Re: improving contraceptive technology is not a zero-sum game.
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Contraception↗
Biomedical subjects
Sandi L Pruitt
Publications and source records attributed to Sandi L Pruitt.
Measures used in studies of informed decision making about cancer screening: a systematic review.
Interventions to promote informed decision making (IDM) for cancer screening are increasingly common. The resulting body of literature provides an opportunity for a systematic review of measures in use. We searched standard databases for intervention trials and other studies of screening decisions and decision aids, finding 2,110 unique citations (most with abstracts) that we reduced to 104 full-text articles; 36 studies met inclusion criteria (prostate = 20, colorectal = 9, breast = 6, cervical = 1). Two independent coders abstracted data on study characteristics, constructs, and measures. Our findings revealed that most studies measured screening (or intention) and knowledge; fewer measured recommended IDM-related constructs and none measured all outcomes proposed for evaluating IDM interventions. Validity and reliability of measures received inadequate attention in study reports, and conceptual overlap exists among measures. Few IDM measures have been developed/carefully adapted from treatment measures and tested for cancer screening or in diverse populations. We recommend that new and in-progress studies emphasize outcomes beyond knowledge-participation in decision making according to personal preference, satisfaction with the process, and consistency between decisions and values. Also needed is better use of theory to guide conceptualization and operationalization of measures, greater attention to reliability and validity (particularly in diverse populations), more thorough reporting of sources and operating characteristics of measures, and increased emphasis and resources focused on these issues by funders, researchers, and journal editors.
Decision Making↗
Knowledge of cervical dysplasia and human papillomavirus among women seen in a colposcopy clinic.
OBJECTIVE: This study was undertaken to evaluate knowledge of cervical dysplasia and human papillomavirus (HPV) among women seen in a colposcopy clinic. STUDY DESIGN: Demographics, knowledge, and psychological distress were assessed in structured interviews with 175 women before, during, and after colposcopy. RESULTS: Respondents had low knowledge scores before and after colposcopy; however, their overall knowledge improved slightly (P = 0.013) following the exam. When responses were examined by question, respondents demonstrated a significant increase of correct answers to only one question: Does dysplasia, or precancerous cells on the cervix, always go away without treatment? Pre-exam knowledge was positively associated with educational level and was lower among Hispanics and patients recruited at the clinic. Post-exam knowledge was positively associated with pre-exam knowledge and educational level. CONCLUSION: Routine clinical education during colposcopy can improve patients' understanding of cervical cancer; however, the low level of knowledge that persisted after colposcopy is a cause for concern.
Adolescent↗
Contraception or abortion? Inaccurate descriptions of emergency contraception in newspaper articles, 1992-2002.
BACKGROUND: Media portrayals of emergency contraception (EC) may influence public health policy and the public's acceptance of this reproductive health option. OBJECTIVES: We investigated the accuracy of newspaper coverage of EC, 1992-2002. METHODS: We conducted a content analysis of a sample of 1077 articles in 113 newspapers discussing both EC and abortion and determined the frequency of confusion between the two. RESULTS: Of all articles, 44.5% (n = 479) included at least one instance of confusion between EC and medical abortion. Inaccurate portrayal of the mode of action of EC as medical abortion occurred in 31.8% (n = 343) of articles; 13.1% (n = 141) inappropriately applied terms such as "abortifacient postcoital contraceptives" for EC. CONCLUSIONS: Errors were prevalent, persisted over time and may have contributed to incorrect beliefs about a form of contraception that is used infrequently, despite its potential to deter unintended pregnancy and abortion.
Abortion, Induced↗