Breast self-examination proficiency in older women: measuring the efficacy of video self-instruction kits

How to inform college students about meningitis B vaccine? Comparative effectiveness of an online theory-based text and video intervention

Objective The purpose of this study was to compare the effect of text and video formats of an online theory-based Meningitis B (MenB) health message intervention on college students. Participants: College freshmen and transfer students admitted at a Southern U.S. University. Methods: In a 2-arm randomized study, knowledge, perceptions, and intention to receive the vaccine were compared pre- and post-intervention. Results: Post intervention, participants in both the written and video interventions had significantly higher scores of knowledge, perceptions, and intentions. Upon comparing the change in scores pre- to post-intervention between both text and video groups, no significant differences were found between both groups. Conclusions: This study, a first in using a theory-based MenB online education intervention and questionnaire to compare text and video formats, suggests that both text and video formats are equally effective in raising young adults' awareness about the MenB vaccine.

The effectiveness of educational intervention based on the Health Action Model (HAM) in improving breast cancer screening behaviors

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.

Evaluation of Health Belief Model-Based Intervention on Breast Cancer Screening Behaviors among Health Volunteers

Breast cancer is the most common cancer and the second leading cause of death among women. Regarding the lack of knowledge about the cause of breast cancer and considering the fact that all women are prone to this disease, training on methods of early diagnosis to reduce its complications is of great importance. Thus, this study aimed to determine the effect of education based on the health belief model on breast cancer screening behaviors in health volunteers of health centers in Isfahan. In this experimental study, 480 healthy volunteers were randomly divided into two groups: the case (n = 240) and control (n = 240). The training program was designed according to health belief model structures. Before the training interventional program, the Champion standard questionnaire and functional checklist were completed for both groups. A standard questionnaire was completed during three stages (before, immediately after, and 2 months after the training). The experimental group received the educational intervention during eight sessions, and the collected data was eventually analyzed using the SPSS statistical software version 16 with relevant statistical tests. Participation of all individuals in the present research was voluntary and with informed consent. The results showed that mean scores of knowledge, perceived susceptibility, severity, benefits, barriers, self-efficacy, and behavioral intention related to breast self-examination (BSE) and mammography in the intervention group significantly increased compared with those of the control group immediately after and 2 months after educational intervention. There was a significant difference between groups in BSE skill 2 months after the intervention, but there was no significant difference between the two groups in BSE behavior and mammography 2 months after the intervention. The results confirmed the efficiency and effectiveness of an educational intervention based on the health belief model on improving factors affecting breast cancer screening behaviors.

Video for Knowledge Translation: Engaging Older Adults in Social and Physical Activity

Une vaste majorité des Canadiens âgés ne pratiquent pas suffisamment d'activité physique. Le développement de stratégies originales et innovantes encourageant et appuyant les modes de vie actifs est donc urgent. La vidéo est un outil prometteur pour l'application de connaissances (AC) visant l'engagement de divers publics dans la discussion et l'adoption de comportements favorisant la santé. L'Approche systématique pour les vidéos fondées sur des données probantes (Systematic Approach to Evidence-informed Video, SAEV), qui fournit un cadre pour guider et structurer le développement de vidéos ayant pour objectif l'AC, a été utilisée pour la création et la diffusion d'un documentaire de 19 minutes, I'd Rather Stay (https://vimeo.com/80503957). Quarante-huit participants âgés de 60 ans et plus ont visionné la vidéo, participé à des groupes de discussion et rempli des questionnaires concernant cette vidéo. Les données ont été recueillies après le visionnement et lors d'un suivi organisé six mois plus tard. La vidéo a éduqué, encouragé et mobilisé les personnes âgées sur les questions liées à l'autonomie, à l'activité physique et aux liens sociaux. Nous encourageons les chercheurs à adopter des stratégies d'AC auxquelles les personnes âgées peuvent s'identifier, qui sont accessibles et par lesquelles elles peuvent s'engager à un niveau critique, autant sur le plan émotionnel qu'intellectuel, comme les vidéos basées sur des preuves scientifiques.

Most older Canadians do not engage in sufficient physical activity. There is an urgent need for outside-the-box strategies that encourage and sustain active lifestyles. Video is a promising knowledge translation (KT) tool to engage diverse audiences in discussion and action around health promoting behaviours. We adopted a KT framework to inform a structured process of video development we have named systematic approach to evidence-informed video (SAEV). This guided the creation and dissemination of a 19-minute documentary video: I’d Rather Stay (https://vimeo.com/80503957). Following screenings, we collected focus group and questionnaire data from 48 participants aged 60 years and older at baseline and 6-month follow-up. The video educated, encouraged, and activated older people around issues such as independence, physical activity and social connectedness. We encourage researchers to adopt KT strategies – and to use evidence-informed video – that older adults can relate to and critically engage with on an accessible, emotional, and intellectual level.

Using a community-based outreach program to improve breast health awareness among women in Hong Kong

OBJECTIVE

To evaluate the effectiveness of a community-based health education program via a mobile van to promote the awareness of breast cancer and breast self-examination (BSE) practice among women in Hong Kong.

DESIGN

One group pretest/posttest design. SAMPLE AND MEASUREMENTS: Seven hundred and seventy-seven women in Hong Kong completed a self-administered questionnaire before and after a breast health education program from May 2002 to March 2003.

RESULTS

About half were aware of breast health and breast diseases (53.7%) and breast screening methods (48.6%) before the intervention. It was found that women who had received instruction on BSE practice, and those who were aware of breast screening methods, breast health, and breast diseases were more likely to have had prior BSE practice. Most indicated their willingness to practice BSE regularly (93.3%) and to pass on the BSE knowledge to their relatives and friends (92%) in the posttest.

CONCLUSIONS

The outreach health education program has successfully reached women living in the 18 districts in Hong Kong. It appears to be useful in raising the awareness of breast health and BSE practice among the women, but longer term follow-up is required to ascertain its sustainability.

A psycho-educational video used in the emergency department provides effective treatment for whiplash injuries

STUDY DESIGN

Randomized control trial conducted between June 2000 and September 2002.

OBJECTIVE

To determine whether a short psycho-educational video shown in the Emergency Department shortly after the injury would produce follow-up pain reductions and reduced medical utilization.

SUMMARY OF BACKGROUND DATA

Chronic pain following a whiplash injury is one example of the massive medical/legal problem of chronic muscular pain. Approaches using local pain sources (trigger points) have shown promise as treatment models for this type of pain.

METHODS

1) SETTING: Emergency Departments (ED) and urgent care (UC) facilities. 2) PATIENTS: 126 patients entering EDs or UCs. 3) INTERVENTION: PATIENTS assigned to 12-minute video or care as usual. 4) MAIN OUTCOME MEASURES: Short Form Musculoskelatal Function Assessment (SMFA), phone questionnaires assessing: narcotics use, ER use, UC use, surgical consultations, etc.

RESULTS AND CONCLUSIONS

PATIENTS viewing the video had dramatically lower pain ratings at a 1-month follow (6.09 [10.6] vs. 21.23 [17.4], P < 0.001) and this pattern held for the 3- and 6-month follow-up period. Similarly, for 17 of 21 items asked at follow-up, the video group showed superior outcomes (chi2 ranged from 5 to 35, P < 0.05, all). For example, 4% of video patients were using narcotics at 6 month post ED visit compared with 36% of controls. The brief psycho-educational video had a profound effect on subsequent pain and medical utilization.

Promoting breast health: older women's perceptions of an innovative intervention to enhance screening

Aims and objectives.  This study is a continuation of prior funded research in which we tested the use of age and ethnically sensitive video breast health kits to increase knowledge about breast cancer and enhance the screening practices of breast self-examination and mammography among older Caucasian and African-American women. Background.  Breast cancer is the most frequent cancer in women worldwide and accounts for 23% of all cancers. Mammography is currently the best procedure available for mass screening of breast cancer. However, underutilization of mammography is a problem among older women in the United States. Elders are at the greatest risk for developing and dying from breast cancer but they are the least likely group to be screened routinely with mammograms or to practice breast self-examination, particularly if they are African-American. Design.  Participatory qualitative evaluation focus groups were used to assess the overall impact of the video kit intervention programme and to elucidate the quantitative findings of the original study. Methods.  Four focus groups were conducted in two diverse settings with a purposive sample of 23 participants (N = 23). The overall sample was predominantly African-American (87%) with mean age of 71 ± 7.9 years and mean education completed of 12 ± 3.4 years. Results.  Five major themes emerged from group discussions: usability and appeal of the intervention, fear and empowerment, personal relevance and intergenerational sharing, impact on screening behaviours, and story telling. Conclusions.  Analyses suggest that customized media materials constructed especially for older African-American women empowered participants in this sample to action regarding their own breast health. Relevance to clinical practice.  These findings may translate to global populations where risk is increasing but screening programmes are not widely available. Given that older women are historically difficult to access and impact, further design and evaluation of innovative and sensitive educational programmes such as the one described here are recommended.

Assessment of the use and feasibility of video to supplement the genetic counseling process: a cancer genetic counseling perspective

Cancer genetic counselors use a variety of teaching modalities for patient education. This survey of cancer genetic counselors assessed their use of educational videos and their recommendations for content of future videos. Thirty percent of respondents use videos for patient education. Cited benefits included reinforcement of information for clients and increased counselor efficiency. Of the 70% who do not use videos, predominant barriers included the perceived lack of an appropriate video, lack of space and/or equipment, and concern that videos are impersonal. Most respondents desired a video that is representative of the genetic counseling session, but emphasized the importance of using broad information. Content considered critical included the pros and cons of genetic testing, associated psychosocial implications, and genetic discrimination. The results of this exploratory study provide data relevant for the development of a cancer genetics video for patient education, and suggestions are made based on aspects of information processing and communication theories.

Knowledge of Breast Self-Examination and Other Determinants’ Relationship on the Self-Rated Health of Elderly Women

This study examines whether the knowledge of breast self-examination (BSE) could be a significant contributor to elderly women’s self-rated health. Additional variables were considered as potential influences on their self-rated health. This research used a quasi-experimental design and random selection to assign assisted living facilities to treatment and control groups. Participants in this study were women, age 75 years and older. All participants were gauged for breast cancer risk as a pretest measurement. Only the experimental group of older women received BSE instruction and then provided their self-rated health eight weeks later. BSE knowledge contributed statistically to the experimental elderly women’s self-rated mental health scores. Instrumental activities of daily living were statistically significant for both groups at explaining variance in their physical health scores. This research study, although limited, points to the value of providing BSE to elderly women and its influence on their mental health.

Video breast health kits: testing a cancer education innovation in older high-risk populations

BACKGROUND

The Breast Health Kit for Women Over 60 project was a 3-year study funded by NCI to develop and field test video self-instruction programs designed to increase breast cancer screening for older black and white women.

METHODS

Impact of kit use on knowledge about breast cancer risk/screening, breast self-examination (BSE) proficiency, and mammography use was assessed with 439 women in Massachusetts and Georgia. BSE proficiency was measured by demonstration of inspection/palpation skills and detection of lumps in a simulation model. Analysis with a noncompliant mammography user subsample (N = 143) tested the effectiveness of kit use on mammography screening. The sample was predominantly black (76%) with mean age of 71.6 years and mean education of 10.6 years.

RESULTS

Analyses of covariance revealed that women who used the kits had significantly better knowledge about breast cancer risk/screening (F = 23.6, P < or =.001) and were more proficient at BSE than kit nonusers as measured by both skills (F = 47.9, P < or =.001) and detection of lumps (F = 36.8, P < or =.001). No significant differences were found between subsample groups in receiving a poststudy mammogram, but a trend toward having mammograms was noted in the subsample who used the kits (chi(2) = 1.7, P < =.09).

CONCLUSIONS

Age and ethnically sensitive self-instructional breast health kits were found to be effective in increasing knowledge about breast cancer risk and BSE proficiency in older women. Future research is needed to explore how other strategies combined with kit use can assure mammography compliance in this population.

Randomized controlled trial comparing the efficacy of a video and information leaflet versus information leaflet alone on patient knowledge about surveillance and cancer risk in ulcerative colitis

BACKGROUND AND AIMS

Knowledge of colorectal cancer risk in patients with ulcerative colitis is inadequate. The authors aimed to improve knowledge in a sample of patients and determine whether this was best achieved by a simple information leaflet or by watching a video reading a leaflet.

MATERIALS AND METHODS

Patients (n = 124) were recruited into a randomized controlled trial conducted from the gastroenterology outpatient departments of two Leicester hospitals. Participants completed a questionnaire prior to receiving the leaflet or viewing the video, immediately afterward, and 1 month later.

RESULTS

One hundred fifteen questionnaires were returned (response rate = 93%). Both videos and leaflets increased knowledge with mean percentage improvements in scores of 71% (95% CI = 40.2-100) and 49% (95% CI = 32.1-66), respectively. However, the difference between the two interventions was not statistically significant (Difference = 22%, 95% CI = -56.3-13.2, p = 0.2). After 1 month, knowledge levels decreased in both groups to 55% (95% CI = 33.2-75.8; video plus leaflet) and 36% (95% CI = 23.7-48.6; leaflet alone).

CONCLUSIONS

Leaflets and videos have an important role in reinforcing information provided by clinicians. However, there appears to be no immediate or prolonged advantage of a video over and above that of a simple information leaflet. The cost implications of producing a video, such as extra staff time, need to be weighed against the minor benefit that this medium has to offer.

The effect of an educational intervention on promoting breast self-examination in older African American and Caucasian women

PURPOSE/OBJECTIVES

To test the efficacy of innovative, age- and race-sensitive, self-monitored, video breast health kits in increasing knowledge about breast cancer risk and screening and breast self-examination (BSE) proficiency.

DESIGN

Quasi-experimental pretest and post-test design.

SETTING

Dual-site study in community-based settings in the Northeast and Southeast United States.

SAMPLE

328 women (206 in the intervention group, 122 in the control group) aged 60 or older; predominantly African American (77%); mean education of 10.8 years; annual income below $10,000 (50%).

METHODS

Individual pretest and post-test interviews conducted by nurses at two-week intervals assessed knowledge about breast cancer risk and screening and BSE proficiency as demonstrated on vested breast models. Intervention subjects used video breast health kits in ethnic editions designed for the study. Control subjects received educational pamphlets.

MAIN RESEARCH VARIABLES

Dependent variables were knowledge about breast health and BSE proficiency measured by demonstration of inspection and palpation skills and detection of lumps in a simulation model.

FINDINGS

Three multiple analyses of covariance revealed statistically significant differences in outcome variables between the intervention and control groups.

CONCLUSIONS

The intervention was effective in increasing knowledge about breast cancer risk and screening and BSE proficiency in this sample of older women.

IMPLICATIONS FOR NURSING

These and other educational interventions designed specifically for age and race sensitivity may enhance cancer screening with vulnerable populations. Future studies with more diverse multicultural groups are needed to improve understanding of how to best influence breast health behaviors of older women.

Impact of videotaped information on frequency and confidence of breast self-examination

BACKGROUND

Videotaped education materials to teach breast self-examination (BSE) are used worldwide. However, evaluation of videotaped BSE instructions is lacking.

METHODS

Premenopausal women (mean age 33.4+/-11.2 years) without history of breast cancer were approached to participate in this experimental study and randomly assigned to a video intervention group (VG; n = 130: length of the video = 15 min) or non-video comparison group (NVG; n = 121). All participants answered a questionnaire on BSE behavior and health beliefs. No additional training was given. The total duration of the session including completion of the questionnaire was 15 min for the NVG and 30 min for the VG. Three months later, changes in BSE behavior were compared in the two groups. The influence of health beliefs on actual BSE behavior was investigated as well.

RESULTS

Women of both the VG and NVG performed BSE significantly more frequently at follow-up than at baseline. Analysis of covariance, using the baseline BSE-frequency as co-variate and the follow-up BSE frequency as the dependent variable, revealed that women in the VG (adjusted mean = 7.9 times per year, 95%CI = 6.5-9.4) performed BSE more frequently than women of the NVG (adjusted mean = 6.1 times per year, 95%CI = 4.6-7.5) (F = 4.2, df= 2, p = 0.02). Among motivational predictors, having an example of a role model (modeling) was shown by regression analysis to explain the greatest amount of variance (13%) in BSE frequency.

CONCLUSION

Use of an educational videotape increased the frequency of BSE among premenopausal women.

A multimedia breast cancer education intervention for low-income Latinas

This paper discusses the results from the field test of a multimedia health education intervention, designed to provide breast cancer education for low income Latinas. The purpose of the field test was to ascertain whether the intervention produced significant changes in breast cancer knowledge and attitude, and screening intentions. A total of 1,197 Latina women participated in the field study at six different sites. The majority of the participants were under 65 years of age, foreign-born with less than eight years of education and a weekly household income that fell in the lowest income quintile for 1998 (<$350.00). Participants were randomly assigned to a control or intervention condition. The control group was interviewed about their breast cancer knowledge, attitude and mammography intentions prior to exposure to the intervention, and served as the baseline group. Women in the intervention group exhibited higher knowledge scores than the pretest group (Chi sq., p < .0001). Never-screened women exhibited the largest differences in knowledge scores relative to the baseline sample. The intervention also increased the likelihood of women seeking information about a mammogram.

Video modelling to educate patients

BACKGROUND

Changes in health care delivery in the United States of America due to economic pressures have required nurses to develop innovative instructional materials for educating patients and families. Educational materials such as videotapes, specifically designed to provide information and promote active participation in treatment decisions, can be effective tools for empowering patients. A comprehensive analysis in 1988 concluded that the concept of 'video modelling' or 'behavioural modelling' offered the greatest benefit of videotaped presentations.

AIM OF THE STUDY

The purpose of this integrative literature review was to examine the concept of video modelling and its applications in clinical practice.

METHODS

A computer search of the electronic databases of Medline and CINHAL between 1990 and 1999 produced a total of 40 research studies on video instruction for patients. Based on criteria for inclusion, 18 research studies involving video modelling were reviewed and three major uses were identified: (1) assisting decision making regarding treatment options; (2) reducing pre-procedural anxiety and improving coping skills; and (3) teaching self-care practices.

RESULTS

The studies reviewed included a variety of research designs, clinical settings, and patient populations. Despite these differences, several benefits to the use of video modelling were found. Patients who viewed videotapes regarding treatment options had a greater understanding of the risks and benefits of those choices and were more apt to be active participants in decision making. Collective results of the studies focusing on stress and coping revealed that preparatory videotapes using video modelling could have a positive effect on reducing anxiety and physiological arousal during stressful procedures. With self-care practices, several of the studies found that there was an increase in desired behaviours in people whose educational programmes included video modelling.

CONCLUSIONS

The use of video modelling has potential benefits for clinical practice in facilitating knowledge acquisition, reducing preparatory anxiety, and improving self-care. Nurses must become more actively involved in evaluating various teaching approaches used with patients to enhance practice and outcomes.

Breast self-examination training: a brief review

A review of the literature on breast self-examination training indicated that any training in breast self-examination improves compliance, confidence, and proficiency; the evidence is unclear about the relative effectiveness of group or individual training; practice on breast models and on the woman's own breasts should be included in breast self-examination training; additional training sessions improve compliance and proficiency; reminders increase compliance, but the effect ceases when the reminders cease; and it is particularly important for older women to search their breasts slowly and thoroughly. Several other new approaches to breast self-examination training are discussed.