Decision making in cancer primary prevention and chemoprevention.
BACKGROUND
We know very little about how individuals decide to undertake, maintain, or discontinue cancer primary prevention or chemoprevention.


OBJECTIVE
The aims of this article are to (a) examine whether and, if so, how traditional health behavior change models are relevant for decision making in this area; (b) review the application of decision aids to forming specific, personal choices between options; and (c) identify the challenges of evaluating these decision processes to suggest areas for future research.


METHODS
Theoretical models and frameworks derived from the health behavior change and decision-making fields were applied to cancer primary prevention choices. Decision aids for the human papillomavirus (HPV) vaccine, Hormone Replacement Therapy (HRT), and tamoxifen were systematically examined.


RESULTS
Traditional concepts such as decisional balance and cues to action are relevant to understanding cancer primary prevention choices; Motivational Interviewing, Self-Determination Theory, and the Preventive Health Model may also explain the facilitators of decision making. There are no well-tested HPV vaccine decision aids, although there have been some studies on aids for HPV testing. There are several effective decision aids for HRT and tamoxifen; evidence-based decision aid components have also been identified.


CONCLUSIONS
Additional theory-based empirical research on decision making in cancer primary prevention and chemoprevention, particularly at the interface of psychology and behavioral economics, is suggested.
Gorin
Sherri Sheinfeld
SS
Columbia University, New York, NY 10027, USA. ssg19@columbia.edu
Wang
Catharine
C
Raich
Peter
P
Bowen
Deborah J
DJ
Hay
Jennifer
J
D001943:Breast Neoplasms / Q000517:prevention & control; D018890:Chemoprevention; D003657:Decision Making; D005260:Female; D005544:Forecasting; D020249:Hormone Replacement Therapy; D006801:Humans; D009369:Neoplasms / Q000517:prevention & control* / Q000628:therapy; D030361:Papillomavirus Infections / Q000517:prevention & control; D053918:Papillomavirus Vaccines / Q000008:administration & dosage; D011322:Primary Prevention / Q000379:methods*; D012307:Risk Factors; D013629:Tamoxifen / Q000627:therapeutic use
D053918:Papillomavirus Vaccines; D013629:Tamoxifen