overdiagnosis, by presenting statements about these issues framed in different ways. To optimize the effect of how changes in attitude are sensitive to framings and facts, we chose evidence based information that conflicted somewhat with the information in the official leaflet (Fig. 3). These facts were based on a Cochrane Systematic Review [7], as this was the highest level of evidence available at the time of our study design, and it pre-dates the results of The UK Independent Panel on Breast Cancer Screening.Fig. 2

Bottom Line: Screening for breast cancer has been subject to intense debate in recent decades regarding benefits and risks.An isolated framing effect was not found.These expectations compromise the perception of balance between screening benefits and potential harmful effects.

View Article: PubMed Central - PubMed

Affiliation: Research Unit and Section for General Practice, Department of Public Health, University of Copenhagen, Oster Farimagsgade 5, 1014, Copenhagen K, Denmark. mikael.jv.henriksen@gmail.com.

ABSTRACT

Background: Screening for breast cancer has been subject to intense debate in recent decades regarding benefits and risks. Participation in breast cancer screening should be based on informed choice, and most countries approach this by sending information leaflets with invitations to attend screening. However, very little attention has been paid to the decision-making process and how the information leaflets are used and understood by women. The aim of this study is twofold. First, we use a theoretical framework to explore how the framing of information influences the intention to participate in breast cancer screening. Second, we discuss how information and attitudes held prior to receiving the invitation influence the perception of the balance between the benefits and risks harms of screening.

Methods: We used a qualitative design and interviewed six women who were soon to receive their first invitation to participate in the breast screening programme in Denmark. The selected women received a copy of the official information leaflet 1 week before we interviewed them. The six women were interviewed individually using an interview guide based on the theory of planned behaviour. We used meaning condensation for our initial analysis, and further analysis was guided by the theory of cognitive dissonance.

Results: For our participants, the decision-making process was dominated by the attitudes of the women's circle of acquaintances and, to a lesser extent, by the information that accompanied the screening invitation. Information that conflicted with attitudes the women already held was actively disregarded. The risk of overdiagnosis as a potentially harmful effect of participation in mammography screening was unknown to the women in our study. An isolated framing effect was not found.

Conclusion: Women have expectations about breast cancer screening that are formed before they receive information from the screening programme. These expectations compromise the perception of balance between screening benefits and potential harmful effects. They also influence the perception of the information in the breast screening leaflet. The phenomenon of overdiagnosis is unknown to the women.

No MeSH data available.


Related in: MedlinePlus