Psychosocial Study on Breast Cancer Risk Assessment
Condition: Breast Cancer
MeSH terms: Breast Neoplasms
Study type: Observational

Summary: 
      The proposed pilot study is part of the design and development process of a final
      questionnaire that aims to gain insight on factors that influences acceptance and adoption of
      breast cancer risk assessment in women. Feedback on the questionnaire will help identify
      potential issues of clarity, comprehensibility, and reliability; and to identify possible
      biases that often accompany a designed questionnaire. Information gained from the large-scale
      study will provide directions for the development of educational strategies in the TIBS
      research program that could accompany increases in public awareness of risk factors, the
      availability of risk assessment tools and preventive lifestyle.
    

Detailed description: 
      The development of risk assessment tools for preventive oncology aims to identify all members
      of a given at risk subpopulation to whom intervention strategies can be offered to reduce
      their risk. An ideal risk assessment tool should permit assessment of a woman's breast cancer
      risk in order to a) identify the needs for and potential benefits of risk reducing
      interventions; b) direct her to the most appropriate risk reducing interventions, and; c)
      monitor the efficacy of the intervention in actually reducing risk. Earlier implemented risk
      reduction interventions could potentially preclude needs for more drastic lifestyle and less
      desirable changes, such as chemoprevention and prophylactic surgeries, later in life.
      Currently, no such classification and monitoring technique has proven effective. Yet several
      candidate techniques are being investigated. While risk assessment tools may potentially
      provide future benefits, the effectiveness of current and new risk assessment tool
      developments certainly requires users to perceive these tools as potentially effective. It is
      this perception of potential effectiveness that would motivate them to adhere to risk
      assessment protocols the evaluation of which would help provide the evidence base for
      understanding true effectiveness. The investigators of this study are currently developing a
      Transillumination Breast Spectroscopy (TIBS) research program, consisting of ongoing studies
      of different types. As part of the technology assessment process for TIBS, and in part due to
      the further development of the research program, there is a need to address factors that may
      directly or indirectly influence willingness to participate in a breast cancer risk
      assessment. The primary goal of this pilot study is to determine the content validity of the
      investigator-designed draft questionnaire. The outcome measure of a final questionnaire is to
      assess general acceptability of breast cancer risk assessment and degree of acceptability
      based on a) knowledge and awareness of breast cancer, b) varying levels of involvement and
      invasiveness of a risk assessment procedure, and c) perceived potential effectiveness of risk
      reducing interventions. Acceptability of risk assessment, willingness to undergo therapy and
      follow through with recommendations is assessed independent of currently available and new
      developments of risk assessment procedures.The secondary goal of this study is to test the
      overall comprehensibility (e.g. language, clarity), question acceptability (e.g.
      appropriateness of response selection), and reliability of the questionnaire.Information
      gained from this pilot study will be considered in the development of a final questionnaire
      to be administered to a large population representative cohort. The results of the planned
      future study will provide directions for the development of educational strategies in the
      TIBS research program that should accompany increases in public awareness on risk factors,
      the availability of risk assessment tools and preventive lifestyle and insight into the
      extent of broad-based community education strategies required to initiate and sustain
      interest in assessment for breast cancer risk among women in the general public to facilitate
      informed decision-making related to breast health in these women. Critical gaps in knowledge
      of risk factors and preventive lifestyle changes identified in this subsequent study can
      provide a focus for the educational strategies, which may address: the costs of risk
      assessment (e.g. stress, financial, inconvenience) and the development of understandable and
      practical educational materials to ensure their accessibility to a broad range of audiences,
      including those women who may be candidates for risk reducing interventions but who are not
      yet aware of its availability. The ultimate hypothesis of a future large-scale study
      is:General knowledge and awareness of breast cancer, psychosocial factors such as perceived
      risk susceptibility and perceived costs of risk assessment (e.g. stress, financial,
      inconvenience), perceived effectiveness of intervention strategies, and socio-demographic
      position are determinants of accepting risk assessment.However, to help guide questionnaire
      design and development, a pilot study is required to identify issues of the questionnaire
      such as content validity, overall comprehensibility (e.g. language, clarity), question
      acceptability (e.g. appropriateness of response selection), and reliability. To achieve the
      goals of the pilot study, we intend to recruit 50 women between ages of 25 - 74 years (10 per
      age group, 25 - 34, 35 - 44, 45 - 54, 55 - 65, 65 - 74). A 26-item investigator-designed,
      self-administered questionnaire was designed with standard measures. The questionnaire
      consists of 7 sections covering the following topics: Breast Cancer Knowledge and Awareness,
      Susceptibility Perception, Likelihood of Undergoing Risk Assessment, Benefits and Barriers of
      Risk Assessment, Breast Cancer Risk Assessment, Risk Reduction Intervention, and Demographics
    

Observational model: Cohort
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Cohort recruited from the University Health Network community.
      
Keywords: Breast Cancer; Breast Cancer Risk; Breast Cancer Risk Assessment; Psychosocial; Acceptance