Informed choice in screening programmes: Do leaflets help? A critical literature review

Fox, Rosemary

doi:10.1093/pubmed/fdl066

Cited by 56 publications

(55 citation statements)

References 18 publications

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“…[5][6][7][8][9] A wider range of potential benefits for families have been proposed, including guidance for family planning, earlier diagnosis and avoidance of the 'diagnostic odyssey'. [8][9][10] NBS programs differ considerably with respect to parental educational materials 6,[11][12][13] and approaches to parental consent for screening. [6][7][8]14,15 In Canada, screening is considered routine and proceeds unless parents explicitly object -an opt-out approach.…”

Section: Introductionmentioning

confidence: 99%

Consent for newborn screening: parents’ and health-care professionals’ experiences of consent in practice

et al. 2016

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Consent processes for newborn bloodspot screening (NBS) are variable, with a lack of descriptive research that depicts how the offer of NBS is made to parents. We explored the experience, in practice, of consent for NBS. Semistructured interviews in two Canadian provinces were held with: (1) parents of children offered NBS (n = 32); and (2) health-care professionals involved in the NBS process (n = 19). Data on recollections of NBS, including consent processes, were utilized to identify emerging themes using the method of constant comparison. Three themes were relevant to NBS consent: (1) The 'offer' of NBS; (2) content and timing of information provision; and (3) the importance of parental experiences for consent decisions. Recollections of consent for NBS were similar between jurisdictions. Excepting midwives and their patients, NBS was viewed as a routine part of giving birth, with little evidence of an informed consent process. Although most parents were satisfied, all respondents suggested information about NBS be provided long before the birth. Accounts of parents who declined screening highlight the influence of parental experiences with the heel prick process in screening decisions. Findings further our understanding of consent in practice and highlight areas for improvement in parent-provider interactions.

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Section: Introductionmentioning

confidence: 99%

Consent for newborn screening: parents’ and health-care professionals’ experiences of consent in practice

et al. 2016

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“…Several studies have found that providing balanced information to support informed decision making does not adversely affect participation in diabetes, breast cancer, or colorectal cancer screening (Fox R, 2006 to be screened (Adab P et al, 2003). They found that after adjusting for variables such as previous Pap test use, socio-economic status, and other preventive health behaviours, women exposed to the intervention brochure expressed a reduced willingness to be screened although the results of the study were not statistically significant.…”

Section: What Goals Values and Beliefs Should Be Considered When Mamentioning

confidence: 88%

Evaluating the Effectiveness of Cervical Cancer Screening Invitation Letters

Decker

Turner

Demers

et al. 2013

Journal of Women's Health

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The purpose of this study was to evaluate the effectiveness of an invitation letter on cervical cancer screening participation among unscreened Manitoba women 30 to 69 years of age. A cluster randomized trial design was used in which unscreened women (n=31,452) were randomly assigned by the forward sortation area (FSA) of their postal code to an intervention group that was sent an invitation letter (n=17,068) or a control group that was not sent an invitation letter (n=14,384). In order to ensure access to screening, a Pap test clinic was held by a health centre in 20 of the 27 FSAs in the intervention group two to three weeks after the invitation letters were mailed.Six months after the letters were mailed, 1,010 women in the intervention group Using the Behavioural Model of Health Services Use as a theoretical framework, predisposing, enabling, and need factors that might influence screening participation were also included as covariables in multivariable logistic regression Generalized Estimating Equation (GEE) models. There was a significant main effect of age group (p<0.001), average household income (p=0.01), area of residence (p=0.01), residential mobility (p=0.05), and access (p=0.001). Interactions between the invitation letter and each iii significant variable were tested. The interaction between the invitation letter and age group remained significant (p=0.02); therefore, the effectiveness of the invitation letter was related to age.Of the 1,451 women who had a Pap test in the next six months, 21 women (1.45%) had a high-grade Pap test result. It is recommended that invitation letters continue to be sent to unscreened Manitoba women 30 to 69 years of age and that other provincial screening programs consider sending invitation letters to unscreened women.iv Acknowledgements

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“…18 A limitation of this study is that there is no general agreement on the definition of being adequately informed. 19 For this study, we focused on the level of knowledge and measured this by being able to answer four knowledgerelated statements correctly. We cannot exclude that participants were able to verify the answers in the information leaflet or guessed the right answer.…”

Section: Discussionmentioning

confidence: 99%

Getting adequate information across to colorectal cancer screening subjects can be difficult

et al. 2008

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Objectives Participation in screening should be the outcome of an informed decision. We evaluated whether invitees in the first Dutch colorectal cancer (CRC) screening programme were adequately informed after having received a detailed information leaflet. Methods A total of 20,623 subjects aged 50 -75 years were invited to the fecal occult blood test (FOBT) screening programme. All received a detailed information leaflet by mail between May 2006 and January 2007. After two weeks, a reminder letter was sent to all invitees, accompanied by a survey on CRC and screening. Results The survey was completed by 9594 invitees (47%). Almost all responders (99%) found the leaflet clear and readable. Almost all indicated that CRC can be treated better if found early (99%). Only 20% of the responders answered all knowledge-related answers correctly. Almost half of the responders (47%) believed that a negative FOBT excludes the presence of CRC. Older age and having a positive family member for CRC were correctly identified as risk factors by 80%. Conclusion This study demonstrates that although an information leaflet was reported as being clear and readable, the information provided in it was not always understood well. This suggests that other educational options should be investigated in order to improve general knowledge of CRC in screening invitees.

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Informed choice in screening programmes: Do leaflets help? A critical literature review

Cited by 56 publications

References 18 publications

Consent for newborn screening: parents’ and health-care professionals’ experiences of consent in practice

Consent for newborn screening: parents’ and health-care professionals’ experiences of consent in practice

Evaluating the Effectiveness of Cervical Cancer Screening Invitation Letters

Getting adequate information across to colorectal cancer screening subjects can be difficult

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