1
|
Mahboobighazaani F, Karimi M, Azadbakht M, Ghahremani L. The effectiveness of educational intervention based on the Health Action Model (HAM) in improving breast cancer screening behaviors. BMC Womens Health 2024; 24:21. [PMID: 38172783 PMCID: PMC10765812 DOI: 10.1186/s12905-023-02816-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/28/2023] [Indexed: 01/05/2024] Open
Abstract
INTRODUCTION Breast cancer disease is known as the most common cancer among women. Lack of knowledge and awareness is a leading cause of breast cancer, and since nearly all women are increasingly susceptible to this disease, training screening behaviors for early detection is proven essential in order to reduce breast cancer mortality. Therefore, the present study was designed to determine the effect of educational intervention based on the Health Action Model in improving breast cancer screening behaviors in women aged 30 to 69 in Kashan, Iran. METHODS This quasi-experimental study was conducted on 162 women aged 30-69 years old among the clients of Comprehensive health service centers in Kashan, Iran and they were assigned to intervention and control groups. The research instrument included a questionnaire assessed within three phases: baseline, 3-months, and 6-months, containing Health Action Model (HAM) structures and also three screening behaviors. The intervention consisted of a model-based education package and was carried out over 2 months. To evaluate the effect of the intervention, the mean of model structures and proportion screening behaviors in the third and sixth months were compared with the baseline phase. All analyses were carried out using SPSS, version 22. RESULTS The intervention and control groups were homogeneous regarding the structures of the HAM and the proportion of screening behaviors in the baseline phase (p > 0.05). In the 3-month (p < 0.05) and 6-month (p < 0.05) phases, the mean scores of the HAM constructs in the intervention group were found higher compared with the control group. Moreover, the proportion of clinical breast examinations in the intervention group was statistically higher than in the control group in the 3-month (p < 0.001) and 6-month (p < 0.001) phases. In addition, the proportion of mammography performed in the 3-month (p = 0.002) and 6-month (p < 0.001) phases were reported to be higher in the intervention group compared with the control group. CONCLUSION Overall, these results provide important insight into the effectiveness of the interventions based on the Health Action Model in promoting breast cancer screening behaviors and the determinants of such behaviors.
Collapse
Affiliation(s)
- Fahimeh Mahboobighazaani
- Student Research Committee, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Razi Ave, Shiraz, Iran
| | - Masoud Karimi
- Student Research Committee, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Razi Ave, Shiraz, Iran
| | | | - Leila Ghahremani
- Student Research Committee, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Razi Ave, Shiraz, Iran.
| |
Collapse
|
2
|
Friedman-Eldar O, Zippel D, Guy-Chen H, Eitan Gur S, Ben-Baruch N, Sharon E, Allweis TM. Advanced Breast Cancer at Diagnosis: Over One Third Adherent to Screening Recommendations. WOMEN'S HEALTH REPORTS 2020; 1:301-307. [PMID: 33786493 PMCID: PMC7784813 DOI: 10.1089/whr.2020.0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/28/2020] [Indexed: 11/16/2022]
Abstract
Background: Advanced breast cancer (ABC) at diagnosis carries a worse prognosis, and can be attributed to delay in diagnosis, failure of screening tests, or aggressive biology. Better understanding of factors related with ABC at diagnosis could help decrease the proportion of such cases. Patients and Methods: This is a retrospective study of all patients diagnosed and treated for breast cancer (BC) at a single institution between 2012 and 2015. Data were collected from medical records and phone interviews, and included demographic, clinical, and tumor-related data, and adherence to screening recommendations. Results: Of 555 newly diagnosed BC patients, 390 (70.3%) were diagnosed early (stage 0–IIa), and 165 (29.7%) were diagnosed with ABC (stage IIb–IV). Of the165 patients diagnosed with ABC, 57 (34.5%) underwent screening mammography as recommended. More patients with ABC were <50 years (29.1% vs. 19%, p = 0.006). ABC was associated with higher grade, higher proliferation rate, Her2/neu overexpression, luminal B-like, and triple negative phenotypes. Mammography within 30 months of diagnosis was more prevalent among those diagnosed early (64.6% vs. 34.5%, p = 0.003). Only 31 (18.8%) of the screening eligible patients who were diagnosed at advanced stage did not adhere to screening recommendations. Conclusions: ABC at diagnosis is related to aggressive tumor biology and age <50 years. It is also associated with lower adherence to screening mammography; however, more than one third of patients diagnosed with ABC who were eligible for screening underwent screening mammography as recommended. Further research is needed to elucidate factors related with ABC at diagnosis, review screening guidelines, and develop more effective screening modalities.
Collapse
Affiliation(s)
- Orli Friedman-Eldar
- Department of Surgery and Sarah Markowitz Breast Health Center, Kaplan Medical Center, Rehovot, Israel.,Meirav Breast Unit, Sheba Medical Center, Ramat-Gan, Israel
| | - Douglas Zippel
- Meirav Breast Unit, Sheba Medical Center, Ramat-Gan, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Helit Guy-Chen
- Department of Plastic Surgery, Kaplan Medical Center, Rehovot, Israel
| | - Shlomi Eitan Gur
- Department of Plastic Surgery, Kaplan Medical Center, Rehovot, Israel
| | - Noa Ben-Baruch
- Department of Oncology, Kaplan Medical Center, Rehovot, Israel
| | - Eran Sharon
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Breast Surgery Unit, Rabin Medical Center, Petach-Tikva, Israel
| | - Tanir M Allweis
- Department of Surgery and Sarah Markowitz Breast Health Center, Kaplan Medical Center, Rehovot, Israel.,Hebrew University Medical School, Jerusalem, Israel
| |
Collapse
|
3
|
Salmani F, Moodi M, Yousefi A, Norozi E. Healthy Beliefs regarding Breast Cancer Screening in Iranian Women Health Volunteers: A Path Analysis. Korean J Fam Med 2020; 42:132-139. [PMID: 32460471 PMCID: PMC8010436 DOI: 10.4082/kjfm.20.0001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 03/17/2020] [Indexed: 11/16/2022] Open
Abstract
Background In Iran, 82% of breast cancer cases are diagnosed in late stages, resulting in low survival rates. In the present study, the Stages of Change Theory and Health Belief Model were used as theoretical frameworks for assessing Women Health Volunteer readiness to act on different breast cancer screening behaviors. Methods A total of 1,410 Women Health Volunteers were enrolled in this cross-sectional study. The breast self-examination (BSE) and mammography stages of change were measured independently. A standardized questionnaire based on the Health Belief Model was used to assess their beliefs about breast cancer screening methods. A path analysis using PASW SPSS ver. 18.0 (SPSS Inc., Chicago, IL, USA) was used to test the effects of individual beliefs on breast cancer screening stages of change. Results Most participants were classified in the pre-contemplation stage of breast cancer screening behaviors. Perceived barriers, benefits, and susceptibility emerged as BSE stages of change predictors. No beliefs were significant mammography stages of change predictors. Conclusion Iranian Women Health Volunteers had a very low adherence to common BSE and mammography practices. Healthy beliefs have a strong association with the stages of change for performing BSE, but not for mammography. The impact of health beliefs on an individual’s readiness to act on different breast cancer screening methods may vary with respect to the type of screening method.
Collapse
Affiliation(s)
- Fatemeh Salmani
- Social Determinants of Health Research Center, Department of Epidemiology and Biostatistics, Faculty of Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Mitra Moodi
- Social Determinants of Health Research Center, Department of Public Health, Faculty of Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Azam Yousefi
- Social Determinants of Health Research Center, Student Research Committee, Birjand University of Medical Science, Birjand, Iran
| | - Ensiyeh Norozi
- Social Determinants of Health Research Center, Department of Public Health, Faculty of Health, Birjand University of Medical Sciences, Birjand, Iran
| |
Collapse
|
4
|
Albeshan SM, Hossain SZ, Mackey MG, Brennan PC. Can Breast Self-examination and Clinical Breast Examination Along With Increasing Breast Awareness Facilitate Earlier Detection of Breast Cancer in Populations With Advanced Stages at Diagnosis? Clin Breast Cancer 2020; 20:194-200. [PMID: 32147405 DOI: 10.1016/j.clbc.2020.02.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 01/20/2020] [Accepted: 02/02/2020] [Indexed: 12/13/2022]
Abstract
Breast cancer is the most common form of cancer among women worldwide. Early detection is central to improving disease outcomes. Three main screening methods - mammography, breast self-examination (BSE), and clinical breast examination (CBE) - have been developed and tested in Western nations. There is ongoing debate regarding the efficacy of BSE and CBE in terms of mortality reduction, and a number of international organizations no longer recommend them as screening methods. In technically less developed countries, however, where women are usually diagnosed with breast cancer at advanced stages and younger ages, the benefits of BSE and CBE might outweigh the harm and facilitate early detection of breast cancer. This paper reviews the history of BSE and CBE and discusses their value as early detection methods. It can contribute to informed decision-making by health policy-makers and clinicians who are involved in breast cancer screening in the developing world to improve women's well-being.
Collapse
Affiliation(s)
- Salman M Albeshan
- Medical Radiation Sciences, Medical Image Optimization and Perception Group (MIOPeG), Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia; Department of Radiological Sciences, College of Applied Medical Sciences, King Saud University (KSU), Kingdom of Saudi Arabia, Riyadh, Saudi Arabia.
| | - Syeda Z Hossain
- Discipline of Behavioural and Social Sciences in Health, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Martin G Mackey
- Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Patrick C Brennan
- Medical Radiation Sciences, Medical Image Optimization and Perception Group (MIOPeG), Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
5
|
Abrao Nemeir I, Saab J, Hleihel W, Errachid A, Jafferzic-Renault N, Zine N. The Advent of Salivary Breast Cancer Biomarker Detection Using Affinity Sensors. SENSORS (BASEL, SWITZERLAND) 2019; 19:E2373. [PMID: 31126047 PMCID: PMC6566681 DOI: 10.3390/s19102373] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 05/09/2019] [Accepted: 05/20/2019] [Indexed: 12/14/2022]
Abstract
Breast Cancer is one of the world's most notorious diseases affecting two million women in 2018 worldwide. It is a highly heterogeneous disease, making it difficult to treat. However, its linear progression makes it a candidate for early screening programs, and the earlier its detection the higher the chance of recovery. However, one key hurdle for breast cancer screening is the fact that most screening techniques are expensive, time-consuming, and cumbersome, making them impractical for use in several parts of the world. One current trend in breast cancer detection has pointed to a possible solution, the use of salivary breast cancer biomarkers. Saliva is an attractive medium for diagnosis because it is readily available in large quantities, easy to obtain at low cost, and contains all the biomarkers present in blood, albeit in lower quantities. Affinity sensors are devices that detect molecules through their interactions with biological recognition molecules. Their low cost, high sensitivity, and selectivity, as well as rapid detection time make them an attractive alternative to traditional means of detection. In this review article, we discuss the current status of breast cancer diagnosis, its salivary biomarkers, as well as the current trends in the development of affinity sensors for their detection.
Collapse
Affiliation(s)
- Imad Abrao Nemeir
- Faculty of Sciences, Holy Spirit University of Kaslik, 446 Jounieh, Mount Lebanon, Lebanon.
- Institut des Sciences Analytiques, Université de Lyon, Claude Bernard Lyon 1, UMR 5280, CNRS - 5, rue de la Doua, 69100 Villeurbanne, France.
| | - Joseph Saab
- Faculty of Sciences, Holy Spirit University of Kaslik, 446 Jounieh, Mount Lebanon, Lebanon.
| | - Walid Hleihel
- Faculty of Sciences, Holy Spirit University of Kaslik, 446 Jounieh, Mount Lebanon, Lebanon.
| | - Abdelhamid Errachid
- Institut des Sciences Analytiques, Université de Lyon, Claude Bernard Lyon 1, UMR 5280, CNRS - 5, rue de la Doua, 69100 Villeurbanne, France.
| | - Nicole Jafferzic-Renault
- Institut des Sciences Analytiques, Université de Lyon, Claude Bernard Lyon 1, UMR 5280, CNRS - 5, rue de la Doua, 69100 Villeurbanne, France.
| | - Nadia Zine
- Institut des Sciences Analytiques, Université de Lyon, Claude Bernard Lyon 1, UMR 5280, CNRS - 5, rue de la Doua, 69100 Villeurbanne, France.
| |
Collapse
|
6
|
Buribekova R, Shukurbekova I, Ilnazarova S, Jamshevov N, Sadonshoeva G, Sayani S, Aminmuhammad A, Amersi F, Asaria S, Saleh M, Talib Z. Promoting Clinical Breast Evaluations in a Lower Middle-Income Country Setting: An Approach Toward Achieving a Sustainable Breast Health Program. J Glob Oncol 2018; 4:1-8. [PMID: 30241226 PMCID: PMC6223421 DOI: 10.1200/jgo.17.00103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To promote a systems-based approach for the early detection and downstaging of breast cancer at presentation in the remote mountainous region of Gorno Badakhshan Autonomous Oblast (GBAO), Tajikistan, by introducing breast cancer awareness into the community and training health care professionals in clinical breast evaluation (CBE). METHODS Through a public-private partnership between the Ministry of Health, the Aga Khan Health Services, Tajikistan, and the Aga Khan Health Board, we organized breast cancer screening in the community and trained family medicine doctors (FMDs) and family medicine nurses (FMNs) in CBE. We identified and trained CBE master trainers, who, in turn, systematically trained FMNs to conduct CBEs in each of the remote regional clinics. RESULTS Between 2014 and 2017, 47 FMDs (85% of all FMDs in GBAO), 166 FMNs (55% of all FMNs in GBAO), and six master trainers were trained. Of 3,556 women who were screened, abnormal CBEs were noted in 696 of them (20%). Of the last 1,101 CBEs that were performed by trainee FMNs, with secondary CBEs by master trainers, the rate of abnormal CBEs plateaued at 9%. A total of 18 women were diagnosed with breast cancer-2.6% of abnormal CBEs and 0.5% of all screened women. CONCLUSION A dual-pronged approach of community awareness and CBE training of health care professionals, supported by CBE master trainers, offers a sustainable approach for the early detection of breast pathology. We observed anecdotal evidence of clinical early-stage detection over time with improved CBE proficiency and community acceptance. Sustaining this program will require advocacy by health care providers and a responsive public policy to support the early detection and treatment of breast cancer across the region.
Collapse
Affiliation(s)
- Roziya Buribekova
- Roziya Buribekova, Irina Shukurbekova, Surayo Ilnazarova, Nekruz Jamshevov, and Guldarbogh Sadonshoeva, Aga Khan Health Services, Dushanbe, Tajikistan; Saleem Sayani and Aliya Aminmuhammad, Aga Khan University; Farin Amersi, Sheemain Asaria, Mansoor Saleh, and Zohray Talib, Aga Khan Health Board, Karachi, Pakistan; Zohray Talib, George Washington University School of Medicine, Washington, DC; and Mansoor Saleh, University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Irina Shukurbekova
- Roziya Buribekova, Irina Shukurbekova, Surayo Ilnazarova, Nekruz Jamshevov, and Guldarbogh Sadonshoeva, Aga Khan Health Services, Dushanbe, Tajikistan; Saleem Sayani and Aliya Aminmuhammad, Aga Khan University; Farin Amersi, Sheemain Asaria, Mansoor Saleh, and Zohray Talib, Aga Khan Health Board, Karachi, Pakistan; Zohray Talib, George Washington University School of Medicine, Washington, DC; and Mansoor Saleh, University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Surayo Ilnazarova
- Roziya Buribekova, Irina Shukurbekova, Surayo Ilnazarova, Nekruz Jamshevov, and Guldarbogh Sadonshoeva, Aga Khan Health Services, Dushanbe, Tajikistan; Saleem Sayani and Aliya Aminmuhammad, Aga Khan University; Farin Amersi, Sheemain Asaria, Mansoor Saleh, and Zohray Talib, Aga Khan Health Board, Karachi, Pakistan; Zohray Talib, George Washington University School of Medicine, Washington, DC; and Mansoor Saleh, University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Nekruz Jamshevov
- Roziya Buribekova, Irina Shukurbekova, Surayo Ilnazarova, Nekruz Jamshevov, and Guldarbogh Sadonshoeva, Aga Khan Health Services, Dushanbe, Tajikistan; Saleem Sayani and Aliya Aminmuhammad, Aga Khan University; Farin Amersi, Sheemain Asaria, Mansoor Saleh, and Zohray Talib, Aga Khan Health Board, Karachi, Pakistan; Zohray Talib, George Washington University School of Medicine, Washington, DC; and Mansoor Saleh, University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Guldarbogh Sadonshoeva
- Roziya Buribekova, Irina Shukurbekova, Surayo Ilnazarova, Nekruz Jamshevov, and Guldarbogh Sadonshoeva, Aga Khan Health Services, Dushanbe, Tajikistan; Saleem Sayani and Aliya Aminmuhammad, Aga Khan University; Farin Amersi, Sheemain Asaria, Mansoor Saleh, and Zohray Talib, Aga Khan Health Board, Karachi, Pakistan; Zohray Talib, George Washington University School of Medicine, Washington, DC; and Mansoor Saleh, University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Saleem Sayani
- Roziya Buribekova, Irina Shukurbekova, Surayo Ilnazarova, Nekruz Jamshevov, and Guldarbogh Sadonshoeva, Aga Khan Health Services, Dushanbe, Tajikistan; Saleem Sayani and Aliya Aminmuhammad, Aga Khan University; Farin Amersi, Sheemain Asaria, Mansoor Saleh, and Zohray Talib, Aga Khan Health Board, Karachi, Pakistan; Zohray Talib, George Washington University School of Medicine, Washington, DC; and Mansoor Saleh, University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Aliya Aminmuhammad
- Roziya Buribekova, Irina Shukurbekova, Surayo Ilnazarova, Nekruz Jamshevov, and Guldarbogh Sadonshoeva, Aga Khan Health Services, Dushanbe, Tajikistan; Saleem Sayani and Aliya Aminmuhammad, Aga Khan University; Farin Amersi, Sheemain Asaria, Mansoor Saleh, and Zohray Talib, Aga Khan Health Board, Karachi, Pakistan; Zohray Talib, George Washington University School of Medicine, Washington, DC; and Mansoor Saleh, University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Farin Amersi
- Roziya Buribekova, Irina Shukurbekova, Surayo Ilnazarova, Nekruz Jamshevov, and Guldarbogh Sadonshoeva, Aga Khan Health Services, Dushanbe, Tajikistan; Saleem Sayani and Aliya Aminmuhammad, Aga Khan University; Farin Amersi, Sheemain Asaria, Mansoor Saleh, and Zohray Talib, Aga Khan Health Board, Karachi, Pakistan; Zohray Talib, George Washington University School of Medicine, Washington, DC; and Mansoor Saleh, University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Sheemain Asaria
- Roziya Buribekova, Irina Shukurbekova, Surayo Ilnazarova, Nekruz Jamshevov, and Guldarbogh Sadonshoeva, Aga Khan Health Services, Dushanbe, Tajikistan; Saleem Sayani and Aliya Aminmuhammad, Aga Khan University; Farin Amersi, Sheemain Asaria, Mansoor Saleh, and Zohray Talib, Aga Khan Health Board, Karachi, Pakistan; Zohray Talib, George Washington University School of Medicine, Washington, DC; and Mansoor Saleh, University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Mansoor Saleh
- Roziya Buribekova, Irina Shukurbekova, Surayo Ilnazarova, Nekruz Jamshevov, and Guldarbogh Sadonshoeva, Aga Khan Health Services, Dushanbe, Tajikistan; Saleem Sayani and Aliya Aminmuhammad, Aga Khan University; Farin Amersi, Sheemain Asaria, Mansoor Saleh, and Zohray Talib, Aga Khan Health Board, Karachi, Pakistan; Zohray Talib, George Washington University School of Medicine, Washington, DC; and Mansoor Saleh, University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Zohray Talib
- Roziya Buribekova, Irina Shukurbekova, Surayo Ilnazarova, Nekruz Jamshevov, and Guldarbogh Sadonshoeva, Aga Khan Health Services, Dushanbe, Tajikistan; Saleem Sayani and Aliya Aminmuhammad, Aga Khan University; Farin Amersi, Sheemain Asaria, Mansoor Saleh, and Zohray Talib, Aga Khan Health Board, Karachi, Pakistan; Zohray Talib, George Washington University School of Medicine, Washington, DC; and Mansoor Saleh, University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| |
Collapse
|