ABSTRACT
We explored longitudinal associations between religion/spirituality (R/S) Salience and R/S Attendance, and colorectal cancer screening, among adults aged ≥ 50 years in Alberta, Canada. R/S Salience was not statistically significantly associated with colorectal cancer screening (adjusted odds ratio [aOR]: 1.06, 95% confidence interval [CI] 0.88-1.28). Conversely, R/S Attendance was statistically significantly associated with higher odds of colorectal cancer screening: the aOR was 1.28 (95% CI 1.02-1.59) for participants attending services at least once a month and 1.31 (95% CI 1.01-1.69) for participants attending between one and four times yearly, compared to participants who never attended. Researchers should explore the possibility of delivering colorectal cancer screening programs in R/S settings.
ABSTRACT
Breast cancer is the leading cause of cancer-related mortality among women. Screening permits the early detection and treatment of malignancies, thereby reducing mortality. A woman's religiosity and spirituality (R/S) may facilitate screening through encouragement of healthy behaviors. Population-level data from Alberta's Tomorrow Project (ATP) were used to explore the cross-sectional association between R/S and breast cancer screening among women aged 50 to 69 years who did not have a history of breast cancer. Two variables were used to measure R/S: (1) R/S Salience was defined as the importance of religion and spirituality in one's life; (2) R/S Attendance was defined as the frequency of attendance at religious or spiritual services. We regressed breast cancer screening (mammogram: yes/no) on each R/S variable in separate multivariable logistic regression models. At baseline (n = 2569), 94% of women reported receiving a mammogram. Greater R/S Salience was not associated with receipt of mammogram: the adjusted odds ratio (aOR) was 1.04 (95% confidence interval [CI]: 0.71-1.51. R/S Attendance also showed no association with mammogram: attending at least once monthly versus never attending (aOR: 1.10; 95% CI: 0.71-1.69); attending one to four times yearly versus never attending (aOR: 0.95, 95% CI: 0.57-1.58). Further research could examine specific subgroups of the population, e.g., whether use of R/S to promote breast cancer screening may be more effective among females with strong pre-existing connections to faith.
ABSTRACT
OBJECTIVE: To explore and characterize published evidence on the ways decision analysis has been used to inform shared decision-making. STUDY DESIGN AND SETTING: For this scoping review, we searched five bibliographic databases (from inception until February 2021), reference lists of included studies, trial registries, a thesis database and websites of relevant interest groups. Studies were eligible if they evaluated the application of decision analysis in a shared decision-making encounter. Pairs of reviewers independently screened and selected studies for inclusion, extracted study information using a data extraction form developed by the research team and assessed risk of bias for all studies with an experimental or quasi-experimental design. Data were narratively synthesized. RESULTS: We identified 27 studies that varied greatly with regard to their patient population, design, content and delivery. A range of outcomes were evaluated to explore the effectiveness and acceptability of decision analytic interventions, with little information about the implementation process. Most studies found that decision analysis was broadly beneficial. CONCLUSION: Despite the compelling rationale on the potential for decision analysis to support shared decision-making, rigorous randomized controlled trials are needed to confirm these interventions' effectiveness, while qualitative studies should seek to understand their potential implementation.
