title: Family physicians' intention to support women in making informed decisions about breast cancer screening with mammography: a cross-sectional survey.
abstract: BACKGROUND
  The net benefits of routine breast cancer screening with mammography have been questioned, and there is evidence to indicate that supporting women to make an informed decision about breast cancer screening with mammography is preferable. The aims of this study were to assess the intention of family physicians to provide women with this support and the determinants of this intention, and to identify factors that might influence family physicians adopting this behavior.
  
  
  METHODS
  Family physicians from the province of Quebec, Canada, attending a 45-min lecture on informed decision making and cancer screening were asked to complete a questionnaire after the lecture regarding their intention to adopt the behavior. The questions, based on the Theory of Planned Behavior, measured physicians' intention and its determinants (attitude, perceived behavioral control, and socio-professional norm) regarding supporting women to make informed decisions about breast cancer screening with mammography. Open-ended questions were also used to explore complementary factors influencing their intention.
  
  
  RESULTS
  Out of 800 questionnaires distributed, 301 (38 %) were returned and 288 were included in data analysis. The mean ± standard deviation and median score for intention were respectively 1.9 ± 1.2 and 2.0 on a 6-point Likert scale (-3 to +3). Perceived behavioral control was the variable most strongly associated with intention (high versus low score, odds ratio = 15.7, 95 % CI 6.7-36.6), followed by attitude (high versus low score, odds ratio = 7.5, 95 % CI 3.3-16.8), then social norm (high versus low score, odds ratio = 5.8, 95 % CI 2.6-12.9). The most-reported barrier to adopting the behavior was time constraints (41 %) while the most-reported facilitator was availability of relevant decision support tools (29 %).
  
  
  CONCLUSIONS
  Respondents showed strong intention to support women in informed decision-making about breast cancer screening, the strongest predictor being perceived behavioral control. These results could contribute to training physicians to integrate this behavior into their practices and to designing relevant decision support tools.
authors.affiliation: Hôpital Saint-Francois d'Assise, Centre Hospitalier Universitaire de Québec Research Centre, 10 Rue de l'Espinay, Québec, QC, G1L 3L2, Canada. lawrence.kiyang@albertahealthservices.ca.|Surgery Strategic Clinical Network, Alberta Health Services, Room 101, Materiel Management Centre, Royal Alexandra Hospital, 10240 Kingsway Avenue NW, Edmonton, AB, T5H 3V9, Canada. lawrence.kiyang@albertahealthservices.ca.
authors.forename: Lawrence-Ndoh
authors.initials: LN
authors.lastname: Kiyang
authors.affiliation: Hôpital Saint-Francois d'Assise, Centre Hospitalier Universitaire de Québec Research Centre, 10 Rue de l'Espinay, Québec, QC, G1L 3L2, Canada. michel.labrecque@fmed.ulaval.ca.|Department of Family and Emergency Medicine, Université Laval, 1050, avenue de la Médecine, Pavillon Ferdinand-Vandry, Bureau 4617, Québec, QC, G1V 0A6, Canada. michel.labrecque@fmed.ulaval.ca.
authors.forename: Michel
authors.initials: M
authors.lastname: Labrecque
authors.affiliation: Institut National de Santé Publique du Québec, 190, boulevard Crémazie Est, Montréal, QC, H2P 1E2, Canada. Doualla-Bell@inspq.qc.ca.
authors.forename: Florence
authors.initials: F
authors.lastname: Doualla-Bell
authors.affiliation: Hôpital Saint-Francois d'Assise, Centre Hospitalier Universitaire de Québec Research Centre, 10 Rue de l'Espinay, Québec, QC, G1L 3L2, Canada. Turcotte@crchudequebec.ulaval.ca.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Turcotte
authors.affiliation: Department of Social and Preventive Medicine, École de santé publique, Université de Montréal, C.P. 6128, Succursale Centre-ville, Montréal, QC, H3C 3J7, Canada. celine.farley@umontreal.ca.
authors.forename: Céline
authors.initials: C
authors.lastname: Farley
authors.affiliation: Institut National de Santé Publique du Québec, 190, boulevard Crémazie Est, Montréal, QC, H2P 1E2, Canada. myrthaciontibas@gmail.com.
authors.forename: Myrtha
authors.initials: M
authors.lastname: Cionti Bas
authors.affiliation: Department of Family and Emergency Medicine, Université Laval, 1050, avenue de la Médecine, Pavillon Ferdinand-Vandry, Bureau 4617, Québec, QC, G1V 0A6, Canada. Blaisj2@videotron.ca.
authors.forename: Johanne
authors.initials: J
authors.lastname: Blais
authors.affiliation: Hôpital Saint-Francois d'Assise, Centre Hospitalier Universitaire de Québec Research Centre, 10 Rue de l'Espinay, Québec, QC, G1L 3L2, Canada. france.legare@mfa.ulaval.ca.|Department of Family and Emergency Medicine, Université Laval, 1050, avenue de la Médecine, Pavillon Ferdinand-Vandry, Bureau 4617, Québec, QC, G1V 0A6, Canada. france.legare@mfa.ulaval.ca.
authors.forename: France
authors.initials: F
authors.lastname: Légaré
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D003657:Decision Making; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D033182:Intention; D016015:Logistic Models; D008297:Male; D008327:Mammography / Q000379:methods*; D015999:Multivariate Analysis; D010821:Physicians, Family / Q000523:psychology / Q000706:statistics & numerical data*; D011792:Quebec; D011795:Surveys and Questionnaires