Effects of a risk-based online mammography intervention on accuracy of perceived risk and mammography intentions

• We developed and tested a risk-based mammography decision intervention.
• Match between objective estimates of BC risk and mammography intentions improved.
• Accuracy of breast cancer risk perceptions increased.
• Effects on risk perceptions were more pronounced for high-numeracy women.

ObjectiveThis experiment tested the effects of an individualized risk-based online mammography decision intervention. The intervention employs exemplification theory and the Elaboration Likelihood Model of persuasion to improve the match between breast cancer risk and mammography intentions.Methods2918 women ages 35–49 were stratified into two levels of 10-year breast cancer risk (<1.5%; ≥1.5%) then randomly assigned to one of eight conditions: two comparison conditions and six risk-based intervention conditions that varied according to a 2 (amount of content: brief vs. extended) x 3 (format: expository vs. untailored exemplar [example case] vs. tailored exemplar) design. Outcomes included mammography intentions and accuracy of perceived breast cancer risk.ResultsRisk-based intervention conditions improved the match between objective risk estimates and perceived risk, especially for high-numeracy women with a 10-year breast cancer risk ≤1.5%. For women with a risk ≤1.5%, exemplars improved accuracy of perceived risk and all risk-based interventions increased intentions to wait until age 50 to screen.ConclusionA risk-based mammography intervention improved accuracy of perceived risk and the match between objective risk estimates and mammography intentions.Practice implicationsInterventions could be applied in online or clinical settings to help women understand risk and make mammography decisions.