@misc{RederBerensSpalleketal., author = {Reder, Maren and Berens, Eva-Maria and Spallek, Jacob and Kolip, Petra}, title = {Development of the Informed Choice in Mammography Screening Questionnaire (IMQ): factor structure, reliability, and validity}, series = {BMC Psychology}, volume = {7}, journal = {BMC Psychology}, number = {1}, issn = {2050-7283}, doi = {10.1186/s40359-019-0291-2}, pages = {12}, abstract = {Background: Informed choice is of ethical and practical importance in mammography screening. To assess the level to which decisions regarding such screening are informed is thus imperative, but no specific instrument has been available to measure informed choice in the German mammography screening programme. The aims of this study were to develop the Informed Choice in Mammography Screening Questionnaire (IMQ) and to find first evidence for the factor structure, reliability and validity of its different components. Methods: The IMQ was sent to 17.349 women aged 50 in Westphalia-Lippe, Germany. The instrument has been developed after consideration of (1) the results of qualitative interviews on decision making in the mammography screening programme, (2) relevant literature on other informed choice instruments and (3) a qualitative study on influencing factors. The IMQ comprises 3 scales (attitude, norms, and barriers), 1 index (knowledge) and singular items covering intention to participate and sociodemographic variables. To assess the psychometric properties of the components of the IMQ, confirmatory factor and item response theory analyses were conducted. Additionally, reliability, validity and item statistics were assessed. Results: 5.847 questionnaires were returned (response rate 33.7\%). For attitude, the confirmatory factor analysis supported a one-factor structure. For norms, the model fit was not acceptable. Reliability levels were good with a Cronbach's α of.793 for attitude (4 items) and.795 for norms (5 items). For barriers, 9 items were deleted because of low discrimination indices; 6 items remained. The hypothesised assumption-subscale and the importance-subscale were confirmed, but these subscales showed poor reliabilities with Cronbach's α=.525 (4 items) and.583 (2 items). For the knowledge index, item response theory analysis showed that 6 out of 7 items were suitable. Hypotheses concerning the correlations between the different components were confirmed, which supported their convergent and divergent validity. Conclusion: The results of this study demonstrated that the IMQ is a multidimensional instrument. Further development of the barriers and norms scales is necessary. The IMQ can be utilised to assess the level of informed choices as well as influencing factors.}, language = {en} } @misc{BerensKaucherEckertetal., author = {Berens, Eva-Maria and Kaucher, Simone and Eckert, Sandra van and Reder, Maren and Kolip, Petra and Spallek, Jacob}, title = {Knowledge about mammography screening in Germany by education and migrant status - results of a cross-sectional study (InEMa)}, series = {Applied Cancer Research}, volume = {39}, journal = {Applied Cancer Research}, number = {6}, issn = {1980-5578}, doi = {10.1186/s41241-019-0076-1}, pages = {8}, abstract = {Background: The population-based mammography screening program (MSP) is aimed to reduce breast cancer mortality, to detect breast cancer at an early stage, and to allow for less invasive treatment. However, it also has some potential harms, such as overdiagnosis and overtreatment. Therefore, it is necessary that women receive sufficient and balanced information to enable informed decision-making. We examined knowledge about benefits and harms of the MSP in Germany among first-time invitees of different socio-demographic backgrounds. Methods: This observational study assessed knowledge about benefits and harms of the MSP among women who were invited to the MSP for the first time by six multiple choice items, using a postal survey. We investigated (i) single items of knowledge, (ii) the distribution of sufficient knowledge stratified by education, migration status and invitation, and (iii) possible determinants of sufficient knowledge by analyzing Odds Ratios (ORs) using bivariate and multivariate logistic regression. Results: In total, 5397 women included in the analyses. 46.1\% of the study population had sufficient knowledge about benefits and harms of the MSP. However, women with low educational level and migration background had higher proportions of insufficient knowledge and used most frequently the option "don't know". Women had the most difficulties answering the numeric question and the question about the target group correctly. Results from the logistic regression showed that the odds of having sufficient knowledge were higher among well-educated women (OR 3.84, 95\%CI 3.24-4.55), among women who already received the MSP invitation (OR 1.38, 95\%CI 1.20-1.59) and lowest among Turkish women (OR 0.14, 95\%CI 0.07-0.25). Conclusions: Women with low education and migration background need adapted information regarding benefits and harms of the MSP and are important target groups for further developing the information material about mammography screening to reduce disparities in knowledge and enable informed decision-making.}, language = {en} } @misc{KaucherKhilKajueteretal., author = {Kaucher, Simone and Khil, Laura and Kaj{\"u}ter, Hiltraud and Becher, Heiko and Reder, Maren and Kolip, Petra and Spallek, Jacob and Winkler, Volker and Berens, Eva-Maria}, title = {Breast cancer incidence and mammography screening among resettlers in Germany}, series = {BMC public health}, volume = {20}, journal = {BMC public health}, number = {1}, doi = {10.1186/s12889-020-08534-7}, pages = {10}, abstract = {Background - European studies showed that women with a migration background are less likely to participate in mammography screenings than autochthonous women. However, the participation in the German mammography screening programme (MSP) among ethnic German migrants from countries of the former Soviet Union (called resettlers) is unclear so far. The aim of this study was to identify possible differences regarding MSP participation between resettlers from the FSU and the general German population. Methods - Data from two independent, complementary studies from North Rhine-Westphalia, Germany (a retrospective cohort study 1994-2013; a cross-sectional study 2013/14) were used for comparisons between resettlers and the general population: Odds Ratios (ORs) for MSP participation utilizing the cross-sectional data and time trends of breast cancer incidence rates as well as Chi-Square tests for breast cancer stages utilizing the cohort data. Results - Resettlers showed higher Odds to participate in the MSP than the general population (OR 2.42, 95\% CI 1.08-5.42). Among resettlers, a large increase in incidence rates was observed during the MSP implementation (2005-2009), resulting in stable and comparable incidence rates after the implementation. Furthermore, pre-MSP implementation, the proportion of advanced breast cancer stages was higher among resettlers than in the German population, post-MSP implementation the proportion was comparable. Conclusions - MSP participating seems surprisingly high among resettlers. An explanation for the increased willingness to participate might be the structured invitation procedure of the MSP. However, the exact reasons remain unclear and future research is needed to confirm this hypothesis and rule out the possibility of selection bias in the cross-sectional study.}, language = {en} }