Decision making in cancer primary prevention and chemoprevention.

  • Gorin S
  • Wang C
  • Raich P
 et al. 
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BACKGROUND: We know very little about how individuals decide to undertake, maintain, or discontinue cancer primary prevention or chemoprevention. PURPOSE: The aims of this article are to (a) examine whether and, if so, how traditional health behavior change models are relevant for decision making in this area; (b) review the application of decision aids to forming specific, personal choices between options; and (c) identify the challenges of evaluating these decision processes to suggest areas for future research. METHODS: Theoretical models and frameworks derived from the health behavior change and decision-making fields were applied to cancer primary prevention choices. Decision aids for the human papillomavirus (HPV) vaccine, Hormone Replacement Therapy (HRT), and tamoxifen were systematically examined. RESULTS: Traditional concepts such as decisional balance and cues to action are relevant to understanding cancer primary prevention choices; Motivational Interviewing, Self-Determination Theory, and the Preventive Health Model may also explain the facilitators of decision making. There are no well-tested HPV vaccine decision aids, although there have been some studies on aids for HPV testing. There are several effective decision aids for HRT and tamoxifen; evidence-based decision aid components have also been identified. CONCLUSIONS: Additional theory-based empirical research on decision making in cancer primary prevention and chemoprevention, particularly at the interface of psychology and behavioral economics, is suggested.

Author-supplied keywords

  • Breast Neoplasms
  • Chemoprevention
  • Decision Making
  • Female
  • Forecasting
  • Hormone Replacement Therapy
  • Humans
  • Neoplasms
  • Papillomavirus Infections
  • Papillomavirus Vaccines
  • Primary Prevention
  • Risk Factors
  • Tamoxifen
  • administration & dosage
  • methods
  • prevention & control
  • therapeutic use
  • therapy

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  • Sherri Sheinfeld Gorin

  • Catharine Wang

  • Peter Raich

  • Deborah J Bowen

  • Jennifer Hay

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