Abstract
BackgroundThe net benefits of routine breast cancer screening with mammography have been questioned, and there is evidence to indicate that supporting women to make an informed decision about breast cancer screening with mammography is preferable. The aims of this study were to assess the intention of family physicians to provide women with this support and the determinants of this intention, and to identify factors that might influence family physicians adopting this behavior.MethodsFamily physicians from the province of Quebec, Canada, attending a 45-min lecture on informed decision making and cancer screening were asked to complete a questionnaire after the lecture regarding their intention to adopt the behavior. The questions, based on the Theory of Planned Behavior, measured physicians’ intention and its determinants (attitude, perceived behavioral control, and socio-professional norm) regarding supporting women to make informed decisions about breast cancer screening with mammography. Open-ended questions were also used to explore complementary factors influencing their intention.ResultsOut of 800 questionnaires distributed, 301 (38 %) were returned and 288 were included in data analysis. The mean ± standard deviation and median score for intention were respectively 1.9 ± 1.2 and 2.0 on a 6-point Likert scale (−3 to +3). Perceived behavioral control was the variable most strongly associated with intention (high versus low score, odds ratio = 15.7, 95 % CI 6.7–36.6), followed by attitude (high versus low score, odds ratio = 7.5, 95 % CI 3.3–16.8), then social norm (high versus low score, odds ratio = 5.8, 95 % CI 2.6–12.9). The most-reported barrier to adopting the behavior was time constraints (41 %) while the most-reported facilitator was availability of relevant decision support tools (29 %).ConclusionsRespondents showed strong intention to support women in informed decision-making about breast cancer screening, the strongest predictor being perceived behavioral control. These results could contribute to training physicians to integrate this behavior into their practices and to designing relevant decision support tools.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-1608-8) contains supplementary material, which is available to authorized users.
Highlights
The net benefits of routine breast cancer screening with mammography have been questioned, and there is evidence to indicate that supporting women to make an informed decision about breast cancer screening with mammography is preferable
Many developed countries have national breast cancer screening programs based on mammography
When controversies arose about the net benefit of breast cancer screening with mammography [1,2,3] and new scientific evidence emerged about the benefits of informed/shared decision making regarding cancer screening [4,5,6,7], the Ministry of Health and Social Services (MHSS) revised its policy and the Quebec Breast Cancer Screening Program (QBCSP) slogan was replaced by “Screening for breast cancer: a choice that belongs to you” [8]
Summary
The net benefits of routine breast cancer screening with mammography have been questioned, and there is evidence to indicate that supporting women to make an informed decision about breast cancer screening with mammography is preferable. When controversies arose about the net benefit of breast cancer screening with mammography [1,2,3] and new scientific evidence emerged about the benefits of informed/shared decision making regarding cancer screening [4,5,6,7], the MHSS revised its policy and the QBCSP slogan was replaced by “Screening for breast cancer: a choice that belongs to you” [8] This approach emphasizes informed decision making, defined as occurring when an individual understands the disease or condition being addressed and understands what the clinical service involves, including benefits, risks, limitations, alternatives, and uncertainties; has considered his or her preferences and makes a decision consistent with them [5]. The objectives of this study were to use the TPB to measure family physicians’ intention to support women targeted by the QBCSP to make informed decisions about breast cancer screening with mammography, to identify determinants of this intention, and to identify barriers and facilitators that physicians perceive to adopting this behavior
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