Implementing decision aid use and shared-decision making in breast cancer screening: A scoping review

IF 3.1 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling Pub Date : 2026-03-01 Epub Date: 2025-12-02 DOI:10.1016/j.pec.2025.109443

Rama Alkhaldi , Neha Pathak , Victoria Mintsopoulos , Rouhi Fazelzad , Sarina Schrager , Patricia Villain , Noah Ivers , Michelle B. Nadler

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引用次数: 0

Abstract

Objectives

International guidelines vary regarding the age range for mammography screening for women at average breast cancer risk; however, all note the importance of shared-decision making (SDM). Decision Aids (DAs) are evidence-based materials demonstrated to facilitate SDM and improve decisional conflict. The integration of SDM/DA is crucial to support patient-informed choice; however, little is known related to their implementation to clinical practice.

Methods

This scoping review searched nine bibliographic databases from January 2010 to May 2023. Inclusion criteria: studies targeting providers and/or women at average risk of developing breast cancer, implementing SDM and/or DA regarding breast cancer screening, and must include at least one implementation outcome. Data were extracted on study design, intervention details, primary outcome, and all implementation outcomes. Studies were coded as efficacy, effectiveness, or implementation. Implementation strategies were coded using Expert Recommendations for Implementing Change (ERIC) and strategies used to change clinical behaviors were coded using Behavior Change Techniques (BCTs) taxonomy.

Results

The search yielded 10,383 records: 22 studies met the inclusion criteria, 2 targeting providers, 16 targeting patients, and 4 targeting both. Studies were classified as follows (provider cohort; patient cohort): efficacy (0/6,0 %; 8/20,40 %), effectiveness (4/6,67 %; 10/20,50 %), and primary implementation (1/6,17 %; 1/20,5 %). In the provider cohort, acceptability was assessed in 6/6(100 %), adoption in 2/6(33 %), feasibility in 2/6(33 %), appropriateness and sustainability in 1/6(17 %). In the patient cohort, acceptability was assessed in 20/20(100 %), feasibility in 3/20(15 %), appropriateness in 3/20(15 %), adoption in 1/20(5 %). DAs demonstrated moderate-to-excellent acceptability. BCTs commonly employed include shaping knowledge, natural consequences, and comparison of outcomes. Implementation strategies frequently used include developing and distributing educational materials.

Practice implications

SDM/DAs appear acceptable to patients and providers; however, these tools can only help if they are used as intended. More primary implementation studies, to evaluate and understand the optimal strategies for implementation of SDM/DA in these healthcare settings.

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在乳腺癌筛查中实施决策辅助和共同决策：范围综述

目的：对于平均乳腺癌风险的女性进行乳房x光检查的年龄范围，国际指南各不相同；然而，所有人都注意到共同决策（SDM）的重要性。决策辅助（DAs）是一种基于证据的材料，用于促进SDM和改善决策冲突。SDM/DA的整合对于支持患者知情选择至关重要；然而，其在临床实践中的实施情况却鲜为人知。方法检索2010年1月至2023年5月的9个文献数据库。纳入标准：针对提供者和/或患乳腺癌平均风险的妇女的研究，在乳腺癌筛查方面实施SDM和/或DA，并且必须包括至少一个实施结果。提取研究设计、干预细节、主要结果和所有实施结果的数据。研究被编码为功效、有效性或实施。实施策略采用实施变革专家建议（ERIC）编码，用于改变临床行为的策略采用行为改变技术（bct）分类法编码。结果检索得到10,383条记录：22项研究符合纳入标准，2项针对提供者，16项针对患者，4项同时针对两者。研究分类如下（提供者队列；患者队列）：疗效（0/6,0 %;8/20,40 %），疗效（4/6,67 %;10/20,50 %）和主要实施（1/6,17 %;1/20,5 %）。在提供者队列中，可接受性评估为6/6(100 %)，采用评估为2/6(33 %)，可行性评估为2/6(33 %)，适当性和可持续性评估为1/6（17 %）。在患者队列中，接受度为20/20(100 %)，可行性为3/20(15 %)，适宜性为3/20(15 %)，采用度为1/20（5 %）。DAs表现出中等到极好的可接受性。通常使用的bct包括塑造知识、自然结果和结果比较。经常使用的执行战略包括编写和分发教育材料。实践意义ssdm /DAs似乎为患者和提供者所接受；然而，这些工具只有在按预期使用时才能发挥作用。更多的初步实施研究，以评估和了解在这些医疗保健环境中实施SDM/DA的最佳策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Patient Education and Counseling 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.60

自引率

11.40%

发文量

384

审稿时长

46 days

期刊介绍： Patient Education and Counseling is an interdisciplinary, international journal for patient education and health promotion researchers, managers and clinicians. The journal seeks to explore and elucidate the educational, counseling and communication models in health care. Its aim is to provide a forum for fundamental as well as applied research, and to promote the study of organizational issues involved with the delivery of patient education, counseling, health promotion services and training models in improving communication between providers and patients.