Messaging Strategies to Reduce Breast Cancer Over-Screening in Older Women

减少老年女性乳腺癌过度筛查的信息传递策略

• 批准号: 10382428
• 负责人: Nancy Schoenborn
• 金额: $ 48.97万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-15 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10382428
• 关键词: Address; Administrator; Advocacy; Age; American Cancer Society; Anecdotes; Attitude; Behavior; Belief; Breast Cancer Detection; Caregivers; Clinical; Clinical Treatment; Communication; Communities; Conflict (Psychology); Data; Diagnosis; Elderly; Family; Family member; Focus Groups; Friends; Goals; Guidelines; Health; Health system; Incidence; Intervention; Knowledge; Life; Life Expectancy; Malignant Neoplasms; Mammographic screening; Morbidity - disease rate; Patients; Randomized; Recommendation; Reporting; Research; Screening for cancer; Social Network; Source; Surveys; Time; Trust; Vacuum; Woman; Work; experience; experimental study; high risk; innovation; malignant breast neoplasm; mortality; multidisciplinary; news; novel; older patient; older women; overtreatment; patient screening; patient-clinician communication; routine screening; screening; screening guidelines; social relationships; young woman

PROJECT SUMMARY Mammography screening may decrease breast cancer mortality and morbidity but the potential benefits are often delayed for many years while significant harms can occur in the short term. While breast cancer incidence increases with age, older women are also at higher risks for screening-related harms and burdens compared to younger women. The harms of routine screening outweigh the benefits among older women with limited life expectancies, but many of these women continue to be screened, highlighting the need for interventions to promote appropriate screening cessation in order to reduce over-screening in older women. Our prior research suggests that older adults are willing to stop routine cancer screening when recommended by their clinicians. We also found that clinicians are increasingly willing to recommend that older patients forgo screening when harms outweigh the benefits. However, patients at times receive contradictory messages from their family, friends, or the news media which weaken the impact of the clinicians' recommendations and contribute to over-screening. This project aims to examine how messages from clinicians, family and friends, and media, separately and together, impact breast cancer screening intentions among older women, with the goal of identifying messaging strategies that most effectively reduce breast cancer over-screening. We seek to accomplish this goal through 3 aims. We will first establish which messages intended to reduce breast cancer over-screening are considered most credible in a national online survey of 600 older women (Aim 1). Then, we will conduct a two-wave online survey experiment with 3,000 older women to examine the combined effects of consistent and conflicting messages from different sources—including clinicians, social relationships, and the news media — on breast cancer screening beliefs, attitudes, and intentions over time (Aim 2). Lastly, we will conduct focus groups with multi-disciplinary stakeholders to devise strategies to deliver the messages from Aim 2 that most effectively reduced over-screening intentions (Aim 3). The proposed project will identify effective messaging strategies to promote appropriate screening cessation and reduce over-screening for breast cancer in older women and engage stakeholders to inform message dissemination. The results will directly inform a communication intervention as a next step to reduce breast cancer over-screening among older women.

项目概要 乳房X光检查可能会降低乳腺癌死亡率和发病率，但潜在的好处 往往会拖延很多年，而重大损害可能在短期内发生。当乳腺癌 发病率随着年龄的增长而增加，老年妇女遭受筛查相关伤害和负担的风险也更高 与年轻女性相比。对于老年女性来说，常规筛查的弊大于利 预期寿命有限，但其中许多妇女继续接受筛查，这凸显了需要 采取干预措施，促进适当停止筛查，以减少老年妇女的过度筛查。 我们之前的研究表明，老年人愿意在建议时停止常规癌症筛查 由他们的临床医生。我们还发现临床医生越来越愿意建议老年患者放弃 当弊大于利时进行筛查。然而，患者有时会收到相互矛盾的信息 他们的家人、朋友或新闻媒体削弱了临床医生建议的影响力 造成过度筛选。 该项目旨在研究来自临床医生、家人和朋友以及媒体的信息如何分别 共同影响老年女性的乳腺癌筛查意愿，目标是确定 最有效减少乳腺癌过度筛查的信息传递策略。我们力求实现这一目标 通过 3 个目标实现目标。我们将首先确定哪些信息旨在减少乳腺癌过度筛查 在一项针对 600 名老年妇女的全国在线调查中被认为是最可信的（目标 1）。然后，我们将进行一次 对 3,000 名老年女性进行了两波在线调查实验，以检验一致和 来自不同来源（包括临床医生、社会关系和新闻媒体）的相互矛盾的信息 随着时间的推移，乳腺癌筛查信念、态度和意图的影响（目标 2）。最后我们要进行重点 与多学科利益相关者组成的小组制定策略，传递目标 2 中最受关注的信息 有效减少过度筛选意图（目标3）。 拟议的项目将确定有效的信息传递策略，以促进适当的筛查 停止和减少老年妇女乳腺癌的过度筛查，并让利益相关者参与告知 消息传播。结果将直接通知沟通干预作为下一步减少 老年女性乳腺癌过度筛查。