How to Measure Informed Choice? Results From the German Mammography Screening Programme

Abstract

Background: Informed choice in mammography screening has long been an ethical requirement with poor implementation. The objective of this study was (1) to develop a questionnaire to assess informed choice in the German mammography screening programme (MSP) and (2) to determine whether women invited to the MSP for the first time make informed choices. Methods: This study was designed as a cross-sectional study with 3-month follow-up on self-reported behaviour. 2084 women from Westfalen-Lippe aged 50 answered the questionnaire in 2013/2014. The primary outcome was informed choice. Secondary outcomes were the components of informed choice (intention, knowledge, attitude) and components of the reasoned action approach. Findings: 23.7% made an informed, 58.0% a partly uninformed and 18.3% a completely uninformed choice. Accordingly, knowledge was low (M=2.8 SD=1.4, possible scores 0 to 8). Attitude was favourable (M=1.1, SD=0.7, possible scores -2 to 2) reflected in 71.1% having a positive intention. Discussion: This study showed that the majority of women in our study did not make an informed choice. Developing tools to improve informed choice in the MSP is therefore imperative.