title: Effects of a risk-based online mammography intervention on accuracy of perceived risk and mammography intentions.
abstract: This experiment tested the effects of an individualized risk-based online mammography decision intervention. The intervention employs exemplification theory and the Elaboration Likelihood Model of persuasion to improve the match between breast cancer risk and mammography intentions.
  
  
  
  2918 women ages 35-49 were stratified into two levels of 10-year breast cancer risk (<1.5%; ≥1.5%) then randomly assigned to one of eight conditions: two comparison conditions and six risk-based intervention conditions that varied according to a 2 (amount of content: brief vs. extended) x 3 (format: expository vs. untailored exemplar [example case] vs. tailored exemplar) design. Outcomes included mammography intentions and accuracy of perceived breast cancer risk.
  
  
  
  Risk-based intervention conditions improved the match between objective risk estimates and perceived risk, especially for high-numeracy women with a 10-year breast cancer risk ≤1.5%. For women with a risk≤1.5%, exemplars improved accuracy of perceived risk and all risk-based interventions increased intentions to wait until age 50 to screen.
  
  
  
  A risk-based mammography intervention improved accuracy of perceived risk and the match between objective risk estimates and mammography intentions.
  
  
  
  Interventions could be applied in online or clinical settings to help women understand risk and make mammography decisions.
authors.affiliation: Annenberg School for Communication, University of Pennsylvania, 3620 Walnut Street, Philadelphia, PA, 19104, USA. Electronic address: hollihseitz@gmail.com.
authors.forename: Holli H
authors.initials: HH
authors.lastname: Seitz
authors.affiliation: Annenberg School for Communication, University of Pennsylvania, 3620 Walnut Street, Philadelphia, PA, 19104, USA. Electronic address: lgibson@asc.upenn.edu.
authors.forename: Laura
authors.initials: L
authors.lastname: Gibson
authors.affiliation: Annenberg School for Communication, University of Pennsylvania, 3620 Walnut Street, Philadelphia, PA, 19104, USA. Electronic address: christine_skubisz@emerson.edu.
authors.forename: Christine
authors.initials: C
authors.lastname: Skubisz
authors.affiliation: Annenberg School for Communication, University of Pennsylvania, 3620 Walnut Street, Philadelphia, PA, 19104, USA. Electronic address: heather.forquer@gmail.com.
authors.forename: Heather
authors.initials: H
authors.lastname: Forquer
authors.affiliation: Annenberg School for Communication, University of Pennsylvania, 3620 Walnut Street, Philadelphia, PA, 19104, USA. Electronic address: s.mello@northeastern.edu.
authors.forename: Susan
authors.initials: S
authors.lastname: Mello
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, USA; Center for Health Equity Research and Promotion, Crescenz VA Medical Center, Philadelphia, PA 19104, USA. Electronic address: mschap@mail.med.upenn.edu.
authors.forename: Marilyn M
authors.initials: MM
authors.lastname: Schapira
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, USA. Electronic address: karmstrong6@mgh.harvard.edu.
authors.forename: Katrina
authors.initials: K
authors.lastname: Armstrong
authors.affiliation: Annenberg School for Communication, University of Pennsylvania, 3620 Walnut Street, Philadelphia, PA, 19104, USA. Electronic address: jcappella@asc.upenn.edu.
authors.forename: Joseph N
authors.initials: JN
authors.lastname: Cappella
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000517:prevention & control* / Q000523:psychology; D003657:Decision Making; D003661:Decision Support Techniques; D055088:Early Detection of Cancer; D005260:Female; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D020407:Internet; D016013:Likelihood Functions; D008327:Mammography; D008875:Middle Aged; D008962:Models, Theoretical; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010414:Pennsylvania; D014930:Women / Q000523:psychology*
keywords: Communication intervention; Decision aid; Mammography; Numeracy; Perceived risk; Risk communication