Breast Cancer Risk-Tailored Messages for More Women

描述（由申请人提供）：本项目将研究低强度干预对乳腺X射线摄影使用的影响。干预措施包括自我管理的计算机化乳腺癌风险评估，随后收到根据计算的风险量身定制的打印健康信息。计算机化的风险评估程序是基于Gail乳腺癌风险计算模型。该干预措施通过应用扩大的健康信念模式的原则来促进乳房X光检查。健康信息是根据个人的风险水平（中度、中度、重度）量身定制的。这项为期5年的试验将前瞻性地评估对妇科诊所常规就诊的妇女的干预。具体目标是：1）评估干预对乳房X线摄影实践的主要结果的影响; 2）测量干预对乳房自我检查、临床乳房检查、风险认知和乳腺癌担忧的次要结果的影响;通过评估协变量的影响，了解干预的作用机制（应对机制、扩展的健康信念模型变量、乳腺癌担忧、乳腺癌风险因素、风险认知、与亲属讨论乳腺癌、既往筛查实践、筛查意图以及各种人口统计学变量--年龄、种族、和教育）进行乳腺癌筛查。900名至少40岁的妇女将被随机分配到干预或控制条件。所有参与者将在等待预约时完成基线调查。在基线调查之后，干预参与者将立即自我管理计算机程序（在研究助理的指导下），以计算他们的乳腺癌风险并接收打印的健康信息。信念和行为结果将在干预后1、6和18个月通过电话进行评估。两组的后续调查将衡量计划和实际的筛查，包括乳房X光检查，乳腺癌的担忧和风险认知。该提案有可能提供基于理论驱动的低强度干预的高影响结果（乳房X线摄影）的有价值的见解。这项研究至少在两个方面与众不同：1）它调查了不一定选择风险状态的不同妇女群体的健康风险评估; 2）通过使用临床环境，它具有很高的实际意义。干预可能导致早期发现，预防和减轻乳腺癌的负担

DESCRIPTION (provided by applicant): This project will investigate the impact of a low-intensity intervention on mammography use. The intervention consists of a self-administered computerized breast cancer risk assessment with subsequent receipt of printed health messages that are tailored to calculated risk. The computerized risk assessment program is based on the Gail model for breast cancer risk calculation. The intervention promotes mammography by applying principles of the expanded Health Belief Model. The health messages are tailored to the individual's level of risk (Usual, Moderate, Strong). This 5-year trial will prospectively evaluate the intervention on women coming for routine visits in a gynecology clinic. The specific aims are: 1) to assess the impact of the intervention on the primary outcome of mammography practice; 2) to measure the effect of the intervention on the secondary outcomes of breast self-examination, clinical breast exam, risk perceptions, and breast cancer worry; and 3) to understand the mechanism of action of the intervention by assessing the impact of covariates (coping mechanisms, expanded Health Belief Model variables, breast cancer worry, breast cancer risk factors, risk perceptions, discussion of breast cancer with relatives, previous screening practices, intentions to screen, and various demographic variables-age, race, and education) on breast cancer screening. Nine hundred women at least 40 years old will be randomly assigned to intervention or control conditions. All participants will complete baseline surveys while waiting for their appointments. Immediately following the baseline survey, intervention participants will self-administer the computer program (under the guidance of a research assistant) to calculate their breast cancer risks and receive the printed health messages. Belief and behavioral outcomes will be assessed at 1, 6, and 18 months post-intervention by telephone. Follow-up surveys of both groups will measure planned and actual screening including mammography, breast cancer worry, and risk perceptions. This proposal has potential to provide valuable insight on a high-impact outcome (mammography) based on a theoretically-driven, low-intensity intervention. This study distinguishes itself in at least two ways: 1) it investigates health risk assessment among a diverse group of women not necessarily selected for risk status; and 2) it has high practical significance by using a clinical setting. The intervention may lead to early detection, prevention, and a reduction of the burden of breast cancer