Core principles that should guide the development of future screening materials, with illustrative comments by participants*
| Principle | Illustrative quote |
|---|---|
| Accurate and evidence-based | “The best way you protect your health is by getting a mammogram every 2 years.” The best way to protect my health? Well, there’s lots of ways to protect my health, and they have nothing to do with getting mammograms. So that may be a big statement to make; it’s not entirely true. (PB3) Because [screening organizations] have that credibility, I think … the onus should be on them to be more balanced. (PA10) I think that if [the evidence is] not in the pamphlets, then it hurts the credibility of the organization. (PA4) |
| Comprehensive | I have to read this and think “This is what I want to do.” Not “Hmm, maybe I need to research more.” It should give me everything I need as a good starting point to make a decision. (PB4) You see here, and they are all guilty of the same darn thing — are mammograms safe? Do they hurt? All they do is talk to the actual mammogram … not about risk, ever, really, anywhere. (PA2) It’s almost like it needs an index at the front that has the categories of information that are in there. So, if all you’re looking for is how should I prepare for my appointment, you go to page 5. If it’s what should I be expecting from my doctor, it’s a little bit of a table of contents, almost, that would guide you through it. Because I think there’s a lot of good information in here, but I agree with you, [the chance of] anybody who would actually sit down and read through the whole thing is probably fairly minimal. But it’s like “Well, there’s the one thing that I’m wondering about that I would like to find.” (PD3) |
| Choice | Just enough [information] to make that informed decision and choice, that’s what I value. Informed choice. Educated decisions. (PB1) I think the only other thing … [is] sort of asking the question when you get the letter of how to decide if breast cancer screening is right for you. So it’s some considerations, like even a hint, at there are some things that you should think about. How to decide if it’s right for you. And maybe it’s 4 or 5 provocative questions that you should be asking yourself. (PD3) Don’t sell me on the mammography, give me the information so I can make a choice. (PA5) |
| Accessible | The font is clearly not for the 50–74 age group, and I find that so annoying because look at who is trying to read this. And we hate getting our reading glasses out. (PC5) |
| Consistent | When I go to a McDonald’s or [Tim Horton’s], I want my coffee to be the same right across Canada. So when I go for medical treatment — and that’s more important to me than my coffee — I want to be able to get the same information if I live in Ontario or [if] my child goes to the east coast for school and stays there, I want to know that she’s getting the same [information] as I am. (PC6) This should be a national discussion, it doesn’t really matter where we live, we’re all going to be affected the same way. (PD11) |
| Transparent | This idea of treating as many people as possible — that’s totally in conflict with the idea of supporting people in making a choice and a decision, because the [earlier] part is saying that we’re going to keep pushing people, regardless … our goal is to get as many people as possible through screening, if they decide it’s appropriate for them or not. (PD8) This one that does the risks and the benefits is nice because I think I tend to believe [it] more. If they give you the benefits and they give you the risks, too, it’s almost giving it more credibility because they are telling you what the risks or the cons are as well. So, to me, this gives this more credibility. (PB4) |
↵* Participants are identified by deliberation (A, B, C or D) and participant number (e.g., A1).