How do women interpret the NHS information leaflet about cervical cancer screening?

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• dc.contributor.author Okan, Yasmina
• dc.contributor.author Petrova, Dafina
• dc.contributor.author Smith, Samuel G.
• dc.contributor.author Lesic, Vedran
• dc.contributor.author Bruine de Bruin, Wändi
• dc.date.accessioned 2023-02-24T07:04:51Z
• dc.date.available 2023-02-24T07:04:51Z
• dc.date.issued 2019
• dc.description.abstract Background. Organized screening programs often rely on written materials to inform the public. In the United Kingdom, women invited for cervical cancer screening receive a leaflet from the National Health Service (NHS) to support screening decisions. However, information about screening may be too complex for people to understand, potentially hindering informed decision making. Objectives. We aimed to identify women’s difficulties in interpreting the leaflet used in England and negative and positive responses to the leaflet. Methods. We used a sequential mixed-methods design involving 2 steps: cognitive think-aloud interviews (n = 20), followed by an England-wide survey (n = 602). Data were collected between June 2017 and December 2018, and participants included women aged 25 to 64 y with varying sociodemographics. Results. Interview results revealed misunderstandings concerning screening results, benefits, and additional tests and treatment, although participants tended to react positively to numerical information. Participants were often unfamiliar with the potential harms associated with screening (i.e., screening risks), key aspects of human papillomavirus, and complex terms (e.g., dyskaryosis). Survey results indicated that interpretation difficulties were common (M correct items = 12.5 of 23). Lower understanding was associated with lower educational level (β’s >0.15, P’s <0.001), lower numeracy scores (β = 0.36, P < 0.001), and nonwhite ethnicity (β = 0.10, P = 0.007). The leaflet was evaluated positively overall. Conclusions. Despite previous user testing of the leaflet, key information may be too complex for some recipients. As a consequence, they may struggle to make informed decisions about screening participation based on the information provided. We discuss implications for the improvement of communications about screening and decision support.
• dc.description.sponsorship The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Financial support for this study was provided in part by a Population Research Fellowship awarded by Cancer Research UK (reference C57775/ A22182) to Yasmina Okan, in addition to internal funding provided by the University of Leeds. Dafina Petrova is supported by a Juan de la Cierva Fellowship (FJCI-2016-28279) from the Spanish Ministry of Science, Innovation and Universities. Samuel G. Smith is supported by Yorkshire Cancer Research. Wändi Bruine de Bruin was supported in part by the Swedish Foundation for Humanities and Social Sciences programme on Science and Proven Experience (VBE).
• dc.format.mimetype application/pdf
• dc.identifier.citation Okan Y, Petrova D, Smith SG, Lesic V, Bruine de Bruin W. How do women interpret the NHS information leaflet about cervical cancer screening? Med Decis Making. 2019;39(7):738-54. DOI: 10.1177/0272989X19873647
• dc.identifier.doi http://dx.doi.org/10.1177/0272989X19873647
• dc.identifier.issn 0272-989X
• dc.identifier.uri http://hdl.handle.net/10230/55915
• dc.language.iso eng
• dc.publisher SAGE Publications
• dc.relation.ispartof Medical Decision Making. 2019;39(7):738-54.
• dc.relation.isreferencedby https://journals.sagepub.com/doi/suppl/10.1177/0272989X19873647/suppl_file/Cervical_screening_leaflet_R1_online_supp.pdf
• dc.relation.projectID info:eu-repo/grantAgreement/ES/1PE/FJCI-2016-28279
• dc.rights © The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (http://www.creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://www.creativecommons.org/licenses/by/4.0/
• dc.subject.keyword cancer screening
• dc.subject.keyword cervical cancer
• dc.subject.keyword informed decision making
• dc.subject.keyword patient information
• dc.subject.keyword risk communication
• dc.title How do women interpret the NHS information leaflet about cervical cancer screening?
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion