Lindsay AbrigoMPH 515 – Principles of Health BehaviorDr. Kimberly BrodieOctober 22, 2013

Test Your Breasts Learning Objectives

Increase awareness of breast cancer› All levels of society (i.e. family, friends, general public,

medical professional community) Emphasize importance of early detection

› Education and implementation Provide necessary information and basic knowledge

› Gain understanding of breast cancer Educate proper technique for breast self-exams

Target Population

Teenage girls aged 17-18 years› High school seniors› Attend a private, Catholic high school

Approaching age for having annual exams with gynecologist including clinical breast exam

Become familiarized with their bodies› Know what is normal for them

Learn how to perform breast self-exams

Instructional Methods

“Test Your Breasts” Questionnaire› Distributed at the start of the program› Identifies participants who are related to/know of someone who

has/has had and beat/died of breast cancer› Questions focused on knowledge of breast cancer/BSE, how/where

knowledge was gained, individuals’ belief of risk, and susceptibility Lecture Presentation

› Delivers information about breast cancer: types/stages of rbeast cancer, early detection and screening, risk factors, and step-by-step guide to preform BSE (Instructional handout with steps provided)

Informational Brochure› Distributed during presentation and is supplemental to the BSE

handout with step-by-step instructions

Instructional Methods

“Test Your Breasts” Reminder Cards› Step-by-step to perform BSE and reminds participants of its importance

Quick, easily accessible, efficient, convenient Easily distributed to friends/families of participants

Door Hanger› Displays statistics of breast cancer, can be displayed anywhere, and serves as another reminder› Place it wherever they choose and serves as another reminder tool

“Breastology Bag”› Provided to eat participant at start of the program› Teaches participants how to feel for changes in their breasts and how to properly perform BSE

Mammary Game› Designed similar to the game Jeopardy› Test participants’ learned knowledge gained through lecture/how well they retained information

“Test Your Breast Knowledge” Assessment› Final to determine how much information was retained/understood› Reassesses each participants’ risk perception and readiness to make intended behavioral changes› Assesses each participants’ confidence in performing BSE

Overview of Breast Cancer

Uncontrolled growth of breast cells that undergo a mutation or abnormal change

1 out of 8 women in the United States will develop breast cancer

In 2007, CDC states 202,964 women were diagnosed with breast cancer› 40,598 of those women died

Women with a family history of breast cancer are two to three times more likely to develop breast cancer

Breast Self-Exams (BSE)

Option for females starting in their 20s

Checking breasts for lumps or changes› Looking and feeling

70% of all breast cancers found through self exams

How to Perform BSE

How to test your breasts› Apply different amounts of pressure› Three patterns to examine breast

What to look for when you Test Your Breasts› Lumps or thickening› Puckering› Inflammation› Nipple discharge

When to Test Your Breasts› Standing up› Laying down

Application of Health Belief Model

Perceived Susceptibility› Participant’s opinion of getting breast cancer› Questionnaire determines which participants have a family history or know of

someone who has, has had, or died of breast cancer› Lecture discusses risk factors, symptoms, causes, and incidence

Perceived Severity› Participant’s opinion of the seriousness/consequences of breast cancer› Lecture discusses consequences/risk of getting breast cancer

Perceived Benefits› Participant’s belief in efficacy of BSE to reduce risk/know how their breasts feel

normally› Lecture explains how/when/where to perform BSE› Brochure/other materials emphasize importance of performing BSE

Application of Health Belief Model

Perceived Barriers› Participant’s opinion of costs/barriers of performing BSE› Lecture allows participants to engage/share concerns/ask questions› Encourage others to get involved

Cues to Action› Strategies used to activate participant’s readiness to perform BSE› Brochure and handout provides step-by-step instructions on performing

BSE› Reminder cards will remind participants and family/friends of the

importance to perform BSE and promote awareness Self-efficacy

› Participant’s confidence in their ability to take action› Instructions train each participant on properly performing BSE

Breast Self-Exams in Current Practice

Health Belief Model used as framework to guide formative research of risk perception for breast cancer› Silk et al. (2006)› Adolescent females/adult females in 4 Michigan counties› 10 focus groups conducted/analyzed based on HBM

Adolescent and mother groups recognized gender and heredity as relevant risk factors related to susceptibility› Detection as a strategy to decrease severity of breast cancer

Adolescent girls expressed more about efficacy issues Mothers focused significantly more on role of government and

industry in breast cancer prevention and treatment

Breast Self-Exams in Current Practice

Descriptive, cross-section study› Karayurt, Özmen, and Çetinkaya (2008)› Target population: High school students at vocational high school

for girls in Turkey, 2006-2007 academic year› 718 female students

Investigate knowledge and practice of BSE Determine knowledge of risk factors for breast cancer Instruments used for data collection:

› Sociodemographic charactistics data form› Knowledge of BSE and risk factors for breast cancer form› BSE practice form

Breast Self-Exams in Current Practice

6.7% performed BSE monthly; 20.3% irregularly Female high school students had little knowledge of:

› Risk factors for breast cancer› Appropriate time for BSE› Proper technique for performing BSE› Frequency of performing BSE

Most common reasons for not performing BSE:› “Not knowing how to perform BSE”› “Not expecting to get breast cancer”› “Not having a close relative with breast cancer”

Most widely known risk factors:› Personal history of breast cancer› Family history of breast cancer

Recommendations

Although breast cancer in teens in rare, it is important for teenage girls to start thinking about breast cancer› Symptoms, risks, causes, and incidence

Teens must take necessary steps and precautions› Become familiar with their bodies, particularly their breasts

Know what is normal for them These young women will be the first to recognize a difference

BSE education should be taught to teenage girls and further encouraged by medical professionals› How to properly perform BSE and what to look for

Conclusion

Instructional methods selected specifically for target population and successfully delivered intended messages:› Informing females in high school about breast cancer symptoms,

causes, and risk factors› Emphasizing importance of performing BSE› Encouraging and promoting good health behaviors

Carry into adulthood and pass on to others Program participants were able to confidently perform BSE

according to step-by-step instructions provided Participants more knowledgeable about necessity of performing

BSE› Involve other female family and friends by utilizing the materials

provided during program