Older Australian women's intentions and psychological outcomes related to breast screening

The aim of this study is to investigate the impact of information that provides older women with a rationale for no longer being invited to participate in the BreastScreen program on informed choice and psychological outcomes (worry, perceived risk). The design of the study is 3x1, a randomised trial with 3 arms. The trial will be conducted online through the Qualtrics survey platform. An online sample of older women living in Australia will be recruited through a large social research organisation that utilises panels. Eligible participants will be women aged 70-74 years with no personal history of breast cancer or ductal carcinoma in situ (DCIS) who have screened for breast cancer at least once in the past 5 years. Eligible women will be presented with a hypothetical scenario. They will be asked to imagine they have gone for a routine mammogram screening and are now receiving a letter with their results. Participants will then be randomised to one of three letters. Group 1 (control): the final letter women receive from Breast Screen that highlights women are invited for screening from 50 to 74 years and shows a "negative" result - i.e., no breast cancer could be seen on the mammogram. Group 2 (control + intervention 1): final BreastScreen letter + brief text informing women they will no longer receive reminders to screen because associated risks outweigh the benefits. This information will include the main points in brief dot-point form that are covered in the animation video (intervention 2) and will be developed by the research team (including experts in health communication, breast physicians, a general practitioner and geriatrician, and older female consumers) in collaboration with BreastScreen NSW. Group 3 (control + intervention 2): final BreastScreen letter + an animated video (2 minutes in length) informing women they will no longer receive reminders to screen, including more detailed information about the benefit/risk ratio. This information will be developed by the research team in collaboration with BreastScreen NSW. The online intervention will be administered once only with no repeat or subsequent sessions upon completion. It will take 15-20 minutes for participants to complete the questionnaire. Adherence to the intervention will be ensured by utilising the forced response tool in Qualtrics for outcome measurement. The overall time taken to complete the online study will also allow the researchers to determine adherence to the intervention.