Knowledge about mammography screening in Germany by education and migrant status – results of a cross-sectional study (InEMa)

Berens, Eva-Maria; Kaucher, Simone; Eckert, Sandra van; Reder, Maren; Kolip, Petra; Spallek, Jacob

doi:10.1186/s41241-019-0076-1

“…Women with less education and an immigrant background were more likely to have insu cient knowledge about the bene ts and possible harms of mammography screening. Su cient knowledge was again associated with higher education and was lowest among Turkish women (19).…”

Section: Introductionmentioning

confidence: 93%

“…As such, they go hand in hand with current Western health standards and ethical principles that oppose persuasion or nudging, as it violates informed choice and undermines the trustworthiness and credibility of the communicator and vaccinator (31,32). Fact boxes are developed according to the recommendations of the German guideline evidence-based health information (19,30). This includes development and evaluation according to the Medical Research Council (MRC) guideline Development and Evaluation of Complex Interventions (33).…”

Section: Introductionmentioning

confidence: 99%

Do evidence-based fact boxes improve informed decision-making about COVID-19 and influenza vaccination in more and less disadvantaged groups equally? - Study protocol for a multi-centre cluster randomised controlled trial in health and social care in Germany

Ellermann,

Rebitschek

2023

Preprint

0

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Background Evidence-based fact boxes have been shown to support informed decision-making. However, few studies have analysed how the boxes support decision-making in different social groups. Further, it is unclear whether fact boxes promote informed and shared decision making equally when implemented by health educators (HE) in different settings. Hence, there is a risk that fact boxes will only help less disadvantaged people to make informed health decisions. The aim of our study is to assess whether fact boxes can help people from different social groups make informed decisions about COVID-19 and influenza vaccination, and whether they contribute to reducing inequities in health care. Methods In a multi-centre cluster randomised controlled trial, HE from usual care (e.g. doctors) and outreach work (e.g. from social services) in Germany will be recruited. HE who are randomized to receive the intervention will receive a flyer with a QR code and a link to an online survey to pass on to those who are about to make a vaccination decision. The back of the flyer contains an evidence-based fact box about COVID-19 or the influenza vaccine, which can be used to inform. HE who are randomized to control will receive the flyer without the fact box. The flyer and online study will be available in Arabic, German, Turkish and Russian language. The primary outcome is informed vaccination intention, based on vaccination knowledge, attitudes, vaccination intentions and behaviour. Secondary outcomes include risk perception, decisional conflict and shared decision making. The statistical analysis plan includes the selection of appropriate measures of effect size, sample size calculation, and significance testing. Discussion Failing to consider inequalities when developing and evaluating interventions that influence health decisions - such as evidence-based health information - exacerbates health inequities. The aim of our study is to find out whether evidence-based fact boxes developed with an equity lens work well in different settings where health communication takes place. The results will help determine if and how fact boxes can be used to improve health care in and outside of traditional primary care structures, especially for disadvantaged groups, and will thus provide valuable insights into advancing health care equity. Trial registration: clinicaltrials.gov (NCT06076421)

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“…As such, they go hand in hand with current Western health standards and ethical principles that oppose persuasion or nudging, as it violates informed choice and undermines the trustworthiness and credibility of the communicator and vaccinator (30,31). Fact boxes are developed according to the recommendations of the German guideline evidence-based health information (19,30). This includes development and evaluation according to the Medical Research Council (MRC) guideline Development and Evaluation of Complex Interventions (32).…”

Section: Introductionmentioning

confidence: 99%

“…19 and u vaccine fact boxes in a tabular and visualized format are available for two different age groups each: COVID-19 vaccination for people aged 18 to 59 and over 60, in uenza vaccination for people aged 16 to 64 and over 65. Health educators are free to decide if and how to use the fact boxes, whether during, before or after vaccination education, and who to target.…”

mentioning

confidence: 99%

Do evidence-based fact boxes improve informed decision-making about COVID-19 and influenza vaccination in more and less disadvantaged groups equally? - Study protocol for a multi-centre cluster randomised controlled trial in health and social care in Germany

Ellermann,

Rebitschek

2023

Preprint

0

View full text Add to dashboard Cite

Background Evidence-based fact boxes have been shown to support informed decision-making. However, few studies have analysed how the boxes support decision-making in different social groups. Further, it is unclear whether fact boxes promote informed and shared decision making equally when implemented by health educators (HE) in different settings. Hence, there is a risk that fact boxes will only help less disadvantaged people to make informed health decisions. The aim of our study is to assess whether fact boxes can help people from different social groups make informed decisions about COVID-19 and influenza vaccination, and whether they contribute to reducing inequities in health care. Methods In a multi-centre cluster randomised controlled trial, HE from usual care (e.g. doctors) and outreach work (e.g. from social services) in Germany will be recruited. HE who are randomized to receive the intervention will receive a flyer with a QR code and a link to an online survey to pass on to those who are about to make a vaccination decision. The back of the flyer contains an evidence-based fact box about COVID-19 or the influenza vaccine, which can be used to inform. HE who are randomized to control will receive the flyer without the fact box. The flyer and online study will be available in Arabic, German, Turkish and Russian language. The primary outcome is informed vaccination intention, based on vaccination knowledge, attitudes, vaccination intentions and behaviour. Secondary outcomes include risk perception, decisional conflict and shared decision making. The statistical analysis plan includes the selection of appropriate measures of effect size, sample size calculation, and significance testing. Discussion Failing to consider inequalities when developing and evaluating interventions that influence health decisions - such as evidence-based health information - exacerbates health inequities. The aim of our study is to find out whether evidence-based fact boxes developed with an equity lens work well in different settings where health communication takes place. The results will help determine if and how fact boxes can be used to improve health care in and outside of traditional primary care structures, especially for disadvantaged groups, and will thus provide valuable insights into advancing health care equity. Trial registration: clinicaltrials.gov (registered on 29 September 2023, not yet published)

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“…As such, they go hand in hand with current Western health standards and ethical principles that oppose persuasion or nudging, which can collide with informed choice and pose the risk of undermining the trustworthiness and credibility of the communicator and vaccinator 31 32 . Fact boxes are developed according to the recommendations of the German guideline evidence-based health information (19,30). This includes development and evaluation according to the Medical Research Council (MRC) guideline Development and Evaluation of Complex Interventions 33 .…”

Section: Introductionmentioning

confidence: 99%

Do summaries of evidence enable informed decision-making about COVID-19 and flu vaccination equitably across more and less disadvantaged groups? - Study protocol for a multi-center cluster RCT with ‘fact boxes’ in health and social care in Germany

Ellermann,

Savaskan,

Rebitschek

2023

Preprint

0

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Introduction Summaries of the best available evidence on the benefits and harms of different treatment options support informed decision making of well-educated participants under controlled conditions. However, few studies have investigated how such formats support decision-making across different social groups. There is a risk that these evidence summaries will only help less disadvantaged people to make informed health decisions – possibly increasing the health equity gap. It is also unclear whether they support decision-making in the field at all. The aim of our study is to assess whether evidence summaries based on the fact box format can help people from different social groups make informed decisions about COVID-19 and influenza vaccination, and to investigate whether these fact boxes can help reduce inequities in health communication. Methods and analysis In a multicentre, cluster-randomised, controlled trial, health educators (HEs) from usual care (e.g. physicians) and outreach work (e.g. social services) in Germany will be randomised to provide either usual health communication plus an evidence summary (‘fact box’) or usual health communication. As part of their health education programme, HEs provide people who are about to make a decision about COVID-19 or flu vaccination with a flyer containing a link to an online study either with (intervention) or without (control) fact box on the reverse side. The flyer and online study will be available in Arabic, German, Turkish and Russian language. The primary outcome is informed vaccination intention, based on vaccination knowledge, attitudes, intentions and behaviour. Secondary outcomes include risk perception, decisional conflict and shared decision making. Data analysis will initially be based on descriptive statistics as well as frequency distributions and histograms to identify outliers and missing data. We will use linear mixed models to analyse the influence of both individual (e.g. education status, health literacy) and cluster level factors (e.g. setting) and account for the expected cluster variability in realising usual health communication or the intervention. The statistical analysis plan includes the selection of appropriate measures of effect size and power calculation. Ethics and dissemination The study and its pre-studies have been reviewed and approved by the ethics committee of the University of Potsdam, Germany (application numbers: 34/2021 and 57/2022). We plan to disseminate our findings through publications in peer-reviewed journals, national and international conferences, and relevant working groups and networks, also targeting relevant community stakeholder. Trial registration: clinicaltrials.gov (NCT06076421)

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Knowledge about mammography screening in Germany by education and migrant status – results of a cross-sectional study (InEMa)

Cited by 6 publications

References 18 publications

Do evidence-based fact boxes improve informed decision-making about COVID-19 and influenza vaccination in more and less disadvantaged groups equally? - Study protocol for a multi-centre cluster randomised controlled trial in health and social care in Germany

Do evidence-based fact boxes improve informed decision-making about COVID-19 and influenza vaccination in more and less disadvantaged groups equally? - Study protocol for a multi-centre cluster randomised controlled trial in health and social care in Germany

Do evidence-based fact boxes improve informed decision-making about COVID-19 and influenza vaccination in more and less disadvantaged groups equally? - Study protocol for a multi-centre cluster randomised controlled trial in health and social care in Germany

Do summaries of evidence enable informed decision-making about COVID-19 and flu vaccination equitably across more and less disadvantaged groups? - Study protocol for a multi-center cluster RCT with ‘fact boxes’ in health and social care in Germany

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