Effectiveness of An Educational Intervention of Breast Cancer Screening Practices Uptake, Knowledge, and Beliefs among Yemeni Female School Teachers in Klang Valley, Malaysia: A Study Protocol for a Cluster-Randomized Controlled Trial

Breast cancer is the most common cancer spread among women worldwide. Whereas many studies have discussed the significance of breast cancer screening among women in various countries, few have attempted to discuss this topic among female school teachers. As teachers educate and communicate with students, this may play an essential role in health education and in promoting healthy behavior, such as breast cancer screening. The primary goal of this study is to develop and implement an educational intervention of breast cancer screening and evaluate its effectiveness among Yemeni female school teachers in Malaysia. This was carried out as per the health belief model. A cluster-randomized controlled trial was conducted among 183 Yemeni female school teachers in twelve schools in Klang Valley, Malaysia. A random assignment of the target schools was made to include them within the intervention or control group. Participants in the intervention group were offered a 90-min session for one-day educational intervention on breast cancer screening. On the other hand, participants in the control group were offered the same educational materials at the end of the study. Relevant data was collected at baseline, one month following the intervention, and then three- and six-months follow-up assessments. Analysis of such data was done via IBM SPSS software 25.0 by generalized estimating equations (GEE) to assess the differential changes over time. A primary outcome embodied in breast cancer screening practice uptake was expected. Secondary outcomes include the target group’s knowledge on and beliefs of breast cancer screening. This study intends to contribute to the credibility and effectiveness of utilizing a theory-based breast cancer screening intervention in order to raise the awareness of women on conducting breast cancer screening.

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.

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

Older women represent the highest risk group for breast cancer but do not use screening at recommended frequencies. Age-sensitive screening programs addressing the developmental issues, unique value systems, and problems of access for all older women are critically needed. Television is an ideal medium for reaching isolated older women with health information and educational programs. This research explored the efficacy of using video self-instruction kits to increase breast self-examination (BSE) proficiency and knowledge about breast cancer among a sample of 62 women > 60 years of age. Participants were given breast health kits containing an instructional video, printed educational materials, a miniature lump model, and BSE skill checks. Before using the kits and 30 days later they were tested on measures of BSE proficiency and knowledge about breast cancer. Results indicate that the self-instruction programs had significant and positive impacts on the two BSE proficiency measures: skill demonstrations (t = 7.32, p < 0.0001) and lump detection using a simulation model (t = 4.23, p < 0.0001). Knowledge about breast cancer scores also improved from pretest to posttest. Implications for cancer nurses and direct outcomes from the research including newly designed instructional media materials are discussed.