Lorna McWilliams, Alexandra Roux, Rhiannon Hawkes, Rachel Cholerton, Hélène Delattre, Agnès Bernoux, Marie-Laure Forzy, D Gareth Evans, Corinne Balleyguier, Debbie Keatley, Cécile Vissac-Sabatier, Suzette Delaloge, Sandrine de Montgolfier, David P French
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引用次数: 0
Abstract
Objective: Risk-stratification should improve the benefits-to-harms ratio for breast screening, whereby higher-risk women receive additional screening and low-risk women are screened less. This study investigated the effects of healthcare context by comparing how women in England and France experienced risk-based breast screening.
Methods and measures: Fifty-two women were purposively sampled from participants who underwent risk-based screening in the MyPeBS trial. Women received objectively-derived 5-year breast cancer risk estimates (low = < 1%, average = 1-1.66%, high = ≥ 1.67 to <6%, very-high-risk = ≥ 6%). This determined future trial-related screening schedules and prevention options. Semi-structured interviews were transcribed for thematic framework analysis.
Results: Two overarching themes were produced: the importance of supported risk communication and accessibility of risk management. Overall, risk-based breast screening was viewed positively. However, trial procedures, especially in risk estimate provision, differed across sites. Women at increased risk were more reassured when appointments were with specialist healthcare professionals (HCP). When absent, this resulted in reduced satisfaction with risk communication and greater uncertainty about its personal relevance. Low-risk women's views on extended mammogram schedules seemed linked to how health services are organised differently.
Conclusions: Context is an important consideration regarding acceptability of healthcare innovations such as risk-stratified screening: it should not be assumed that findings from one country apply universally.
期刊介绍：
Psychology & Health promotes the study and application of psychological approaches to health and illness. The contents include work on psychological aspects of physical illness, treatment processes and recovery; psychosocial factors in the aetiology of physical illnesses; health attitudes and behaviour, including prevention; the individual-health care system interface particularly communication and psychologically-based interventions. The journal publishes original research, and accepts not only papers describing rigorous empirical work, including meta-analyses, but also those outlining new psychological approaches and interventions in health-related fields.
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