Investigating informed choice in screening programmes: a mixed methods analysis

BMC Public Health

Research

Natalie Tyldesley-Marshall¹  Megha Singh¹  Lena Al-Khudairy¹  Abimbola Ayorinde¹  Aileen Clarke¹  Iman Ghosh¹  Sian Taylor-Phillips¹  Laura Kudrna²  Amy Grove³  Edward Mehaan⁴ 

[1] Applied Research Collaboration West Midlands, Warwick Medical School, University of Warwick, CV4 7AL, Coventry, UK;Applied Research Collaboration West Midlands, Warwick Medical School, University of Warwick, CV4 7AL, Coventry, UK;Present address : Institute of Applied Health Research, University of Birmingham, B15 2TT, Edgbaston, UK;Applied Research Collaboration West Midlands, Warwick Medical School, University of Warwick, CV4 7AL, Coventry, UK;Public Health and Health Technology Assessment and Implementation Science, Warwick Medical School, University of Warwick, CV4 7AL, Coventry, UK;Monash University, Wellington Road, 3800, Clayton, Melbourne, VIC, Australia;

关键词: Screening;    Fetal anomalies;    Cancer;    Public policy;    Informed choice;    Mixed methods;    Decision-making;    Decision aids;    Health communication;    Non-invasive pregnancy testing;   

DOI  :  10.1186/s12889-022-14685-6

 received in 2022-04-14, accepted in 2022-11-21,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundScreening programmes aim to identify individuals at higher risk of developing a disease or condition. While globally, there is agreement that people who attend screening should be fully informed, there is no consensus about how this should be achieved. We conducted a mixed methods study across eight different countries to understand how countries address informed choice across two screening programmes: breast cancer and fetal trisomy anomaly screening.MethodsFourteen senior level employees from organisations who produce and deliver decision aids to assist informed choice were interviewed, and their decision aids (n = 15) were evaluated using documentary analysis.ResultsWe discovered that attempts to achieve informed choice via decision aids generate two key tensions (i) between improving informed choice and increasing uptake and (ii) between improving informed choice and comprehensibility of the information presented. Comprehensibility is fundamentally at tension with an aim of being fully informed. These tensions emerged in both the interviews and documentary analysis.ConclusionWe conclude that organisations need to decide whether their overarching aim is ensuring high levels of uptake or maximising informed choice to participate in screening programmes. Consideration must then be given to all levels of development and distribution of information produced to reflect each organisation’s aim. The comprehensibility of the DA must also be considered, as this may be reduced when informed choice is prioritised.

【 授权许可】

CC BY   
© Crown 2022

【 图 表 】

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