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Informed choice in screening programmes: do leaflets help? A critical literature review.

Rosemary Fox1

  • 1National Public Health Service for Wales, Temple of Peace and Health Cathays Park, Cardiff CF10 3NW, UK. rosemary.fox@nphs.wales.nhs.uk

Journal of Public Health (Oxford, England)
|October 25, 2006
PubMed
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Information leaflets in health screening increase knowledge but do not guarantee informed choice. Further research is needed to determine effective methods for promoting informed decision-making in screening programmes.

Area of Science:

  • Public Health
  • Health Communication
  • Decision Science

Background:

  • Screening programmes aim to balance maximizing population benefit through high uptake with ensuring individuals can make informed choices about participation.
  • Information leaflets are commonly provided to potential participants in screening programmes.
  • This review examines the effectiveness of these leaflets in facilitating informed choice.

Purpose of the Study:

  • To review existing research on the effectiveness of information leaflets in promoting informed choice in health screening.
  • To identify gaps in understanding and measurement of informed choice in screening contexts.

Main Methods:

  • A systematic search of 15 electronic databases and UK screening programme websites was conducted.
  • Bibliographies of identified studies were searched, and experts were contacted.

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  • Included studies were randomized controlled trials (RCTs) and controlled clinical trials assessing leaflet contribution to informed screening decisions.

    • Main Results:

    • Nine trials across various screening programmes were identified.
    • While most studies showed leaflets increased knowledge, evidence for promoting informed choice was weak.
    • Measured outcomes included knowledge, attitudes, intention, uptake, anxiety, satisfaction, and perceived adequacy of information.

    Conclusions:

    • The definition and measurement of informed choice in screening research remain unclear, hindering progress.
    • Relying solely on written information is insufficient for achieving informed choice in screening programmes.
    • Additional strategies beyond leaflets are necessary to effectively promote informed choice.