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: 10617181
• 负责人: Nancy Schoenborn
• 金额: $ 46.74万
• 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/10617181
• 关键词: Address; Administrator; Advocacy; Age; American Cancer Society; Anecdotes; Attitude; Behavior; Belief; Breast Cancer Detection; Caregivers; Clinical; Clinical Treatment; Communication; Communities; Data; Diagnosis; Early 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; Odds Ratio; 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.

项目摘要 乳房X线摄影筛查可能会降低乳腺癌的死亡率和发病率，但潜在的好处 通常会延迟多年，而短期内可能会造成重大伤害。而乳腺癌 发病率随着年龄的增长而增加，老年妇女也面临与筛查相关危害的风险更高的风险 与年轻女性相比。常规筛查的危害超过了老年妇女的利益 预期寿命有限，但其中许多女性继续进行筛查，强调了对 为了减少老年妇女的过度筛查，采取干预措施以促进适当的筛查。 我们先前的研究表明，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 筛查损害大于收益时进行筛查。但是，患者有时会收到矛盾的信息 他们的家人，朋友或新闻媒体削弱了临床医生建议的影响 有助于过度筛查。 该项目旨在研究临床医生，家人和朋友以及媒体的信息如何单独研究 以及对老年妇女的乳腺癌筛查意图的影响，目的是确定 消息传递策略最有效地减少了过度筛查的乳腺癌。我们试图实现这一目标 实现3个目标。我们将首先确定旨在减少乳腺癌过度筛查的信息 在对600名老年妇女的全国性在线调查中被认为是最可信的（AIM 1）。然后，我们将进行 两波在线调查实验与3,000名老年妇女一起研究一致和一致的综合效果 来自不同来源的信息（包括临床医生，社会关系和新闻媒体）相互矛盾 随着时间的流逝，乳腺癌筛查，参加者和意图（AIM 2）。最后，我们将集中精力 具有多学科利益相关者的小组，以制定策略来传递AIM 2的信息 有效地降低了过度筛选意图（AIM 3）。 拟议的项目将确定有效的消息传递策略以促进适当的筛选 停止并减少老年妇女乳腺癌的过度筛查，并吸引利益相关者通知 消息传播。结果将直接告知交流干预措施，作为减少的下一步 老年妇女的乳腺癌过度筛查。