Effect of information about the benefits and harms of mammography on women's decision making: The InforMa randomised controlled trial.

BACKGROUND:In Spain, women invited to breast screening are not usually informed about potential harms of screening. The objective of the InforMa study is to assess the effect of receiving information about the benefits and harms of breast screening on informed choice and other decision-making outcom...

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Main Authors: María José Pérez-Lacasta, Montserrat Martínez-Alonso, Montse Garcia, Maria Sala, Lilisbeth Perestelo-Pérez, Carmen Vidal, Núria Codern-Bové, Maria Feijoo-Cid, Ana Toledo-Chávarri, Àngels Cardona, Anna Pons, Misericòrdia Carles-Lavila, Montserrat Rue, with the InforMa Group
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2019-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0214057
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author María José Pérez-Lacasta
Montserrat Martínez-Alonso
Montse Garcia
Maria Sala
Lilisbeth Perestelo-Pérez
Carmen Vidal
Núria Codern-Bové
Maria Feijoo-Cid
Ana Toledo-Chávarri
Àngels Cardona
Anna Pons
Misericòrdia Carles-Lavila
Montserrat Rue
with the InforMa Group
author_facet María José Pérez-Lacasta
Montserrat Martínez-Alonso
Montse Garcia
Maria Sala
Lilisbeth Perestelo-Pérez
Carmen Vidal
Núria Codern-Bové
Maria Feijoo-Cid
Ana Toledo-Chávarri
Àngels Cardona
Anna Pons
Misericòrdia Carles-Lavila
Montserrat Rue
with the InforMa Group
author_sort María José Pérez-Lacasta
collection DOAJ
description BACKGROUND:In Spain, women invited to breast screening are not usually informed about potential harms of screening. The objective of the InforMa study is to assess the effect of receiving information about the benefits and harms of breast screening on informed choice and other decision-making outcomes, in women approaching the age of invitation to mammography screening. METHODS:Two-stage randomised controlled trial. In the first stage, 40 elementary territorial units of the public healthcare system were selected and randomised to intervention or control. In the second stage, women aged 49-50 years were randomly selected. The target sample size was 400 women. Women in the intervention arm received a decision aid (DA) with detailed information on the benefits and harms of screening. Women in the control arm received a standard leaflet that did not mention harms and recommended accepting the invitation to participate in the Breast Cancer Screening Program (BCSP). The primary outcome was informed choice, defined as adequate knowledge and intentions consistent with attitudes. Secondary outcomes included decisional conflict, worry about breast cancer, time perspective, opinions about the DA or the leaflet, and participation in the BCSP. RESULTS:In the intervention group, 23.2% of 203 women made an informed choice compared to only 0.5% of 197 women in the control group (p < 0.001). Attitudes and intentions were similar in both study groups with a high frequency of women intending to be screened, 82.8% vs 82.2% (p = 0.893). Decisional conflict was significantly lower in the intervention group. No differences were observed in confidence in the decision, anxiety, and participation in BCSP. CONCLUSIONS:Women in Spain lack knowledge on the benefits and harms of breast screening. Providing quantitative information on benefits and harms has produced a considerable increase in knowledge and informed choice, with a high acceptance of the informative materials. TRIAL REGISTRATION:Trial identifier NCT03046004 at ClinicalTrials.gov registry. Registered on February 4 2017. Trial name: InforMa study.
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spelling doaj.art-fa3722c2990c44659016833b7bf049682022-12-21T22:51:22ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-01143e021405710.1371/journal.pone.0214057Effect of information about the benefits and harms of mammography on women's decision making: The InforMa randomised controlled trial.María José Pérez-LacastaMontserrat Martínez-AlonsoMontse GarciaMaria SalaLilisbeth Perestelo-PérezCarmen VidalNúria Codern-BovéMaria Feijoo-CidAna Toledo-ChávarriÀngels CardonaAnna PonsMisericòrdia Carles-LavilaMontserrat Ruewith the InforMa GroupBACKGROUND:In Spain, women invited to breast screening are not usually informed about potential harms of screening. The objective of the InforMa study is to assess the effect of receiving information about the benefits and harms of breast screening on informed choice and other decision-making outcomes, in women approaching the age of invitation to mammography screening. METHODS:Two-stage randomised controlled trial. In the first stage, 40 elementary territorial units of the public healthcare system were selected and randomised to intervention or control. In the second stage, women aged 49-50 years were randomly selected. The target sample size was 400 women. Women in the intervention arm received a decision aid (DA) with detailed information on the benefits and harms of screening. Women in the control arm received a standard leaflet that did not mention harms and recommended accepting the invitation to participate in the Breast Cancer Screening Program (BCSP). The primary outcome was informed choice, defined as adequate knowledge and intentions consistent with attitudes. Secondary outcomes included decisional conflict, worry about breast cancer, time perspective, opinions about the DA or the leaflet, and participation in the BCSP. RESULTS:In the intervention group, 23.2% of 203 women made an informed choice compared to only 0.5% of 197 women in the control group (p < 0.001). Attitudes and intentions were similar in both study groups with a high frequency of women intending to be screened, 82.8% vs 82.2% (p = 0.893). Decisional conflict was significantly lower in the intervention group. No differences were observed in confidence in the decision, anxiety, and participation in BCSP. CONCLUSIONS:Women in Spain lack knowledge on the benefits and harms of breast screening. Providing quantitative information on benefits and harms has produced a considerable increase in knowledge and informed choice, with a high acceptance of the informative materials. TRIAL REGISTRATION:Trial identifier NCT03046004 at ClinicalTrials.gov registry. Registered on February 4 2017. Trial name: InforMa study.https://doi.org/10.1371/journal.pone.0214057
spellingShingle María José Pérez-Lacasta
Montserrat Martínez-Alonso
Montse Garcia
Maria Sala
Lilisbeth Perestelo-Pérez
Carmen Vidal
Núria Codern-Bové
Maria Feijoo-Cid
Ana Toledo-Chávarri
Àngels Cardona
Anna Pons
Misericòrdia Carles-Lavila
Montserrat Rue
with the InforMa Group
Effect of information about the benefits and harms of mammography on women's decision making: The InforMa randomised controlled trial.
PLoS ONE
title Effect of information about the benefits and harms of mammography on women's decision making: The InforMa randomised controlled trial.
title_full Effect of information about the benefits and harms of mammography on women's decision making: The InforMa randomised controlled trial.
title_fullStr Effect of information about the benefits and harms of mammography on women's decision making: The InforMa randomised controlled trial.
title_full_unstemmed Effect of information about the benefits and harms of mammography on women's decision making: The InforMa randomised controlled trial.
title_short Effect of information about the benefits and harms of mammography on women's decision making: The InforMa randomised controlled trial.
title_sort effect of information about the benefits and harms of mammography on women s decision making the informa randomised controlled trial
url https://doi.org/10.1371/journal.pone.0214057
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