A Transformative Decision-Making Process for Mammography Screening Among Rural, Low-Income Women

Using Facebook to communicate mammography messages to rural audiences

OBJECTIVE

The purpose of this scholarly project was to answer the following question: What is the highest level of engagement achieved with a mammography campaign on Facebook?

DESIGN AND SAMPLE

An Idaho public health department implemented a tailored message mammography campaign on Facebook during Breast Cancer Awareness Month. Target sample for the Facebook campaign were women and men over the age of 40 in rural Idaho.

MEASURES

Data collected from Facebook were used to measure and stratify engagement into a hierarchy of six levels, with intent to get a mammogram representing the highest level of engagement. A survey measuring women's intent to a get a mammogram was distributed via an online link.

RESULTS

The posts reached 48,503 Facebook users-11,147 of the total reach were unique users. Intent to get a mammogram, the highest level of engagement, was stated both in Facebook comments and on the online survey. Forty-nine women completed the survey, and 82% of women expressed intent to get a mammogram in the next year.

CONCLUSION

This project conducted as a program evaluation demonstrates how public health nurses can develop, implement, and evaluate Facebook mammography campaigns in the future.

Fostering early breast cancer detection

This article examines how faith community nurses (FCNs) fostered early breast cancer detection for those at risk in rural and African American populations throughout nine counties in midwestern Illinois to decrease breast cancer disparities. Flexible methods for breast cancer awareness education through FCNs, effective strategies for maximizing participation, and implications for practice were identified. In addition, networking within faith communities, connecting with complementary activities scheduled in those communities, and offering refreshments and gift items that support educational efforts were identified as effective ways of maximizing outcomes and reinforcing learning. Flexible educational programming that could be adapted to situational and learning needs was important to alleviate barriers in the project. As a result, the number of participants in the breast cancer awareness education program exceeded the grant goal, and the large number of African American participants and an unexpected number of Hispanic and Latino participants exceeded the target.

Transformative learning theory: facilitating mammography screening in rural women

PURPOSE/OBJECTIVES

To use transformative learning to investigate what experiences serve as catalysts for mammography screening, the cognitive and affective responses that result from the catalyst, and how screening behavior is impacted.

RESEARCH APPROACH

A descriptive qualitative study.

SETTING

Southeastern Wyoming.

PARTICIPANTS

25 low-income, rural women aged 40 years and older.

METHODOLOGIC APPROACH

Four focus group interviews.

FINDINGS

Cancer experiences triggered universal responses of fear by screeners and nonscreeners. The manner in which that fear response was interpreted was a critical factor in the facilitation of, or impedance to, screening. Dichotomous interpretations of fear responses provided the context for screening behavior. Immobilizing and isolating experiences were associated with nonscreening behavior, whereas motivation and self-efficacy were associated with screening behavior.

CONCLUSIONS

Transformative learning theory is a useful framework from which to explain differences in mammography screening behavior. Creating opportunities that facilitate dialogue and critical reflection hold the potential to change immobilizing and isolating frames of reference in nonscreening women.

INTERPRETATION

To help women transcend their fear and become self-efficacious, nurses can assess how cancer and the screening experience is viewed and, if indicated, move beyond standard education and offer opportunities for dialogue and critical reflection.