title: Development and evaluation of a breast cancer prevention decision aid for higher-risk women.
abstract: OBJECTIVE
  To develop and evaluate the effectiveness of a breast cancer prevention decision aid for women aged 50 and older at higher risk of breast cancer.
  
  
  METHODS
  Pre-test-post-test study using decision aid alone and in combination with counselling.
  
  
  METHODS
  Breast Cancer Risk Assessment Clinic.
  
  
  METHODS
  Twenty-seven women aged 50-69 with 1.66% or higher 5-year risk of breast cancer.
  
  
  METHODS
  Self-administered breast cancer prevention decision aid.
  
  
  METHODS
  Acceptability; decisional conflict; knowledge; realistic expectations; choice predisposition; intention to improve life-style practices; psychological distress; and satisfaction with preparation for consultation.
  
  
  RESULTS
  The decision aid alone, or in combination with counselling, decreased some dimensions of decisional conflict, increased knowledge (P < 0.01), and created more realistic expectations (P < 0.01). The aid in combination with counselling, significantly reduced decisional conflict (P < 0.01) and psychological distress (P < 0.02), helped the uncertain become certain (P < 0.02), and increased intentions to adopt healthier life-style practices (P < 0.03). Women rated the aid as acceptable, and both women and practitioners were satisfied with the effect it had on the counselling session.
  
  
  CONCLUSIONS
  The decision aid shows promise as a useful decision support tool. Further research should compare the effect of the decision aid in combination with counselling to counselling alone.
authors.affiliation: Population Health Program, University of Ottawa, Ottawa, Canada. dstacey@ohri.ca
authors.forename: Dawn
authors.initials: D
authors.lastname: Stacey
authors.forename: Annette M
authors.initials: AM
authors.lastname: O'Connor
authors.forename: Cathy
authors.initials: C
authors.lastname: DeGrasse
authors.forename: Shailendra
authors.initials: S
authors.lastname: Verma
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000517:prevention & control*; D003376:Counseling; D003661:Decision Support Techniques; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods* / Q000592:standards; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D017060:Patient Satisfaction; D016730:Program Development; D015397:Program Evaluation; D012307:Risk Factors; D012647:Self-Assessment; D011795:Surveys and Questionnaires