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Investigating informed choice in screening programmes : a mixed methods analysis
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Tyldesley-Marshall, Natalie, Grove, Amy L., Ghosh, Iman, Kudrna , Laura , Ayorinde, Abimbola, Singh, Megha, Mehaan, Edward, Clarke, Aileen, Taylor-Phillips, Sian and Al-Khudairy, Lena (2022) Investigating informed choice in screening programmes : a mixed methods analysis. BMC Public Health, 22 . 2319. doi:10.1186/s12889-022-14685-6 ISSN 1471-2458.
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Official URL: http://doi.org/10.1186/s12889-022-14685-6
Abstract
Background
Screening programmes aim to identify individuals at higher risk of developing a disease or condition. While globally, there is agreement that people who attend screening should be fully informed, there is no consensus about how this should be achieved. We conducted a mixed methods study across eight different countries to understand how countries address informed choice across two screening programmes: breast cancer and fetal trisomy anomaly screening.
Methods
Fourteen senior level employees from organisations who produce and deliver decision aids to assist informed choice were interviewed, and their decision aids (n = 15) were evaluated using documentary analysis.
Results
We discovered that attempts to achieve informed choice via decision aids generate two key tensions (i) between improving informed choice and increasing uptake and (ii) between improving informed choice and comprehensibility of the information presented. Comprehensibility is fundamentally at tension with an aim of being fully informed. These tensions emerged in both the interviews and documentary analysis.
Conclusion
We conclude that organisations need to decide whether their overarching aim is ensuring high levels of uptake or maximising informed choice to participate in screening programmes. Consideration must then be given to all levels of development and distribution of information produced to reflect each organisation’s aim. The comprehensibility of the DA must also be considered, as this may be reduced when informed choice is prioritised.
| Item Type: | Journal Article | |||||||||||||||
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| Subjects: | R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine | |||||||||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | |||||||||||||||
| Library of Congress Subject Headings (LCSH): | Medical screening, Medicine -- Decision making, Health -- Decision making | |||||||||||||||
| Journal or Publication Title: | BMC Public Health | |||||||||||||||
| Publisher: | BioMed Central Ltd. | |||||||||||||||
| ISSN: | 1471-2458 | |||||||||||||||
| Official Date: | 12 December 2022 | |||||||||||||||
| Dates: |
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| Volume: | 22 | |||||||||||||||
| Article Number: | 2319 | |||||||||||||||
| DOI: | 10.1186/s12889-022-14685-6 | |||||||||||||||
| Status: | Peer Reviewed | |||||||||||||||
| Publication Status: | Published | |||||||||||||||
| Access rights to Published version: | Open Access (Creative Commons) | |||||||||||||||
| Date of first compliant deposit: | 7 February 2023 | |||||||||||||||
| Date of first compliant Open Access: | 7 February 2023 | |||||||||||||||
| RIOXX Funder/Project Grant: |
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