TY - JOUR
T1 - A cross-cultural consumer-based decision aid for screening mammography
AU - Lawrence, Valerie A.
AU - Streiner, David
AU - Hazuda, Helen P.
AU - Naylor, Roxana
AU - Levine, Mark
AU - Gafni, Amiram
N1 - Funding Information:
Supported by San Antonio Cancer Institute, National Cancer Institute P30CA54174; Developmental Research Funds of the San Antonio Breast Cancer SPORE, National Cancer Institute P50CA58183; Mexican American Medical Treatment Effectiveness Research Center at the University of Texas Health Science Center at San Antonio, Agency for Health Care Policy and Research 1-UO1-HS07397; and Hispanic Healthy Aging Center, National Institute on Aging 1-P20-AG12044.
PY - 2000/3
Y1 - 2000/3
N2 - Background. 'Women should have mammograms' is the usual perspective of educational interventions about screening. The perspective that 'women should be informed' about potential risks and benefits so they can make value- and evidence-integrated personal decisions has recently been advocated. However, this perspective has not previously been operationalized. We developed an evidence-based cross-cultural mammography decision aid (MDA), for European American and Mexican American women who are 50-70 years old, at average risk of breast cancer, of varying educational levels, and English- or Spanish- speaking. Methods. MDA development included: (1) content development by a multidisciplinary team and lay women and (2) testing for validity and reliability. Four parts include: (1) introduction; (2) information about logistics (cost, time, discomfort) and risks (sequelae of false-positive or negative results; (3) probability of developing breast cancer; and (4) benefit of mammography regarding breast cancer outcomes (e.g., death and recurrence). We assessed reliability (stability of decisions with the same information) after 1-2 weeks. We assessed validity (comprehension of information) quantitatively (probabilities were changed to see whether preferences changed predictably) and qualitatively (focus groups, standardized probes for comprehension). Subjects were a convenience sample of 49 European American (50-81 years old) and 54 Mexican American (49-89 years old) women from administrative staff at a medical school, the waiting room of an indigent primary care clinic, and a community center. Results. Reliability was 100%. In quantitative validity testing, 22 of 28 women (89%) changed preference as predicted with changed probabilities. Comprehension was confirmed qualitatively in all phases of testing with both Spanish and English versions. Conclusion. The decision aid is valid and reliable in English and Spanish for southwestern Mexican American and European American women at average risk of breast cancer, including those of low educational levels. (C) 2000 American Health Foundation and Academic Press.
AB - Background. 'Women should have mammograms' is the usual perspective of educational interventions about screening. The perspective that 'women should be informed' about potential risks and benefits so they can make value- and evidence-integrated personal decisions has recently been advocated. However, this perspective has not previously been operationalized. We developed an evidence-based cross-cultural mammography decision aid (MDA), for European American and Mexican American women who are 50-70 years old, at average risk of breast cancer, of varying educational levels, and English- or Spanish- speaking. Methods. MDA development included: (1) content development by a multidisciplinary team and lay women and (2) testing for validity and reliability. Four parts include: (1) introduction; (2) information about logistics (cost, time, discomfort) and risks (sequelae of false-positive or negative results; (3) probability of developing breast cancer; and (4) benefit of mammography regarding breast cancer outcomes (e.g., death and recurrence). We assessed reliability (stability of decisions with the same information) after 1-2 weeks. We assessed validity (comprehension of information) quantitatively (probabilities were changed to see whether preferences changed predictably) and qualitatively (focus groups, standardized probes for comprehension). Subjects were a convenience sample of 49 European American (50-81 years old) and 54 Mexican American (49-89 years old) women from administrative staff at a medical school, the waiting room of an indigent primary care clinic, and a community center. Results. Reliability was 100%. In quantitative validity testing, 22 of 28 women (89%) changed preference as predicted with changed probabilities. Comprehension was confirmed qualitatively in all phases of testing with both Spanish and English versions. Conclusion. The decision aid is valid and reliable in English and Spanish for southwestern Mexican American and European American women at average risk of breast cancer, including those of low educational levels. (C) 2000 American Health Foundation and Academic Press.
KW - Cross-cultural comparison
KW - Decision-making
KW - Mammography
KW - Mass screening
KW - Prevention and control
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U2 - 10.1006/pmed.1999.0620
DO - 10.1006/pmed.1999.0620
M3 - Article
C2 - 10684743
AN - SCOPUS:0034062494
VL - 30
SP - 200
EP - 208
JO - Preventive Medicine
JF - Preventive Medicine
SN - 0091-7435
IS - 3
ER -