国际上，人群乳腺癌筛查正朝着风险分层的方法发展，并需要当前和未来的筛查对象的参与和接受。基于妇女的观点、价值观和对风险分层乳腺癌筛查的知识，制定了一份决策辅助工具（网址：www.defineau.org）。本研究旨在评估该决策辅助工具对妇女的知识、风险感知、风险评估接受度、筛查频次变化和决策过程的影响。在本文中，我们报道了一项前后调查的结果，邀请维多利亚州乳腺筛查中心的妇女客户在查看决策辅助工具之前和之后完成在线问卷调查。共邀请了3200名潜在参与者，其中242人回应，127人完成了两次调查。在查看决策辅助工具后，知识、接受风险分层乳腺癌筛查和降低低风险筛查频次方面发生了显著变化。高水平的风险分层接受度、遗传测试和针对个体的筛查支持在查看前后均得以维持。DEFINE决策辅助工具对于接受较低频次筛查有积极影响，这是风险分层策略成功的重要障碍，并有可能促进澳大利亚人群乳腺癌筛查计划的变革。© 2023. Springer Nature Limited.

Internationally, population breast cancer screening is moving towards a risk-stratified approach and requires engagement and acceptance from current and future screening clients. A decision aid ( www.defineau.org ) was developed based on women's views, values, and knowledge regarding risk-stratified breast cancer screening. This study aims to evaluate the impact of the decision aid on women's knowledge, risk perception, acceptance of risk assessment and change of screening frequency, and decision-making. Here we report the results of a pre and post-survey in which women who are clients of BreastScreen Victoria were invited to complete an online questionnaire before and after viewing the decision aid. 3200 potential participants were invited, 242 responded with 127 participants completing both surveys. After reviewing the decision aid there was a significant change in knowledge, acceptance of risk-stratified breast cancer screening and of decreased frequency screening for lower risk. High levels of acceptance of risk stratification, genetic testing and broad support for tailored screening persisted pre and post review. The DEFINE decision aid has a positive impact on acceptance of lower frequency screening, a major barrier to the success of a risk-stratified program and may contribute to facilitating change to the population breast screening program in Australia.© 2023. Springer Nature Limited.