Abstract
Background/Aims Americans are continually exposed to a message in the popular media that more healthcare services leads to better health. With respect to cancer screening, evidence-based guidelines on breast and prostate cancer screening run counter to a similar prevailing message in the popular media, which often encourages patients to “do their part” and screen for the disease. While considerable resources have been invested in the development of evidence-based decision aids (DAs) – patient education tools providing unbiased information about potential options and outcomes of a medical decision – patients may find these tools counter-intuitive because the evidence presented is often in direct contradiction to popular media depictions. Through focus groups and stimulus materials, this study investigated the influence and impact popular media has on medical decision-making for breast, colorectal and prostate cancer screening.
Methods Eighteen focus groups were conducted in the San Francisco Bay Area. Participants attended a group focused on screening for one of 3 cancers and completed a brief socio-demographic questionnaire. Using popular media stimulus materials and DAs, the researcher-facilitated discussions explored participants’ perceptions of and motivations to participate in cancer screening. Audiotapes of discussions were transcribed and analyzed to identify salient themes.
Results Ninety-two diverse participants recruited from the community participated in one of 18 focus groups (6 per condition). The average age of participants was 53, with slightly more women (55%) than men (45%). Most participants reported Caucasian ethnicity (62%) and had graduated from college (51%). Participants overwhelmingly trusted the DA over popular media stimulus materials. In deliberating the decision of whether to screen, participants drew upon their (a) personal experiences with providers and the healthcare system, (b) personal experiences with cancer, (c) trust in a particular media source, and (d) ability to pay for screening tests.
Conclusions Media messaging about cancer screening yielded very little influence on the decision to undergo screening. Rather, when presented with a DA, patients were more likely to place trust in that source, particularly if provided by a doctor. These data suggest a need for greater distribution of evidence-based decision support tools to aid patients in making decisions about cancer screening.
