Pilot Evaluation of Patient-centered Survey Tools for Breast Cancer Screening Decision-making in Women 75 and Older

2020 ◽  
Vol 7 (1) ◽  
pp. 13-18
Author(s):  
Annamarie Beckmeyer ◽  
Rachel Smith ◽  
Laura Miles ◽  
Mara Schonberg ◽  
Amanda Toland ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Patient Centered

Shared decision making for supporting women’s decisions about breast cancer screening

2020 ◽  
Author(s):  
Paula Riganti ◽  
M. Victoria Ruiz Yanzi ◽  
Camila Micaela Escobar Liquitay ◽  
Karin S Kopitowski ◽  
Juan VA Franco
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Shared Decision Making ◽  
Shared Decision

scholarly journals Relationship between dementia severity in older women and family caregivers’ preferences for shared decision making about breast cancer screening

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Molly Frank ◽  
Nicole Fowler
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Shared Decision Making ◽  
Family Caregiver ◽  
Standard Of Care ◽  
Shared Decision ◽  
Dementia Severity ◽  
The Relationship

Background/Objective: Mammography is one of the most effective ways to diagnose breast cancer early; however, its perceived benefits are complicated by terminal conditions such as dementia. By undergoing mammography, women with dementia risk treatment complications and false-positive results, which can exacerbate psychological distress. The lack of a standard of care confounds the individual roles of the patient, family caregiver, and physician in the decision-making process. This study evaluates the relationship between dementia severity and family caregiver preferences for shared decision making. Methods: Data were gathered from the Decisions about Cancer screening in Alzheimer’s Disease trial, which uses the Dementia Severity Rating Scale (DSRS) and a revised version of the Control Preferences Scale (CPS) to assess family caregiver preferences for decision-making as a dyad (patient and caregiver) and triad (patient, caregiver, and physician). Two multinomial logistic regression models assessed the relationship between DSRS and CPS categories (active, passive, and collaborative), while controlling for the caregivers’ age, gender, education, relationship to patient, self-perceived income, and race. Both models used the “active” group as the baseline; however, Model 1 examined preferences as a dyad and Model 2 as a triad. Results: Model 1 found a statistically significant association between dementia severity and a collaborative approach (p<0.001), and between dementia severity and a passive approach (p=0.014). For every one-unit increase in DSRS score, the odds of being in the collaborative group decreased by 0.083 and the odds of being in the passive group decreased by 0.085. There was no statistically significant association between dementia severity and decision-making preferences in Model 2. Clinical Significance: The association between dementia severity and family caregiver decision-making preferences supports the need for a standard of care regarding breast cancer screening in women with dementia.

Web-based decision aids to support breast cancer screening decisions: systematic review and meta-analysis

2020 ◽  
Vol 9 (14) ◽  
pp. 985-1002
Author(s):  
Lin Yu ◽  
Ping Li ◽  
Shu Yang ◽  
Pingping Guo ◽  
Xuehui Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Decision Making ◽  
Cancer Screening ◽  
Usual Care ◽  
Breast Cancer Screening ◽  
Meta Analysis ◽  
Decision Aids ◽  
Web Based ◽  
Mean Differences

Aim: Breast cancer is a leading cause of cancer among women. Because guidelines on screening for breast cancer for certain ages are controversial, many experts advocate the use of shared decision making (SDM) using validated decision aids (DAs). Recent studies have concluded that DAs are beneficial; however, the results have great heterogeneity. Therefore, further studies are needed to improve understanding of these tools. Objective: This systematic review and meta-analysis aimed to investigate the impact of using web-based DAs in women aged 50 years and below facing the decision to be screened for breast cancer in comparison with usual care. Methods: PubMed, Web of Science, Embase and the Cochrane CENTRAL databases were searched up to February 2020 for studies assessing web-based DAs for women making a breast cancer screening decision and reported quality of decision-making outcomes. Using a random-effects model or a fixed-effects model, meta-analyses were conducted pooling results using mean differences (MD), standardized mean differences (SMD) and relative risks (RR). Results: Of 1097 unique citations, three randomized controlled trials and two before–after studies met the study eligibility criteria. Compared with usual care, web-based DAs increased knowledge (SMD = 0.69; 95% CI: 0.57–0.80; p < 0.00001), reduced decision conflict and increased the proportion of women who made an informed choice (RR = 1.86; 95% CI: 1.38 to 2.50; p < 0.0001), but did not change the intention of women deciding to be screened or affect decision regret. Conclusion: This analysis showed the positive effect of web-based DAs on patient-centered outcomes in breast cancer screening. In the future, more internet devices and free or larger discount WI-FI should be established to ensure more women can benefit from this effective tool.

Using an integrated social-behavioral text message approach to improve screening mammography in African American women.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 240-240
Author(s):  
Amina Dhahri ◽  
Paapa Nyanin ◽  
Shana Ntiri
Keyword(s):  
Breast Cancer ◽  
Black Women ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Text Messaging ◽  
Text Message ◽  
Screening Mammography ◽  
Text Messages ◽  
Patient Centered ◽  
Self Advocacy

240 Background: The rate of breast cancer among Black and White women is nearly equivalent but the death rate is 40% higher for Blacks. This disparity is often attributed to lower screening mammography rates in Black women. The effectiveness of text messages on increasing screening mammography among Black women is not well known. Importantly, the themes that are most effective at promoting behavioral changes in Black women’s breast cancer screening practices through text message interventions have not been explored. An integrated social-behavioral approach was used to identify themes associated with Black women’s response to two types of text messaging: reminder and educational texts. Methods: A qualitative study was conducted in Metropolitan Baltimore with two focus groups among Black breast cancer survivors. Participants completed a demographic survey and indicated text messaging practices and preferences for future breast screening texts via survey. Participants provided feedback on a series of 17 educational and reminder text messages. Focus groups were digitally recorded and transcribed for analysis. Text message preferences were analyzed using a content analysis approach. Multiple themes were identified, discussed and recorded. Results: 17 participants had an average age of 60. All participants reported cell phone ownership and 82% of participants reported texting. 46% reported an interest in reminder text messages and 54% reported an interest in educational text messages. Four main themes were derived from participants’ responses the text message series: 1) access to cancer care surveillance, 2) social network support, 3) patient-centered approach, and 4) self-advocacy. Text messages that included themes of self-advocacy, social network support, and patient-centered approach generated positive responses and the text messages that included access to cancer care surveillance were perceived as demotivating. Educational text messages were perceived to be more motivating than reminder text messages. Conclusions: Breast cancer screening behaviors are affected by various demographic, social-behavioral, and socioeconomic factors. The findings from this study suggest that developing an educational text message content that incorporates social and behavioral themes focusing on the patient may be more beneficial to improve breast cancer screening rates in this population.

scholarly journals Using Collaborative Simulation Modeling to Develop a Web-Based Tool to Support Policy-Level Decision Making About Breast Cancer Screening Initiation Age

2017 ◽  
Vol 2 (2) ◽  
pp. 238146831771798
Author(s):  
Elizabeth S. Burnside ◽  
Sandra J. Lee ◽  
Carrie Bennette ◽  
Aimee M. Near ◽  
Oguzhan Alagoz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Simulation Modeling ◽  
Web Based ◽  
Collaborative Simulation ◽  
Policy Level ◽  
Support Policy

BPI19-012: Differences in Stakeholder Perspectives Regarding Key Components of Shared Decision-Making for Mammography in Breast Cancer Screening for Women Ages 40–50

2019 ◽  
Vol 17 (3.5) ◽  
pp. BPI19-012
Author(s):  
Lori L. DuBenske ◽  
Sarina B. Schrager ◽  
Terry A. Little ◽  
Elizabeth S. Burnside
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Shared Decision Making ◽  
Average Risk ◽  
Shared Decision ◽  
Delphi Consensus ◽  
Annual Screening ◽  
Core Elements

Background: National health organizations offer contrasting guidelines for women aged 40–49 regarding when to begin and how often to use mammography screening for breast cancer. The ACS recommends average risk women aged 40–44 receive annual screening “if they wish to do so” and annual screening for women aged 45–54. The United States Preventive Services Task Force recommends individualized screening for average-risk women before age 50 advised by risk assessment and shared decision-making (SDM). Clinicians lack guidance on how to conduct and what elements to include in mammography SDM. Our prior work identified core elements via scoping review applied to a modified Delphi consensus process involving patients, primary care physicians (PCP), and healthcare decision scientists (HDS). This study examines stakeholder group differences in endorsing core SDM elements. Methods: The Delphi consensus included 10 patients, 10 PCP, and 10 HDS and fielded 48 items to codify core elements of mammography SDM. A threshold of 80% agreement across all participants was set to establish consensus for retaining or dropping an item. In this study, separate stakeholder groups’ endorsement rates for each item were calculated. Items were deemed to have stakeholder discrepancy if one group differed from the 2 others in either meeting or not meeting the 80% threshold criteria. Results: 16 items (13 retained, 3 dropped in Delphi) had a discrepant group. For all retained items, the discrepant group fell below 80% criteria for retaining. For 2 of the dropped items, discrepant groups achieved threshold for retaining the item. One item was dropped despite most participants voting to retain it (>80%) due to the discrepant group’s rating <80%. Patients rated less importance to educating women about risks and recommendations. PCPs rated lower importance to training PCPs and women for discussions about mammograms and having discussions on a regular basis. HDSs rated greater importance to considering mammogram procedures and costs in SDM. Discussion: Leading healthcare organizations are increasingly recommending SDM in breast cancer screening, among other decisions. Guidelines enumerating core elements of SDM are needed to effectively direct clinicians. This study, by illuminating differences between stakeholder group perspectives, highlights the importance of eliciting varied perspectives in identifying core elements of SDM when informing healthcare practices and policy.

Sign in / Sign up

Export Citation Format

Share Document