Screening Intentions Research Articles

Assessing impact of a community-based screening campaign to address social determinants of cervical cancer.

Screening represents a cornerstone of cervical cancer control strategy. However, disparities in social determinants of health (SoDoH) have perpetuated gaps in screening among racial/ethnic minorities. SoDoH including cultural stigma and lack of insurance have contributed to decreased screening among Hispanic women. To increase cancer screening in this population, community-academic partnerships and culturally-tailored media have emerged as promising strategies. This study assessed the impact of a culturally-tailored cervical cancer screening campaign implemented through academic-community-government partnership. Intercept surveys, conducted from 2015-2018 in eastern neighborhoods of Los Angeles, assessed campaign recall, interpretation and screening intention among Hispanic women aged 21-65 after exposure to the campaign. Screening intention was evaluated using Chi-square tests and logistic regression by participant characteristics, with thematic analysis for campaign interpretation. Out of 673 participants, 26.1% were uninsured and 85.9% primarily spoke Spanish at home. Campaign recall was 25.1%, with 64.5% interpreting the campaign's message as cervical cancer screening or health checkups. The campaign's most-liked aspect was emphasis on family (cited by 37.1% of participants). Post-campaign, 89.5% of participants overall were likely or extremely likely to schedule a Pap test, including 83.5% of women who had not had a Pap test in the last three years. Our findings underscore several important strategies to reduce cervical cancer disparities: 1) associating positive cultural values with screening to decrease stigma, 2) combining culturally-tailored outreach with interventions that target other known screening barriers, 3) facilitating long-term community relationships and 4) leveraging academic-community-government partnerships.

Exploring the determinants to accept dementia screening among patients at high risk of dementia based on the theory of planned behavior: A cross-sectional study.

Dementia represents a major public health challenge. Despite numerous initiatives promoting screening for early cognitive impairment to help prevent or delay its onset, participation remains limited. Moreover, there is limited evidence regarding screening intentions and predictors among populations at high risk of dementia. This study used the theory of planned behavior to identify modifiable factors associated with screening participation. This cross-sectional survey was conducted from November 16, 2021, to April 2, 2022, and involved 439 individuals at high risk of dementia selected using convenience sampling from two major regional communities in Guangzhou, China. A validated custom questionnaire based on the theory of planned behavior was used for data collection, and logistic regression and structural equation modeling were applied to identify related predictors. Overall, 62 % of the participants expressed willingness to undergo dementia screening. Behavioral intention was primarily associated with Perceived behavioral control (PBC, path coefficient = 0.36), Subjective norm (path coefficient = 0.16), and Attitude (path coefficient = 0.13). Additionally, PBC was associated with a positive attitude toward dementia screening (path coefficient = 0.39). PBC, subjective norm, and attitudes are associated with dementia screening willingness among high-risk groups. Healthcare professionals and policymakers should focus on enhancing favorable attitudes toward screening, increasing familial encouragement, and reducing perceived barriers to developing effective prevention or intervention strategies.

How do young women approaching screening age interpret the NHS cervical screening leaflet? A mixed methods study of identifying interpretation difficulties, barriers, facilitators, and leaflet interpretation, engagement and future screening behaviour

ABSTRACT Background: Cervical cancer is a common cancer among young women aged 25–29 in England, and the NHS cervical screening leaflet is the first point of contact for those being invited for their first screening. This study aimed to explore how young women (18–24) understand and engage with the leaflet, as well as the barriers and facilitators associated with its interpretation, engagement, and screening intentions. Methods: The study used a mixed-methods approach, including a survey (n = 120) to identify interpretation difficulties and how they were affected by different characteristics, and a follow-up interview (n = 10) to assess the utility of the leaflet, identify issues with its practicality, and determine the factors that influence screening intentions. Results: The survey results showed that interpretation difficulties were common, particularly regarding HPV assessment, screening results, additional tests/treatment, and screening risks. Lower interpretation accuracy was associated with lower numeracy scores and non-white ethnicity. Despite these difficulties, participants had high confidence and motivation to engage with the leaflet. The interviews revealed knowledge gaps, issues with the leaflet's practicality, and a preference for digital information. Factors that were identified as barriers and facilitators of leaflet interpretation, engagement, and screening intentions included knowledge, social influence, beliefs about consequences, environmental context and resources, social role and identity, emotions and intentions. Conclusion: The current leaflet does not provide enough information for young women to make an informed decision about screening attendance. Implementing a digital invitation featuring simplified gist representation, targeted behaviour change techniques (BCTs), videos, and interactive tools can enhance education and promote screening behaviour. Future research should consider using digital tools and strategies to address existing barriers related to interpretation and engagement.

Investors’ pro-environmental attitude, spirituality and socially responsible investing: a mediating role of greenwashing practices

Purpose The objective of this study is to examine the influence of investors’ pro-environmental attitudes and spirituality on their intentions to invest in socially responsible investment projects in the context of India. This study also examines whether investors’ perceptions of firms’ greenwashing practices mediate the relationship between their pro-environmental attitude, spirituality and investing decisions. Design/methodology/approach The authors collected data from 337 investors registered at the National Stock Exchange of India. Additionally, data were analyzed, and hypotheses were tested using linear regression, zero-order correlation and mediation approaches in SPSS 28. Findings The findings of this study report that investors’ pro-environmental attitudes and spirituality have a significant positive impact on their intentions to invest in socially responsible investment projects. Additionally, their mediation analysis further shows that both manipulative and selective disclosures of greenwashing practices mediate the association between investors’ pro-environmental attitude, spirituality and their intentions to invest in socially responsible investment projects. Practical implications The findings of the study have important implications for regulators, policymakers, firms and researchers in understanding the impact of pro-environmental attitudes and firms’ greenwashing practices on investors’ socially responsible investing decisions. Social implications This study also has implications for regulators in creating awareness for tackling greenwashing practices and screening intentions to invest in socially responsible investment projects in developing countries. Originality/value This study stresses creating awareness for incorporating pro-environmental and spiritual mindset into addressing the challenges of socially responsible investing in the presence of greenwashing practices.

Preparing patient navigators and assessing the impact of patient navigation in promoting cervical cancer screening uptake, knowledge, awareness, intention, and health beliefs: a protocol for a randomized controlled trial.

There are limited studies in Tanzania concerning the modality of preparing patient navigators and the influence of patient navigation strategies on cervical cancer screening. This protocol describes the preparation of patient navigators and assesses the impact of a patient navigation strategy on promoting cervical cancer screening uptake, knowledge, awareness, intention, and health beliefs. This is a protocol for a community-based randomized controlled trial. The method is categorized into two phases. (1) Preparing patient navigators, which will involve the training of five patient navigators guided by a validated training manual. The training will be conducted over three consecutive days, covering the basic concepts of cervical cancer screening and guiding navigators on how to implement a patient navigation strategy in the communities. (2) Delivering a patient navigation intervention to community women (COMW) which will involve health education, screening appointments, navigation services, and counseling. The study will recruit 202 COMW who will be randomized 1:1 by computer-based blocks to either the patient navigation intervention group or the control group. The study will prove that the trained patient navigators are easily accessible and offer timely and culturally acceptable services to promote cervical cancer screening uptake in communities.

Addressing knowledge and attitude barriers to lung cancer screening: Development and evaluation of web-based decision aid

ObjectiveLow-dose computed tomography screening reduces lung cancer and overall mortality, but the participation rate remains low. The objective of this study was to develop a decision aid (DA) that addresses the overabundance of healthcare options and barriers to participation in lung cancer screening (LCS) among the general population aged 40–79 years in Korea. Materials and MethodsThe DA was developed by following the International Patient Decision Aid Standards process. To evaluate the DA, participants aged 40–79 years were purposively sampled from four districts of the Seoul metropolitan area, with 25 individuals from each decade of the age range. Participants used the DA for LCS, and pre–post comparison was conducted. The primary outcome was a change in intention to undergo LCS after completing the DA. The secondary outcomes were changes in knowledge and attitude about LCS, decisional conflict, and the perceived usefulness of the DA. ResultsThe DA prototype contained lung cancer risk assessment and decision-making components that addressed knowledge, risks, benefits, costs, and personal values. In a pilot study of 100 participants (mean age 59.0 [SD 11.1] years, 80 % male, 25 % of whom had undergone LCS), knowledge about LCS increased (mean [SD] score [out of 100] before vs. after: 68.3 [13.4] vs. 73.6 [18.0], p < 0.001). A positive change in attitude was observed (p = 0.004), but the intention to screen remained consistent (70 % before vs. 72 % after; p = 0.650). Eighty-eight participants reported the lowest level of conflict in decision-making, and most reported that the DA was useful (mean [SD] score 78.8 [9.0] out of 100). 72 % reported that the DA facilitated self-decision-making, but 27 % felt the DA recommended LCS. ConclusionsThis study highlights the potential of a well-designed DA to enhance knowledge and attitudes about LCS, but those improvements did not translate to a significant change in screening intentions.

Leveraging female partner influence in health interventions: a study on prostate cancer screening uptake among men in rural Kiambu County, Kenya

Background: Globally, prostate cancer is the second most common cancer affecting men, with considerably high fatality rates. The aim of this study was to assess the effect of a female partner-led brochure method on perception, attitude, and cultural beliefs toward the intention of prostate cancer screening among men in rural Kiambu County, Kenya. Methods: The research adopted a randomized controlled trial design. Multistage sampling was employed in this study. The Chi-square test was used to assess differences in perception, attitude, and cultural beliefs towards intention to undergo prostate cancer screening (PCS) between the control and intervention groups at baseline and end line. Further, data were subjected to structural equation modeling to assess the influence of perception, attitude, and cultural beliefs on PCS intention pre-and post-intervention. Results: The results revealed no significant difference in perception between the control and intervention groups at baseline and end-line. Regarding attitude, there was a 39.8% and 24.7% increase in positive attitudes in the group that used gain-framed and loss-framed brochure methods, respectively, at the end line. In the end, there was a significant reduction in the number of respondents who had fatalistic beliefs, whereby 23.1% and 13.2% of the respondents in the groups’ intervention used gain-framed and loss-framed brochures, respectively. Conclusions: The study recommends the implementation of female partner-led interventions using gain-framed messaging in prostate cancer screening campaigns, as this approach demonstrated superior effectiveness in improving attitudes, reducing fatalism beliefs, and increasing the perceived benefits of screening among men.

Delegated recruitment and statistical discrimination

We study how delegated recruitment shapes talent selection. Firms often pay recruiters via refund contracts, which specify a payment upon the hire of a suggested candidate and a refund if a candidate is hired but terminated during an initial period of employment. We develop a model of delegated recruitment and show that refund contracts with strong screening incentives lead to statistical discrimination in favor of candidates with more precise productivity information. This contrasts with a first-best direct-hiring benchmark, where the firm has option value from uncertain candidates. Under tractable parametric assumptions, we provide a closed-form expression for the unique equilibrium contract and show that it features strong screening incentives. As a result, candidates with lower expected productivity but more informative signals (“safe bets”) are hired over candidates with higher expected productivity but less informative signals (“diamonds in the rough”).

Communicating Probabilities of Cervical Cancer Screening Results with Icon Arrays or Tree Diagrams: A Longitudinal Experiment

ABSTRACT Simple graphical displays such as icon arrays and tree diagrams have been proposed for communicating health risks and supporting informed decisions. The UK’s National Health Service (NHS) uses tree diagrams to communicate the chances of different cervical cancer screening results, but their effectiveness has not been compared to icon arrays. We conducted a well-powered longitudinal experiment involving 3,100 UK women eligible for cervical screening (25–64 years) to examine the effectiveness of icon arrays to communicate possible cervical screening results, relative to the UK NHS’s tree diagram and to a numerical-only format. We also examined whether the presence (vs. absence) of explanatory text referring to different types of results (i.e. distinguishing between HPV positive results with vs. without abnormal cervical cells) moderated effects of presentation format. Presentation format did not affect verbatim or gist knowledge of probabilities at initial assessment (i.e. immediately after participants viewed the displays), but icon arrays were associated with better gist knowledge of absolute magnitudes than tree diagrams and numerical-only formats at 1-month follow-up. Participants exposed to icon arrays also perceived lower likelihood of adverse screening results and reported stronger screening intentions at initial assessment. For displays without explanatory text, icon arrays were also associated with more positive user evaluations and less negative affective reactions than tree diagrams at initial assessment. Overall, our findings suggest that icon arrays support enduring knowledge of approximate magnitudes of probabilities and are better suited than tree diagrams for communicating possible screening results.

Determinants of cervical cancer screening intention among reproductive age women in Ethiopia: A systematic review and meta-analysis.

Cervical cancer is a leading cause of cancer-related mortality in Ethiopia, despite being preventable. Screening programs remain underutilized despite multiple initiatives. This systematic review and meta-analysis aimed to assess the pooled prevalence of intention to undergo cervical cancer screening and its associated factors among Ethiopian women, addressing a significant gap in national data. This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases such as PubMed, EMBASE, CINAHL, Web of Science, Cochrane Library, HINARI, Google Scholar, and African Journals online were searched using specific keywords and Medical Subject Headings (MeSH). Studies were assessed using a standardized appraisal format adapted from the Newcastle-Ottawa Scale (NOS). Data extraction and analysis were performed using Microsoft Excel-10 and STATA 17 software, respectively. Heterogeneity was evaluated with the I2 statistic and publication bias was examined using Egger's test. Meta-analysis employed a random-effects model. Out of the 750 articles retrieved, nine were included in this systematic review and meta-analysis. The pooled prevalence of intention to screen for cervical cancer in Ethiopia was 33% (95% CI: 9%-56%). Factors significantly associated with intention to undergo cervical cancer screening included favorable attitude (POR = 2.15, 95% CI: 1.29, 4.26), good knowledge about cervical cancer screening (POR: 3.49; 95% CI: 2.04, 6.93), and direct subjective norm (POR: 1.54; 95% CI: 1.32, 3.54). Based on the findings of this meta-analysis, it was observed that women's intention toward cervical cancer screening was low. Determinants identified included favorable attitude, direct subjective norm, and good knowledge of cervical cancer screening. To enhance women's intention for cervical cancer screening, strategies, and activities should be developed to positively influence perceptions among women and those who influence their decisions. Additionally, efforts to enhance public awareness about cervical cancer and its prevention are crucial.

The association between cancer literacy and cancer screening behaviours: a systematic review

Abstract Background This study aimed at investigating the association between cancer literacy (CL) and adherence to cancer screening programs. Methods PubMed, Scopus and Web of Science were searched. Any study, published until March 2024, that investigated the associations between CL and cancer screening intention or uptake in any target population were eligible. For CL measurement, both validated and ad hoc tools were considered. For each outcome, articles were grouped according to the type of cancer investigated and results were narratively synthesized. Results A total of 3426 records were retrieved. After deduplication and screening process, six studies were included. Population enrolled was heterogeneous as well as the tool used to measure CL. Four studies explored the relationship between CL and screening uptake, one focused solely on screening intention and another investigated both intention and uptake. Significant association was found between CL and screening intention in the two studies included, with higher literacy levels correlating to increased intent for screening. A significant association between higher CL and skin cancer screening uptake was reported, while the uptake of prostate cancer screening was not significantly associated with CL levels. By contrast, mixed results were obtained investigating breast, cervix and colorectal screening uptake. Conclusions Higher levels of cancer literacy appeared to be associated with screening intention, while its association with screening uptake was found barely significant for any screening type, suggesting that other factors influence the actual screening uptake. However, the scarce number of studies, along with the absence of validated tools and the heterogeneity of target populations, limits the generalizability of the results. Further research, differentiating screening types and timelines and using multivariate models, is needed to clarify the role of CL in screening behaviours. Key messages • Higher levels of cancer literacy appear to be associated with screening intention, suggesting its importance in promoting motivation for early cancer detection. • Association between cancer literacy and screening uptake was found barely significant for any screening type, suggesting that other factors influence actual screening uptake, urging further research.

Mixed-methods systematic review of shared decision-making tools for cancer screening

Abstract Shared decision-making (SDM) tools hold promise for guiding informed choices in cancer screening. However, their effectiveness among underserved people, as well as the specific characteristics of these tools preferred by this group and clinicians, remains unclear. This review aimed to synthesize evidence on the effectiveness of SDM tools for cancer screening and explored the preferences of underserved people and clinicians regarding the specific characteristics of the SDM tools. A mixed-method convergent segregated approach was employed, which involved an independent synthesis of quantitative and qualitative data. Articles were systematically selected and screened, resulting in the inclusion and critical appraisal of 55 studies. Results from the meta-analyses showed that SDM tools for cancer screening are effective in reducing decisional conflict for both the general population and the underserved, and in increasing cancer screening knowledge and intention for underserved people only. Subgroup analyses showed minimal heterogeneity for decisional conflict outcomes, measured over a six-month period. Insights from the qualitative findings revealed that underserved people highly preferred SDM tools with relevant information about cancer risk, culturally tailored content, and high accessibility, both during clinical encounters and beyond. Meanwhile, clinicians highly preferred tools that can be easily integrated into medical systems, and can effectively guide SDM, while considering their patients’ values and the limited time for consultation. There is strong evidence on the effectiveness of SDM tools in facilitating informed choice in cancer screening, especially among underserved people. However, evidence on long-term outcomes remains insufficient. Additionally, considering the difference in preferences of key stakeholders in terms of tool characteristics, fostering collaboration with them during the creation of an SDM tool for cancer screening is essential. Key messages • Shared decision-making tools are effective in increasing screening knowledge and intention among underserved people. • Considering the difference in preferences of key stakeholders in terms of tool characteristics, fostering collaboration with them during the creation of an SDM tool for cancer screening is essential.

Improving access to syphilis screening among unhoused people in Yolo County

Background: This study aimed to increase syphilis screening rates amongst unhoused residents of Yolo County, California, through the implementation of plan-do-study-act (PDSA) cycles. Yolo County has a strategic goal to eliminate congenital syphilis cases. Homelessness is a known risk factor for syphilis. Methods: The primary researcher was embedded in a street medicine team. Using quality improvement tools like stakeholder interviews, workflow diagrams, and best practices from literature, we outlined the team's workflow for syphilis screening and developed ideas to improve uptake and expand capacity. The most effective cycle implemented gift card incentives for syphilis screening. During the patient intake we offered the option to receive a syphilis test, informing the patient of the gift card incentive. Results: Prior to gift card incentives, the team screened 1.6 patients on average per clinic for a total of 30 patients screened in April to June of 2022. After the gift card incentive was implemented, the team screened 3.0 patients on average per clinic, screening a total of 223 patients from July 2022 to May 2023. The intervention produced an 87.5% increase in screening rates (P=0.0094). The data showed a significant increase in syphilis testing upon implementing the gift card incentive program. Conclusion: These findings contribute to evidence supporting the use of patient incentives for public health prevention measures. This model could be applied to other populations to increase health screening participation. More research is needed on the effect of gift card incentives on confirmatory testing and treatment rates for syphilis.

Dissemination of colorectal cancer information among Hispanic patients and their social network

BackgroundColorectal cancer (CRC) screening decision aids can inform patients about CRC screening benefits, costs, and procedures. Patients who receive the decision aid report wanting to share the information with their families and friends. We evaluated a CRC screening decision aid on Hispanic patients’ communication to their alters and whether patient-alter communication leads to alters’ CRC screening intention.MethodsWe conducted a one-arm pre/post study of Hispanic patients and their alters; patients (n = 42) and their alters (n = 19) were recruited from a clinic site in Yakima County, Washington State. Patients viewed a CRC screening decision aid at the clinic site. Survey data from patients and alters were collected via telephone including patients’ communication with their alters about CRC screening after viewing the decision aid and alters’ intention to be screened for CRC after talking to the patient.ResultsMost participants reported sharing CRC information with their alters after viewing the decision aid, and most alters confirmed they had received CRC information from participants (68%). The decision aid was associated with participants' own intention to undergo CRC screening and with alters' intention to be screened for CRC using a fecal occult blood test (p = 0.014) and sigmoidoscopy (p = 0.011).ConclusionsPatient decision aids have the potential to increase CRC screening behavior beyond the decision aid recipients to their social network.Trial registrationTrials Registration Number: NCT04444232 “Retrospectively registered.”

Mhealth-based interventions to improving liver cancer screening among high-risk populations: a study protocol for a randomized controlled trial

BackgroundLiver cancer (LC) screening, such as AFP test and abdominal ultrasound, is an effective way to prevent LC, one of the most common cancers worldwide. Despite the proven screening benefits, screening participation among high-risk populations for LC remains low. This suggests that targeted, systematic, and effective interventions should be provided to improve knowledge and awareness related to LC screening, enhance screening intentions, and thereby promote screening behaviors. Telephone is people’s main medium of daily communication and mHealth-based programs offer a potential and effective solution for promoting health behaviors. The purpose of this study is to develop and implement a mHealth (WeChat app) based intervention guided by Fogg’s Behavior Model (FBM) to augment the knowledge of LC prevention among people at risk of LC and enhance their motivation for screening, and to validate its effectiveness in improving LC screening.MethodsWe propose a two-arm, single-blind randomized controlled trial with 82 at-risk individuals of LC, delivering a 6-month mHealth-based intervention program with optional health counseling. Recruitment will be through tertiary hospitals and community organizations in 4 districts in Heng Yang. In total, 82 individuals at high risk for HCC will be randomized 1:1 to intervention or control (usual care) groups. The intervention group will receive intervention, whose contents are based on the FBM model, via multiple forms of media including PowerPoint presentation, multimedia video, health information booklet and screening message, which is delivered in the WeChat Applet. Control dyads will be provided with usual health education. Outcomes will be assessed at baseline and post-intervention.DiscussionThe findings of this study will provide evidence of the benefits of utilizing mHealth-based approaches in intervention development to enhance the effectiveness of screening adherence for high-risk people of LC. Further, the findings would provide reference to the potential incorporation of the targeted intervention in local community organizations.Trial registrationChinese Clinical Trial Registry (ChiCTR2400080530) Date registered: 31/1/2024.

Comparative Effectiveness of Decision Aids for Cancer-Screening Decision Making: An Overview of Reviews.

Decision aids (DAs), compared to no DAs, help improve the key aspects of shared decision-making, including increased knowledge, discussion frequency, and reduction in decisional conflict. However, systematic reviews have reported varied conclusions on screening uptake, and which DAs are superior to alternative forms in shared decision-making for cancer screening has not been comprehensively reviewed. An overview of systematic reviews was performed. Multiple databases were searched up to December 31, 2023, for systematic reviews of randomized controlled trials (RCTs) and non-randomized comparative studies (NRCSs) of any size that assessed a decision aid aimed to facilitate cancer-screening decision making communications. Dual screening of abstracts and full-text reports, dual data extraction and quality assessment, and qualitative synthesis were performed. The 22 eligible publications included 24 reviews on cancer screening DAs for a single specific cancer (8, 8, 7, and 1 on prostate, breast, colorectal, and lung cancer, respectively) and three reviews on multiple aggregate cancers. Individual reviews were based on different primary study designs (92 RCTs and 37 NRCSs); each study was infrequently cited (median citation count 2; range 1-9). Although the DAs had variable formats and delivery methods, the reviews generally focused on use and non-use comparisons. DAs decreased the intention or actual uptake for prostate and breast cancer screening, but increased it for colorectal cancer screening. DAs were associated with increased knowledge, well-informed choice, and reduced decisional conflict, regardless of cancer type. Only four reviews on comparative effectiveness between alternative formats of DAs (based on 14 RCTs and 2 NRCSs) failed to conclude on the specific format that was superior to others. DAs improve cancer screening shared decision-making by boosting cancer screening knowledge and informed choice and lowering decisional conflict and may facilitate preference-based, individualized screening participation. Comparative data on different cancer screening DAs are limited. PROSPERO, CRD42021235957.

Intention to have blood-based multi-cancer early detection (MCED) screening: a cross-sectional population-based survey in England

BackgroundTrials assessing the clinical utility of blood-based multi-cancer early detection (MCED) tests are underway. Understanding public attitudes towards MCED screening is essential if these tests are to be used. We aimed to quantify MCED screening intention and potential barriers and facilitators to uptake.MethodsAdults aged 50–77 (n = 958) completed an online survey. The primary outcome was intention to have MCED screening if offered. Psychological variables including barriers and facilitators were assessed. We used logistic regressions to explore associations between socio-demographics and psychological factors and intention.Results93.8% of participants said they would ‘definitely’ or ‘probably’ have MCED screening if offered. Intention was significantly associated with previous screening participation and general cancer attitudes but not with socio-demographic factors. Participants were more likely to be intenders if they had higher health motivation, and perceived greater benefits of blood tests. Participants were less likely to be intenders if they perceived greater disadvantages of blood tests, more practical barriers, were more worried about the outcome and more concerned about a positive result.Conclusions and implicationsMCED screening intention was high. The lack of socio-demographic variation suggests equitable interest in this type of screening; however, future research should consider how intention translates to uptake.

Effect of Messaging on Support for Breast Cancer Screening Cessation Among Older US Women

Many older women are screened for breast cancer beyond guideline-recommended thresholds. Messaging holds promise to reduce overscreening. To investigate the effect of a message on older women's support for and intentions of stopping breast cancer screening. A 2-wave randomized clinical online survey trial using a nationally representative online panel was performed from May 12 to June 19, 2023. Women 65 years or older without breast cancer were eligible to participate. A pilot-tested breast cancer screening cessation message delivered to a hypothetical older woman with serious illnesses and functional impairment. The message was described as from 1 of 3 sources (clinician, news story, or family member). Participants were randomized into 4 groups: no message (group 1 [control]), a single message from a clinician at wave 1 and no message at wave 2 (group 2), a message from a news story (wave 1) and a clinician (wave 2) (group 3), and a message from a family member (wave 1) and a clinician (wave 2) (group 4). Support for stopping screening in the hypothetical older woman (primary) and screening intentions for oneself (secondary) were assessed on 7-point scales, with higher values indicating stronger support for and intentions to stop screening. Means were compared using analysis of variance. The message effect on screening intentions among participants 75 years or older and those with life expectancy of less than 10 years were also explored. A total of 3051 women participated in wave 1 of the trial. The mean (SD) age was 72.8 (5.9) years; 272 (8.9%) were non-Hispanic Black and 2506 (82.1%) were non-Hispanic White. Of these women, 2796 (91.6%) completed wave 2. Group 2 had significantly higher support for screening cessation in the hypothetical patient at wave 2 (mean score, 3.14 [95% CI, 2.99-3.29]) compared with group 1 (mean score, 2.68 [95% CI, 2.54-2.82]; P < .001). The effect was even stronger in group 3 (mean score, 4.23 [95% CI, 4.09-4.38]) and group 4 (mean score, 4.12 [95% CI, 3.97-4.27]) compared with both groups 1 and 2 (all P < .001). Message effects on self-screening intentions followed a similar pattern, with larger effects among participants 75 years or older or with limited life expectancy. In this randomized clinical trial, a breast cancer screening cessation message significantly increased older women's support for and intentions of screening cessation. The strongest effects were observed when the message was delivered over time from multiple sources. Future work needs to engage potential message sources to examine the feasibility and acceptability of multilevel messaging strategies and their effect on screening behavior. ClinicalTrials.gov Identifier: NCT05821023.

Community Senior Center Intervention to Address Factors Related to Memory Screening Engagement.

There are many individual and societal benefits to screen older adults for memory problems. Four theoretically derived psychosocial factors are predictive of dementia screening intention: perceived benefits, perceived susceptibility, self-efficacy, and knowledge about memory. The current study tested whether these factors could be modified with an educational memory screening intervention given in community senior centers. An educational presentation was designed to address these factors by increasing knowledge about memory and aging, discussing the benefits of screening and older adults' susceptibility to memory issues, and increasing self-efficacy by teaching about the memory screening process, discussing a vignette, and fielding participants' questions. The educational presentation was offered four times at three community senior centers. Quantitative data on the psychosocial factors were collected before and after the presentation from 44 older adult participants (age M = 78.70, SD = 7.21). Narrative data on satisfaction and feedback about the intervention were collected. Hierarchical linear modeling analyses were performed to measure change from pre- to post-presentation and follow-up 1 to 2 weeks after the intervention. The educational presentation effectively increased knowledge about aging memory, perceived benefits of screenings, and self-efficacy to seek screening. The presentation intervention was well received by community participants. Results provide guidance about how an intervention based in community senior centers can be refined to address factors predictive of memory screening intention in older adults.

Using a community-engaged research process to plan, implement, and evaluate a cancer education program to improve knowledge and screening intentions among African American men

Objective We assessed acceptability, feasibility, and preliminary efficacy of a culturally appropriate, cancer education program to improve cancer knowledge, attitudes, subjective norms, and screening intentions for oropharynx, colon, and prostate cancers among African American men. We detailed the community-engaged research process used for African American men to design, implement, and evaluate the program. Materials and Methods We recruited 84 (61 in-person, 23 online) African American men over 2-months across 4 churches in Middle Tennessee in 2021. A single group, pre-post-test design was used to evaluate the 2.5-h hybrid program. Scales used were: General self-efficacy for cancer screening; attitudes toward cancer; general cancer knowledge; and subjective norms related to cancer. One-item measured cancer screening intention. Taba robust partial correlation measured the degree of association between changes in means of each explanatory variable with changes in means of each outcome variable. IBM SPSS version 28 and R/RStudio version 3.6.0 was used for data analysis. We conducted three focus groups (n = 17) to assess program acceptability. Microsoft Excel version 26 was used to conduct thematic analysis for this data. Findings Quantitative Significant differences were found in the pre/post comparisons of knowledge (mean difference: 0.22; p-value = 0.015), self-efficacy (mean difference: 0.23; p-value < 0.001), and prostate cancer screening intention (mean difference: 0.19; p-value = 0.049) scores. This indicates the mean score for knowledge, self-efficacy, and prostate cancer screening intention was significantly higher post-intervention. Qualitative Focus group themes were: (1) Impact of Program on Participants Psychosocial Health (2) Perspectives on Life after the program. (3) Views on Programmatic Components; (4) Recommendations for Program Improvement. Conclusions Results demonstrate our program is feasible, acceptable, and could increase cancer screening intentions and behavior. Psychosocial providers should demonstrate cultural awareness and humility when providing services to address the psychological and social needs for cancer screening among African American men.