A systematic review of interventions to improve breast cancer screening health behaviours
File(s)
Supporting information
Author(s)
Acharya, Amish
Sounderajah, Viknesh
Ashrafian, Hutan
Darzi, Ara
Judah, Gaby
Type
Journal Article
Abstract
Whilst breast cancer screening has been implemented in many countries, uptake is often suboptimal. Consequently, several interventions targeting non-attendance behaviour have been developed. This systematic review aims to appraise the successes of interventions, identifying and comparing the specific techniques they use to modify health behaviours. A literature search (PROSPERO CRD42020212090) between January 2005 and December 2020 using PubMed, Medline, PsycInfo, EMBASE and Google Scholar was conducted. Studies which investigated patient-facing interventions to increase attendance at breast cancer screening appointments were included. Details regarding the intervention delivery, theoretical background, and contents were extracted, as was quantitative data on the impact on attendance rates, compared to control measures. Interventions were also coded using the Behavioural Change Techniques (BCT) Taxonomy. In total fifty-four studies, detailing eighty interventions, met the inclusion criteria. Only 50% of interventions reported a significant impact on screening attendance. Thirty-two different BCTs were used, with 'prompts/cues' the most commonly incorporated (77.5%), however techniques from the group 'covert learning' had the greatest pooled effect size 0.12 (95% CI 0.05-0.19, P < 0·01, I2 = 91.5%). 'Problem solving' was used in the highest proportion of interventions that significantly increased screening attendance (69.0%). 70% of the interventions were developed using behavioural theories. These results show interventions aimed at increasing screening uptake are often unsuccessful. Commonly used approaches which focus upon explaining the consequences of not attending mammograms were often ineffective. Problem solving, however, has shown promise. These techniques should be investigated further, as should emerging technologies which can enable interventions to be feasibly translated at a population-level.
Date Issued
2021-12-01
Date Acceptance
2021-10-03
Citation
Preventive Medicine, 2021, 153
ISSN
0091-7435
Publisher
Elsevier
Journal / Book Title
Preventive Medicine
Volume
153
Copyright Statement
© 2021 Published by Elsevier Inc. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/34624390
PII: S0091-7435(21)00397-2
Subjects
Behaviour change techniques
Breast cancer
Health behaviour
Mass screening
Publication Status
Published
Coverage Spatial
United States
Article Number
ARTN 106828
Date Publish Online
2021-10-05