PROMOTING INFORMED DECISION MAKING ABOUT MAMMOGRAPHY

最近关于乳腺癌筛查的争议导致了混乱 在供应商和公众之间。我们的初步数据和公布的 报告显示，40多岁的女性对患上糖尿病的风险感到困惑， 乳腺癌，乳房X光检查的风险和好处，以及是否和如何 经常去做乳房X光检查。但老年妇女也误解了 乳腺癌和乳房X光检查的风险和好处，这可能 是乳腺X光检查使用不足的原因之一。整体 该项目的目的是加强知情决策， 通过纠正误解为不同年龄的妇女进行乳房X光检查 关于乳腺癌的风险和乳房X光检查的好处和风险， 通过电话或非电话提供适合年龄的定制反馈 辅导这项研究将对1300名妇女进行， 北卡罗来纳州蓝十字蓝盾个人选择健康维护组织 他们将从三个年龄组别中随机选出--38-42岁的妇女， 48-52和58-62。女性将被随机分配到常规护理， 单独反馈或定制反馈和电话咨询， 两轮干预和两轮后续评估。我们将 使用CPRU核心变量，包括决策的衡量标准 过程以及措施，以反映我们的两个阶段为基础的概念 模型、变革阶段模型和预防采纳模型。作为 通过干预，我们希望提高 女性对乳腺癌风险的个人看法;增加 50多岁和60多岁的妇女定期接受乳房X光检查的比例; 增加妇女与其健康之间对乳房X光检查的讨论 提供者和提高妇女对乳房X光检查决定的满意度。 这项研究的结果将不仅应用于乳房X光检查， 也适用于其他主题的知情决策。

Recent controversies about breast cancer screening have led to confusion among providers and the public. Our preliminary data and published reports indicate that women in their 40's are confused about the risk of breast cancer, the risks and benefits of mammography and whether and how often to get mammograms. But older women also misperceive the risks of breast cancer and the risks and benefits of mammography, and this may account for some proportion of the underuse of mammography. The overall aim of this project is to enhance informed decision making about mammography for women of different ages by correcting misperceptions about breast cancer risk and the benefits and risks of mammography and by providing age-appropriate tailored feedback with or without telephone counseling. The study will be conducted with 1 ,300 women who are members of the Personal Choice HMO of Blue Cross Blue Shield of North Carolina they will be selected randomly from three age cohorts - women aged 38-42, 48-52 and 58-62. Women will be assigned randomly to usual care, tailored feedback alone or tailored feedback and telephone counseling, with two rounds of intervention and two rounds of follow-up assessment. We will use the CPRU core variables, including measures of the decision making process as well as measures to reflect our two stage-based conceptual models, the Stages of Change Model and the Precaution Adoption Model. As a result of the interventions, we expect to improve the accuracy of women's personal perceptions about breast cancer risk; increase the proportion of women in their 50's and 60's who obtain regular mammograms; increase the discussion of mammography between women and their health providers and improve women's satisfaction with mammography decisions. The results of this study will have application not only for mammography but for other topics in informed decision making as well.