Background
Method
Design
Participants
Measures
Demographics
Decision-making styles
“We would like to start by asking you some questions about how you make important decisions. I am going to read out some statements describing how individuals go about making important decisions and I would like you to tell me how much you agree or disagree with each one.”
Screening participation
“The next set of questions are about breast screening. The NHS breast screening programme invites women to have regular mammograms (x-rays of their breasts).”
“I have never heard of breast screening/I have heard of breast screening but have never been invited/I have been invited to breast screening but have never been/I have been invited to breast screening but have not been every time I was invited/I have been invited to breast screening and have been every time I was invited”
“Every time I was invited (including if you have only been invited once before your last invitation)/Most times I was invited/Some of the times I was invited/Very rarely or never/I have never been invited before my most recent invitation” (the first option was excluded for participants who had been screened at their last invitation, in order to prevent incompatible responses).
Reading information leaflets at participants’ most recent screening invitation
Piloting
Analysis
Results
Participant characteristics
Amount read of the breast screening leaflet: n (%)/M (SD) | Adjusted OR, 95% CI |
p-value | ||||||
---|---|---|---|---|---|---|---|---|
None of it | Some of it | About half of it | Most of it | All of it | Total | Read all of the leaflet | ||
Characteristic | (n = 28; 10.2%) | (n = 43; 15.6%) | (n = 13; 4.7%) | (n = 44; 16.0%) | (n = 147; 53.5%) | (n = 275) | (vs. read less than all) | |
Ethnicity | ||||||||
White British | 25 (10.2) | 37 (15.0) | 10 (4.1) | 37 (15.0) | 137 (55.7) | 246 | 3.28, 1.36 to 7.89 |
.008
|
vs. Other ethnic groups | 3 (10.3) | 6 (20.7) | 3 (10.3) | 7 (24.1) | 10 (34.5) | 29 | ||
Marital status | ||||||||
Married or living as a couple | 15 (8.4) | 30 (16.9) | 9 (5.1) | 29 (16.3) | 95 (53.4) | 178 | 0.80, 0.45 to 1.42 | .802 |
vs. Single, widowed, divorced, or separated | 13 (13.4) | 13 (13.4) | 4 (4.1) | 15 (15.5) | 52 (53.6) | 97 | ||
Highest level of education | Overall: .150 | |||||||
No formal qualifications | 11 (12.5) | 15 (17.0) | 6 (6.8) | 20 (22.7) | 36 (40.9) | 88 | 0.44, 0.19 to 1.01 | .052 |
Approximately Level 1, 2, or 3 | 13 (10.5) | 15 (12.1) | 4 (3.2) | 21 (16.9) | 71 (57.3) | 124 | 0.60, 0.29 to 1.24 | .168 |
vs. Approximately Level 4 | 4 (6.3) | 13 (20.6) | 3 (4.8) | 3 (4.8) | 40 (63.5) | 63 | ||
Social class grade | Overall: .876 | |||||||
Grade A or B | 7 (11.3) | 8 (12.9) | 4 (6.5) | 8 (12.9) | 35 (56.5) | 62 | 0.90, 0.40 to 2.07 | .811 |
Grade C1 or C2 | 9 (7.4) | 20 (16.5) | 6 (5.0) | 16 (13.2) | 70 (57.9) | 121 | 1.08, 0.57 to 2.05 | .811 |
vs. Grade D or E | 12 (13.0) | 15 (16.3) | 3 (3.3) | 20 (21.7) | 42 (45.7) | 92 | ||
Personal diagnosis of cancer | ||||||||
Yes | 3 (14.3) | 1 (4.8) | 1 (4.8) | 4 (19.0) | 12 (57.1) | 21 | 0.90, 0.35 to 2.35 | .834 |
vs. No | 25 (9.8) | 42 (16.5) | 12 (4.7) | 40 (15.7) | 135 (53.1) | 254 | ||
Knows someone with cancer | ||||||||
Yes | 21 (10.4) | 32 (15.8) | 7 (3.5) | 29 (14.4) | 113 (55.9) | 202 | 1.23, 0.69 to 2.20 | .493 |
vs. No | 7 (9.6) | 11 (15.1) | 6 (8.2) | 15 (20.5) | 34 (46.6) | 73 | ||
Breast screening regularity | Overall: .014
| |||||||
Never or very rarely attended… | 6 (35.3) | 4 (23.5) | 2 (11.8) | 2 (11.8) | 3 (17.6) | 17 | 0.16, 0.04 to 0.63 |
.009
|
Attended some or most of the time… | 1 (6.3) | 4 (25.0) | 2 (12.5) | 3 (18.8) | 6 (37.5) | 16 | 0.43, 0.14 to 1.30 | .135 |
vs. Always attended before most recent invitation | 21 (8.7) | 35 (14.5) | 9 (3.7) | 39 (16.1) | 138 (57.0) | 242 | ||
Age (in years) | 60.1 (5.7) | 61.7 (6.4) | 59.7 (5.5) | 62.2 (5.4) | 59.8 (6.1) | 60.5 (6.0) | 0.96, 0.92 to 1.00 |
.048
|
Decision-making styles | ||||||||
Avoidant score | 12.3 (3.6) | 14.0 (4.2) | 14.9 (5.2) | 12.6 (3.2) | 12.5 (3.6) | 12.8 (3.8) | 0.97, 0.89 to 1.05 | .452 |
Dependent score | 16.0 (3.9) | 17.3 (3.5) | 17.6 (4.6) | 16.1 (4.4) | 16.5 (3.8) | 16.6 (3.9) | 1.03, 0.96 to 1.11 | .434 |
Intuitive score | 19.1 (2.5) | 18.2 (2.4) | 18.6 (3.3) | 19.3 (2.7) | 18.8 (2.8) | 18.8 (2.7) | 1.01, 0.91 to 1.12 | .892 |
Rational score | 19.1 (3.0) | 20.0 (2.0) | 19.5 (3.0) | 19.1 (2.9) | 19.9 (2.9) | 19.7 (2.8) | 1.08, 0.97 to 1.19 | .151 |
Spontaneous score | 14.9 (4.0) | 13.4 (3.3) | 15.2 (4.7) | 15.2 (4.7) | 13.8 (3.9) | 13.9 (3.7) | 1.03, 0.95 to 1.11 | .528 |
Amount read of the cervical screening leaflet: n (%)/M (SD) | Adjusted OR, 95% CI |
p-value | ||||||
---|---|---|---|---|---|---|---|---|
None of it | Some of it | About half of it | Most of it | All of it | Total | Read more of the leaflet | ||
Characteristic | (n = 94; 16.9%) | (n = 108; 19.4%) | (n = 34; 6.1%) | (n = 106; 19.1%) | (n = 214; 38.5%) | (n = 556) | (i.e. any amount more) | |
Ethnicity | ||||||||
White British | 85 (19.5) | 84 (19.3) | 19 (4.4) | 78 (17.9) | 169 (38.9) | 435 | 0.79, 0.53 to 1.18 | .248 |
vs. Other ethnic groups | 9 (7.4) | 24 (19.8) | 15 (12.4) | 28 (23.1) | 45 (37.2) | 121 | ||
Marital status | ||||||||
Married or living as a couple | 61 (16.1) | 73 (19.3) | 25 (6.6) | 70 (18.5) | 150 (39.6) | 379 | 1.11, 0.79 to 1.56 | .558 |
vs. Single, widowed, divorced, or separated | 33 (18.6) | 35 (19.8) | 9 (5.1) | 36 (20.3) | 64 (36.2) | 177 | ||
Highest level of education | Overall: .850 | |||||||
No formal qualifications | 14 (19.4) | 12 (16.7) | 4 (5.6) | 15 (20.8) | 27 (37.5) | 72 | 0.92, 0.52 to 1.64 | .784 |
Approximately Level 1, 2, or 3 | 51 (17.2) | 57 (19.3) | 19 (6.4) | 55 (18.6) | 114 (38.5) | 296 | 1.06, 0.73 to 1.53 | .770 |
vs. Approximately Level 4 | 29 (15.4) | 39 (20.7) | 11 (5.9) | 36 (19.1) | 73 (38.8) | 188 | ||
Social class grade | Overall: .142 | |||||||
Grade A or B | 20 (15.4) | 29 (22.3) | 6 (4.6) | 22 (16.9) | 53 (40.8) | 130 | 0.77, 0.47 to 1.26 | .297 |
Grade C1 or C2 | 52 (18.1) | 59 (20.6) | 17 (5.9) | 57 (19.9) | 102 (35.5) | 287 | 0.67, 0.44 to 1.00 | .050 |
vs. Grade D or E | 22 (15.8) | 20 (14.4) | 11 (7.9) | 27 (19.4) | 59 (42.4) | 139 | ||
Personal diagnosis of cancer | ||||||||
Yes | 4 (14.8) | 4 (14.8) | 1 (3.7) | 4 (14.8) | 14 (51.9) | 27 | 1.27, 0.60 to 2.68 | .537 |
vs. No | 90 (17.0) | 104 (19.7) | 33 (6.2) | 102 (19.3) | 200 (37.8) | 529 | ||
Knows someone with cancer | ||||||||
Yes | 67 (18.0) | 76 (20.4) | 20 (5.4) | 63 (16.9) | 147 (39.4) | 373 | 0.87, 0.62 to 1.22 | .420 |
vs. No | 27 (14.8) | 32 (17.5) | 14 (7.7) | 43 (23.5) | 67 (36.6) | 183 | ||
Cervical screening regularity | Overall: .023
| |||||||
Never or very rarely attended… | 14 (27.5) | 11 (21.6) | 5 (9.8) | 6 (11.8) | 15 (29.4) | 51 | 0.51, 0.30 to 0.87 | .014
|
Attended some or most of the time… | 9 (15.5) | 12 (20.7) | 12 (20.7) | 8 (13.8) | 17 (29.3) | 58 | 0.68, 0.41 to 1.12 | .131 |
vs. Always attended before most recent invitation | 71 (15.9) | 85 (19.0) | 17 (3.8) | 92 (20.6) | 182 (40.7) | 447 | ||
Age (in years) | 43.0 (10.8) | 42.7 (11.1) | 43.0 (11.8) | 42.8 (11.2) | 44.7 (11.3) | 43.5 (11.2) | 1.01, 1.00 to 1.03 | .144 |
Decision-making styles | ||||||||
Avoidant score | 13.6 (4.1) | 14.0 (3.9) | 14.6 (4.1) | 13.9 (3.4) | 13.0 (3.8) | 13.6 (3.8) | 0.97, 0.93 to 1.02 | .211 |
Dependent score | 16.8 (4.1) | 17.4 (3.1) | 18.0 (3.1) | 17.0 (3.5) | 17.0 (3.4) | 17.1 (3.5) | 1.00, 0.95 to 1.05 | .984 |
Intuitive score | 18.9 (2.5) | 18.8 (2.3) | 18.5 (2.6) | 19.0 (2.7) | 18.7 (2.9) | 18.7 (2.7) | 0.99, 0.93 to 1.05 | .663 |
Rational score | 18.7 (3.2) | 19.4 (2.0) | 19.9 (2.3) | 19.8 (2.3) | 20.0 (2.8) | 19.6 (2.6) | 1.13, 1.06 to 1.21 |
<.0005
|
Spontaneous score | 14.8 (3.7) | 14.2 (3.5) | 15.4 (3.8) | 14.7 (3.3) | 14.2 (3.6) | 14.5 (3.6) | 1.02, 0.97 to 1.07 | .466 |
Amount read of the bowel screening leaflet: n (%)/M (SD) | Adjusted OR, 95% CI |
p-value | ||||||
---|---|---|---|---|---|---|---|---|
None of it | Some of it | About half of it | Most of it | All of it | Total | Read more of the leaflet | ||
Characteristic | (n = 13; 4.2%) | (n = 44; 14.2%) | (n = 14; 4.5%) | (n = 63; 20.4%) | (n = 175; 56.6%) | (n = 309) | (i.e. any amount more) | |
Gender | ||||||||
Male | 8 (5.0) | 28 (17.5) | 7 (4.4) | 31 (19.4) | 86 (53.8) | 160 | 0.79, 0.50 to 1.27 | .338 |
vs. Female (reference category) | 5 (3.4) | 16 (10.7) | 7 (4.7) | 32 (21.5) | 89 (59.7) | 149 | ||
Ethnicity | ||||||||
White British | 10 (3.5) | 41 (14.5) | 11 (3.9) | 57 (20.2) | 163 (57.8) | 282 | 2.58, 1.20 to 5.56 |
.015
|
vs. Other ethnic groups | 3 (11.1) | 3 (11.1) | 3 (11.1) | 6 (22.2) | 12 (44.4) | 27 | ||
Marital status | ||||||||
Married or living as a couple | 4 (1.9) | 23 (11.1) | 10 (4.8) | 45 (21.7) | 125 (60.4) | 207 | 1.65, 0.99 to 2.76 | .056 |
vs. Single, widowed, divorced, or separated | 9 (8.8) | 21 (20.6) | 4 (3.9) | 18 (17.6) | 50 (49.0) | 102 | ||
Highest level of education | Overall: .003
| |||||||
No formal qualifications | 8 (7.1) | 18 (16.1) | 5 (4.5) | 27 (24.1) | 54 (48.2) | 112 | 0.30, 0.14 to 0.64 |
.002
|
Approximately Level 1, 2, or 3 | 4 (3.2) | 21 (16.9) | 4 (3.2) | 27 (21.8) | 68 (54.8) | 124 | 0.31, 0.15 to 0.40 |
.001
|
vs. Approximately Level 4 | 1 (1.4) | 5 (6.8) | 5 (6.8) | 9 (12.3) | 53 (72.6) | 73 | ||
Social class grade | Overall: .907 | |||||||
Grade A or B | 3 (3.5) | 10 (11.6) | 4 (4.7) | 13 (15.1) | 56 (65.1) | 86 | 0.92, 0.45 to 1.88 | .916 |
Grade C1 or C2 | 5 (4.1) | 11 (9.1) | 4 (3.3) | 32 (26.4) | 69 (57.0) | 121 | 1.06, 0.61 to 1.85 | .844 |
vs. Grade D or E | 5 (4.9) | 23 (22.5) | 6 (5.9) | 18 (17.6) | 50 (49.0) | 102 | ||
Personal diagnosis of cancer | ||||||||
Yes | 2 (5.7) | 2 (5.7) | 2 (5.7) | 10 (28.6) | 19 (54.3) | 35 | 1.18, 0.5 to 2.48 | .662 |
vs. No | 11 (4.0) | 42 (15.3) | 12 (4.4) | 53 (19.3) | 156 (56.9) | 274 | ||
Knows someone with cancer | ||||||||
Yes | 8 (3.9) | 23 (11.3) | 6 (2.9) | 37 (18.1) | 130 (63.7) | 204 | 1.84, 1.13 to 2.99 |
.014
|
vs. No | 5 (4.8) | 21 (20.0) | 8 (7.6) | 26 (24.8) | 45 (42.9) | 105 | ||
Bowel screening regularity | Overall: <.0005
| |||||||
Never or very rarely attended… | 7 (11.3) | 14 (22.6) | 4 (6.5) | 12 (19.4) | 25 (40.3) | 62 | 0.34, 0.19 to 0.59 |
<.0005
|
Attended some or most of the time… | 1 (5.3) | 2 (10.5) | 2 (10.5) | 7 (36.8) | 7 (36.8) | 19 | 0.43, 0.18 to 1.04 | .061 |
vs. Always attended before most recent invitation | 5 (2.2) | 28 (12.3) | 8 (3.5) | 44 (19.3) | 143 (62.7) | 228 | ||
Age (in years) | 65.5 (2.8) | 67.3 (2.6) | 65.8 (3.8) | 65.8 (2.9) | 65.4 (3.3) | 65.8 (3.2) | 0.92, 0.85 to 0.99 |
.029
|
Decision-making style | ||||||||
Avoidant score | 13.1 (3.1) | 13.5 (3.9) | 13.9 (3.8) | 13.0 (3.5) | 12.6 (3.4) | 12.9 (3.5) | 0.96, 0.89 to 1.04 | .298 |
Dependent score | 15.4 (4.7) | 16.5 (3.5) | 16.8 (4.6) | 16.0 (4.1) | 16.5 (3.5) | 16.4 (3.7) | 1.04, 0.97 to 1.11 | .291 |
Intuitive score | 18.1 (3.4) | 18.3 (2.8) | 18.9 (2.6) | 18.8 (2.8) | 18.5 (2.6) | 18.6 (2.7) | 1.10, 1.00 to 1.22 | .061 |
Rational score | 18.2 (4.0) | 19.3 (2.9) | 19.1 (2.1) | 19.8 (2.2) | 20.0 (2.1) | 19.8 (2.4) | 1.11, 1.00 to 1.23 |
.045
|
Spontaneous score | 15.5 (4.4) | 14.5 (3.6) | 14.9 (3.9) | 13.5 (3.0) | 13.2 (3.4) | 13.6 (3.4) | 0.93, 0.86 to 1.00 | .051 |
Predictors of reading the breast screening information leaflet
Predictors of reading the cervical screening information leaflet
Predictors of reading the bowel screening information leaflet
Discussion
Conclusions
n (%) | |||
---|---|---|---|
Reason for exclusion | Breast | Cervical | Bowel |
Inapplicable gender | 989 (46.8) | 989 (46.8) | N/A |
Older or younger than eligible age range | 717 34.0) | 281 (13.3) | 1647 (78.0) |
Previous diagnosis of relevant cancer | 19 (0.9) | 17 (0.8) | 2 (0.1) |
Non-ordinal highest level of education | 33 (1.6) | 81 (3.8) | 55 (2.6) |
No previous screening invitation | 35 (1.7) | 72 (3.4) | 66 (3.1) |
Did not see the screening information leaflet at last invitation | 16 (0.8) | 57 (2.7) | 9 (0.4) |
Missing data on either dependent or independent variables | 27 (1.3) | 58 (2.7) | 23 (1.1) |
Total excluded | 1836 (87.0) | 1555 (73.7) | 1802 (85.4) |
Total analysed | 275 | 556 | 309 |
Amount read of the breast screening leaflet | |||||||||
---|---|---|---|---|---|---|---|---|---|
Read at least some of the leaflet | Read at least about half of the leaflet | Read most/all of the leaflet | Read all of the leaflet | ||||||
Characteristic | (vs. read none) | (vs. read less than about half) | (vs. read less than most/all) | (vs. read less than all) | |||||
OR, 95% CI | p | OR, 95% CI | p | OR, 95% CI | p | OR, 95% CI | p | ||
Ethnicity | |||||||||
White British | 1.66, 0.43 to 6.46 | .464 | 1.43, 0.59 to 3.47 | .428 | 1.76, 0.76 to 4.10 | .187 | 3.28, 1.36 to 7.89 |
.008
| |
vs. Other ethnic groups | |||||||||
Marital status | |||||||||
Married or living as a couple | 1.32, 0.54 to 3.23 | .540 | 0.96, 0.52 to 1.80 | .907 | 0.97, 0.53 to 1.78 | .924 | 0.80, 0.45 to 1.42 | .450 | |
vs. Single, widowed, divorced, or separated | |||||||||
Highest level of education | Overall: .452 | Overall: .913 | Overall: .791 | Overall: .150 | |||||
No formal qualifications | 0.44, 0.10 to 1.90 | .269 | 1.09, 0.44 to 2.68 | .856 | 0.85, 0.36 to 2.01 | .704 | 0.44, 0.19 to 1.01 | .052 | |
Approximately Level 1, 2, or 3 | 0.44, 0.12 to 1.64 | .222 | 1.18, 0.54 to 2.60 | .683 | 1.07, 0.50 to 2.29 | .861 | 0.60, 0.29 to 1.24 | .168 | |
vs. Approximately Level 4 | |||||||||
Social class grade | Overall: .689 | Overall: .925 | Overall: .782 | Overall: .876 | |||||
Grade A or B | 0.73, 0.21 to 2.59 | .631 | 1.18, 0.47 to 2.98 | .731 | 0.77, 0.31 to 1.89 | .565 | 0.90, 0.40 to 2.07 | .811 | |
Grade C1 or C2 | 1.23, 0.43 to 3.54 | .706 | 1.01, 0.50 to 2.06 | .977 | 0.79, 0.39 to 1.59 | .508 | 1.08, 0.57 to 2.05 | .811 | |
vs. Grade D or E | |||||||||
Personal diagnosis of cancer | |||||||||
Yes | 0.70, 0.17 to 2.84 | .612 | 1.25, 0.39 to 4.04 | .708 | 1.11, 0.37 to 3.32 | .846 | 0.90, 0.35 to 2.35 | .834 | |
vs. No | |||||||||
Knows someone with cancer | |||||||||
Yes | 0.66, 0.24 to 1.86 | .435 | 0.71, 0.36 to 1.40 | .328 | 0.90, 0.48 to 1.69 | .750 | 1.23, 0.69 to 2.20 | .493 | |
vs. No | |||||||||
Breast screening regularity | Overall: .008
| Overall: .014
| Overall: .003
| Overall: .014
| |||||
Never or very rarely attended… | 0.12, 0.03 to 0.48 |
.003
| 0.19, 0.06 to 0.58 |
.004
| 0.14, 0.44 to 0.47 |
.001
| 0.16, 0.04 to 0.63 |
.009
| |
Attended some or most of the time… | 1.30, 0.15 to 11.04 | .812 | 0.65, 0.21 to 2.03 | .458 | 0.43, 0.14 to 1.26 | .122 | 0.43, 0.14 to 1.30 | .135 | |
vs. Always attended before most recent invitation | |||||||||
Age (in years) | 1.01, 0.95 to 1.09 | .705 | 0.97, 0.92 to 1.02 | .205 | 0.98, 0.93 to 1.03 | .352 | 0.96, 0.92 to 1.00 |
.048
| |
Decision-making styles | |||||||||
Avoidant score | 1.13, 0.99 to 1.30 | .082 | 0.97, 0.89 to 1.06 | .523 | 0.94, 0.87 to 1.03 | .176 | 0.97, 0.89 to 1.05 | .452 | |
Dependent score | 1.02, 0.91 to 1.14 | .761 | 1.00, 0.92 to 1.09 | .973 | 1.01, 0.93 to 1.09 | .876 | 1.03, 0.96 to 1.11 | .434 | |
Intuitive score | 0.97, 0.82 to 1.13 | .671 | 1.08, 0.96 to 1.21 | .191 | 1.09, 0.98 to 1.22 | .116 | 1.01, 0.91 to 1.12 | .892 | |
Rational score | 1.02, 0.86 to 1.20 | .853 | 0.99, 0.88 to 1.11 | .801 | 0.98, 0.88 to 1.09 | .722 | 1.08, 0.97 to 1.19 | .151 | |
Spontaneous score | 0.92, 0.81 to 1.04 | .169 | 0.99, 0.91 to 1.08 | .861 | 0.98, 0.90 to 0.90 | .653 | 1.03, 0.95 to 1.11 | .528 |