title: What Matters to Women When Making Decisions About Breast Cancer Chemoprevention?
abstract: OBJECTIVE
  Despite the effectiveness of chemoprevention (tamoxifen and raloxifene) in preventing breast cancer among women at high risk for the disease, uptake is low. The objective of this study was to determine the tradeoff preferences for various attributes associated with chemoprevention among women not currently taking the drugs.
  
  
  METHODS
  We used rating-based conjoint analysis to evaluate the relative importance of a number of attributes associated with chemoprevention, including risk of side effects, drug effectiveness, time needed to take the drugs, and availability of a blood test to see if the drugs were working in an Internet sample of women. We generated mean importance values and part-worth utilities for all attribute levels associated with taking chemoprevention. We then used multivariable linear regression to examine attribute importance scores controlling for participant age, race, Hispanic ethnicity, educational level, and a family history of breast cancer.
  
  
  RESULTS
  Overall interest in taking chemoprevention was low among the 1094 women included in the analytic sample, even for the scenario in which participants would receive the greatest benefit and fewest risks associated with taking the drugs. Time needed to take the pill for it to work and 5-year risk of breast cancer were the most important attributes driving tradeoff preferences between the chemoprevention scenarios.
  
  
  CONCLUSIONS
  Interest in taking chemoprevention among this sample of women at average risk was low. Addressing women's concerns about the time needed to take chemoprevention for it to work may help clinicians improve uptake of the drugs among those likely to benefit.
authors.affiliation: Ann Arbor VA Center for Clinical Management Research, Building 16, 4th Floor, 2800 Plymouth Road, Ann Arbor, MI, 48105, USA. katiemartinez@gmail.com.
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Martinez
authors.affiliation: Ann Arbor VA Center for Clinical Management Research, Building 16, 4th Floor, 2800 Plymouth Road, Ann Arbor, MI, 48105, USA.|Division of General Medicine, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Angela
authors.initials: A
authors.lastname: Fagerlin
authors.affiliation: Department of Family and Emergency Medicine and Office of Education and Continuing Professional Development, Laval University, Quebec City, QC, Canada.|Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Centre, Quebec City, QC, Canada.
authors.forename: Holly O
authors.initials: HO
authors.lastname: Witteman
authors.affiliation: Berlin School of Public Health, Berlin, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Holmberg
authors.affiliation: Ann Arbor VA Center for Clinical Management Research, Building 16, 4th Floor, 2800 Plymouth Road, Ann Arbor, MI, 48105, USA.|Division of General Medicine, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Sarah T
authors.initials: ST
authors.lastname: Hawley
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000188:drug therapy / Q000517:prevention & control / Q000523:psychology*; D018890:Chemoprevention / Q000009:adverse effects / Q000379:methods / Q000523:psychology*; D003657:Decision Making; D004965:Estrogen Antagonists / Q000008:administration & dosage / Q000009:adverse effects / Q000592:standards*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D016014:Linear Models; D040541:Marketing / Q000379:methods; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data; D013997:Time Factors; D014481:United States
chemical_list: D004965:Estrogen Antagonists