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İncesu O, Kara Ö, Şenyuva E. The effect of web based and traditional self breast examination education on nursing students' knowledge, skills and self-directed learning skills: A randomised controlled study. Nurse Educ Pract 2024; 81:104167. [PMID: 39467338 DOI: 10.1016/j.nepr.2024.104167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Revised: 10/08/2024] [Accepted: 10/14/2024] [Indexed: 10/30/2024]
Abstract
AIM The aim of this study is to examine the effect of web based self-breast examination education on nursing students' knowledge, skills, and self-directed learning skills in self-breast examination. BACKGROUND Breast cancer is the most prevalent type of cancer among women, mortality rates are still high today. It is critical to improve the knowledge and skills and raise the self-awareness and health consciousness of individuals and society about self-breast examination, which is important in the early diagnosis of breast cancer, in order to lower mortality rates. Accordingly, one of the basic nursing skills aimed to be acquired by nursing students future nursing professionals is a self-breast examination. DESIGN This study was conducted with a randomised, controlled, and experimental trial. METHODS A total of 90 students were included in the study: the intervention group (n=43) and the control group (n=47). Intervention group students participated in web-based SBE Education.Control group students participated in SBE Education based on a traditional learning model.A Student Information Form, the Self-Breast Examination Knowledge Test, the Self-Breast Examination Skill Rubric, and the Self-Directed Learning Skills Scale were used in the study. Descriptive statistics, Mann-Whitney U test, and Wilcoxon test were run to analyse the data. RESULTS It was observed that the control group had a higher score in self-breast examination knowledge than the intervention group during the intervention period and the follow-up period after 15 days. No difference was noticed between the groups after the intervention for self-breast examination skill score, but the intervention group had a higher score than the control group for self-breast examination skill during the follow-up period after 15 days. No significant difference was noted between the groups for self-directed learning scores. This result validated hypothesis H4. This result refuted hypothesis H1, H2, H3, H5. CONCLUSIONS Web based education on self-breast examination improves students' breast self-examination skills and self-directed learning skills, but not their knowledge level of self-breast examination.
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Affiliation(s)
- Olga İncesu
- Istanbul University-Cerrahpaşa, Florence Nightingale Faculty of Nursing, Skill Laboratory, Istanbul, Turkey.
| | - Öykü Kara
- Istanbul University-Cerrahpaşa, Florence Nightingale Faculty of Nursing, Department of Surgical Nursing, Istanbul, Turkey.
| | - Emine Şenyuva
- Istanbul University-Cerrahpaşa, Florence Nightingale Faculty of Nursing, Department of Nursing Education, Istanbul, Turkey.
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Ogunmodede EO, Ajala DE, Aluko JO, Anokwuru RA, Awotunde TA, Olajide AO, Dosumu TO, Olabisi OI, Ajala RG. Promoting breast health among female adolescents: a comparative analysis of the effects of two didactic tools on knowledge and practice regarding breast self-examination in Southwest Nigeria. BMC Cancer 2024; 24:1183. [PMID: 39334017 PMCID: PMC11438366 DOI: 10.1186/s12885-024-12949-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 09/12/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Teaching effective methods for breast self-examination (BSE) to adolescent females is essential for promoting early detection and improving outcomes in breast cancer management. This study therefore aimed to compare two pedagogical tools for teaching BSE among adolescent females. METHODS A quasi-experimental design with a group for pre- and post-intervention tests was adopted. The sample included 970 female senior secondary school class I-III students. The Yamane formula was used to determine a sample size of 276. Pre- and post-intervention data were collected using an observation checklist for practice and a validated questionnaire with a Cronbach's alpha coefficient of 0.76 for knowledge of BSE. A proportionate stratified random sampling technique was used to determine the number of participants for each group. Among the 276 participants, 161 were taught the traditional method (TM), i.e., a lecture, and 115 were taught using the modern method (MM) by watching a podcast that contained BSE lessons. Post-intervention data were collected after six weeks. The data were analysed using descriptive and inferential statistics at a 5% level of significance to compare the effectiveness of the methods. RESULTS The findings of this study showed that the participants' mean ages across the two methods were 15.49 ± 1.65 and 15.43 ± 1.40 years for the traditional method (TM) and modern method (MM), respectively. Pre-intervention mean BSE knowledge scores in both the TM and MM groups were 8.19 ± 3.17 and 8.31 ± 2.39, respectively, and BSE practice scores were 7.17 ± 2.48 and 6.44 ± 2.75, respectively. Post-intervention knowledge mean scores in both the TM and MM groups increased to 13.75 ± 4.09 and 16.92 ± 2.91, respectively, and post-intervention practice scores increased to 13.06 ± 2.74 and 15.68 ± 3.12, respectively. CONCLUSION This study revealed that both teaching methods were effective at teaching breast self-examination among female adolescents; nevertheless, modern methods are more effective at teaching breast self-examination among female adolescents.
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Affiliation(s)
| | | | - Joel Ojo Aluko
- Department of Nursing, University of Ilorin, Ilorin, Nigeria
| | | | | | | | - Taiwo Omotayo Dosumu
- Department of Maternal and Child Health, Faculty of Nursing, Bowen University, Iwo, Nigeria
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Karimian Z, Zare R, Zarifsanaiey N, Salehi N. The effect of video-based multimedia training on knowledge, attitude, and performance in breast self-examination. BMC Womens Health 2022; 22:298. [PMID: 35850913 PMCID: PMC9289655 DOI: 10.1186/s12905-022-01877-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 07/13/2022] [Indexed: 11/17/2022] Open
Abstract
Background/Objectives Breast neoplasm is one of the most common cancers in Iranian women due to the late diagnosis. Awareness of breast neoplasm and using Breast Self-Examination (BSE) assist in the early detection and treatment of cancer. This study examined the effectiveness of video-based multimedia training versus face-to-face training in awareness of breast neoplasm and BSE and possible factors affecting their effectiveness.
Methods This research was a pre-test, a post-test experimental study comparing the knowledge, attitude, and performance of women about BSE across two training intervention groups (face-to-face versus video-based multimedia). The study was conducted at Shiraz University of Medical Sciences (SUMS), and 100 women between 20 to 60 years old were allocated to each intervention group via multi-stage cluster sampling (n:110). Three valid and reliable researcher-made questioners were used. Data were analyzed using SPSS 24 with independent t-test, paired t-test, and ANOVA. Results Both video-based multimedia and face-to-face training methods significantly increased the participant's knowledge, attitude, and skills about breast self-examination (P < 0.001). In the sub-categories, the results showed that the face-to-face training improved negligence and forgetfulness in applying BSE (P = 0.03) and correcting or modifying the previous knowledge around the issue (P = 0.02). The effect of the video-based method on participants with university education was more than on non-university (P = 0.04). Conclusion Incorporating video-based multimedia training in awareness of breast neoplasm and breast self-examination provides an easy, flexible, and affordable way for detection, particularly considering crisis restrictions. This can be of particular attention in more populated, developing/low-income countries and rural and remote areas to enhance equitable access to training and facilitation diagnosis and treatment if applicable.
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AKARSU NAGIHANKÜÇÜ, ANDSOY ISILISIK. Evaluation of Breast Self-examination Training in Turkish Women Living in Northwestern Turkey. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 63:E76-E82. [PMID: 35647363 PMCID: PMC9121684 DOI: 10.15167/2421-4248/jpmh2022.63.1.2305] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 01/04/2022] [Indexed: 11/11/2022]
Abstract
Introduction Breast cancer (BC) is one of the most significant health problems among the women. Breast self-examination (BSE) is an examination method which is used by women to detect breast cancer as much early as possible. Training of women about BSE is crucial. Methods The current study was semi-experimentally single-group pretest-posttest designed in order to evaluate breast self-examination (BSE) training efficacy on Turkish women's knowledge and skills. The study was performed on 119 Turkish women. The data were collected with a three questionnaires and BSE Training Skills Evaluation Form in three phases. Results 81.5% of the women did not perform BSE regularly. Rate of correct responses about knowledge on BC, risk factors and screening increased after posttest. Significant improvements were observed in the post-test (after training, after one month and three months training) scores for knowledge of Turkish women' towards BC, risk factors and screening, steps of BSE after the intervention (p < 0.001). To quantify the efficiency of training, effect size (Cohen's d) was derived. For knowledge and ability to do BSE scores, Cohen's d was 1,01 ≤ with large effect size indicating highly effective impact of the training. Conclusions It seems that BSE training is beneficial in women. However, women should receive regular BSE training to renew their knowledge and skills. Long follow-up is required.
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Affiliation(s)
| | - ISIL ISIK ANDSOY
- Correspondence: Isil Isik Andsoy, Surgical Nursing Department, University Health Sciences Department, Istanbul, Turkey. E-mail:
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Zhang S, Zhu W, Chen B, Tang T, Tao Z, Li X, Hua T, Ju N, Zheng S. Relationship between demographic factors, health education, breast cancer-related knowledge, attitudes, and breast self-examination behavior among Chinese female college student: A structural equation analysis. J Obstet Gynaecol Res 2021; 47:4440-4449. [PMID: 34643014 DOI: 10.1111/jog.15064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/08/2021] [Accepted: 10/03/2021] [Indexed: 12/09/2022]
Abstract
AIMS This study aimed to create a structural equation model to evaluate the associations among demographic factors, health education, breast cancer-related knowledge, attitudes, and breast self-examination behavior among Chinese female college students. METHODS A survey was undertaken using a self-administered questionnaire and targeting 2233 students from Eastern China. Structural equation modeling with the bootstrap approach was utilized to estimate the interrelationships and the strength of the associations among measured variables based on the hypothetical model. RESULTS Among the total participants, 14.7% of the female college students reported having performed breast self-examination. The final structural equation model showed highly satisfactory fitness on indices. Breast self-examination behavior was significantly linked to demographic factors, breast cancer related-knowledge, attitudes, and health education. Health education had the greatest influence on breast self-examination behavior. In addition, breast cancer related-knowledge was significantly associated with demographic factors and health education. Health education and knowledge all significantly affected attitudes towards breast cancer. CONCLUSION Breast self-examination behavior was influenced by demographic factors, breast cancer related-knowledge, attitudes towards breast cancer, and health education in a sample of female college students in China. Health education was the most important predictor of breast self-examination behavior.
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Affiliation(s)
- Shunhua Zhang
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
| | - Weihao Zhu
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
| | - Baole Chen
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
| | - Ting Tang
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
| | - Zhaoyu Tao
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
| | - Xiang Li
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
| | - Tiantian Hua
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
| | - Nianting Ju
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
| | - Suge Zheng
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China
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Sadoh AE, Osime C, Nwaneri DU, Ogboghodo BC, Eregie CO, Oviawe O. Improving knowledge about breast cancer and breast self examination in female Nigerian adolescents using peer education: a pre-post interventional study. BMC WOMENS HEALTH 2021; 21:328. [PMID: 34507568 PMCID: PMC8431890 DOI: 10.1186/s12905-021-01466-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 08/20/2021] [Indexed: 11/10/2022]
Abstract
Background Prevention of BC of which the cornerstone is creating awareness and early detection is important in adolescents and young women because of their worse outcomes. Early detection strategies such as mammography are currently beyond the reach of most women in sub-Saharan Africa.. Lack of awareness and late presentation contribute to the poor outcomes. Awareness creation among adolescents may result in modification of some risk factors for BC with adoption of healthy life styles including accessing early detection activities. This study determined the effect of peer education as a strategy to create awareness on BC and breast self examination (BSE) among in-school female adolescents in Benin City. Methods This was a pre-post interventional study carried out in October –December 2016 on female students of four secondary schools in Benin City. Pre-peer training, using a pre-tested self-administered questionnaire, knowledge about BC and BSE was assessed in about 30% of each school population. This was followed by training of 124 students selected from the schools (one student per class) as peer trainers. The peer trainers provided training on BC and BSE (the intervention) for their classmates. Within two weeks of peer training knowledge about BC and BSE was reassessed in 30% of each school population. Selection of students for assessment pre and post intervention was by systematic sampling. Correct knowledge was scored and presented as percentages. Chi square test, student t test and ANOVA were used to assess associations and test differences with level of significance set at p < 0.05. Results There were 1337 and 1201 students who responded to the pre and post-training questionnaires respectively. The mean BC knowledge score (20.61 ± 13.4) prior to training was low and it statistically significantly improved to 55.93 ± 10.86 following training p < 0.0001 Following peer training, statistically significant improvement (p 0.037- < 0.001) occurred in most knowledge domains apart from symptomatology. Pre-peer training 906(67.8%) students knew about BSE but only 67(4.8%). Significantly more students 1134(94.7%) knew about BSE following peer training. Conclusions Peer education strategy can be used to improve BC and BSE knowledge in adolescents. This strategy is low cost and could be very useful in low resource settings. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01466-3.
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Affiliation(s)
- Ayebo E Sadoh
- Institute Of Child Health, University Of Benin, PMB 1154, Benin City, Nigeria.
| | - Clement Osime
- Department of Surgery, University Of Benin, PMB 1154, Benin City, Nigeria
| | - Damian U Nwaneri
- Institute Of Child Health, University Of Benin, PMB 1154, Benin City, Nigeria
| | | | - Charles O Eregie
- Institute Of Child Health, University Of Benin, PMB 1154, Benin City, Nigeria
| | - Osawaru Oviawe
- Institute Of Child Health, University Of Benin, PMB 1154, Benin City, Nigeria
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Liu N, Li P, Wang J, Guo PP, Zhang XH, Yang S, Yu L, Zhang XM, Zhang W. Factors influencing breast cancer awareness: a cross-sectional study in China. J Comp Eff Res 2020; 9:679-689. [PMID: 32648473 DOI: 10.2217/cer-2020-0037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Aim: This study aimed to explore the factors that influence breast cancer awareness. Materials & methods: A community-based cross-sectional study was conducted between January and April 2019 in Changchun, Jilin Province, China. Results: A total of 274 women were recruited for this cross-sectional study. Participants had a moderate level of breast cancer awareness (median = 76.50 [68.75, 84.00]). Women in the action/maintenance stages reported higher breast cancer awareness (p = 0.044). Women's breast cancer awareness was positively associated with high health information literacy level, husbands' higher educational degrees, seeing doctors after detecting abnormal breast changes and living within a short distance from the nearest hospital. Conclusion: History of screening and higher health information literacy levels are important positive factors linked to higher breast cancer awareness.
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Affiliation(s)
- Na Liu
- Nursing School, Jilin University, Changchun, Jilin Province, China
| | - Ping Li
- Department of Developmental Pediatrics, The Second Hospital of Jilin University, Changchun, Jilin Province, China
| | - Jie Wang
- Nursing School, Jilin University, Changchun, Jilin Province, China
| | - Ping-Ping Guo
- Nursing School, Jilin University, Changchun, Jilin Province, China
| | - Xue-Hui Zhang
- Nursing School, Jilin University, Changchun, Jilin Province, China
| | - Shu Yang
- Nursing School, Jilin University, Changchun, Jilin Province, China
| | - Lin Yu
- Nursing School, Jilin University, Changchun, Jilin Province, China
| | - Xiu-Min Zhang
- School of Public Health of Jilin University, Changchun, Jilin Province, China
| | - Wei Zhang
- Nursing School, Jilin University, Changchun, Jilin Province, China
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Bashirian S, Mohammadi Y, Barati M, Moaddabshoar L, Dogonchi M. Effectiveness of the Theory-Based Educational Interventions on Screening of Breast Cancer in Women: A Systematic Review and Meta-Analysis. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2019; 40:219-236. [PMID: 31488039 DOI: 10.1177/0272684x19862148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Screening plays an essential role in the reduction of mortality and morbidity of breast cancer, which is one of the most common cancers in women worldwide. The aim of this study was to find out whether the use of health education model and theory-based behavioral interventions is effective in women’s breast cancer screening behavior. Applying different search strategies, we searched electronic databases including PubMed, ScienceDirect, Web of Science, and Scopus without time limit from January 12 to March 11, 2017. Keywords included “Breast neoplasm,” Screening,” “Women,” and “Health Education.” First, screening was conducted based on title, abstract, and full text. Then, the studies were screened according to the selection criteria of our study. The relevant and eligible studies were critically appraised by Delphi checklist. In addition, a meta-analysis of eligible studies was conducted with the random-effect approach. Twenty-six of 8,620 initial studies (with sample size of 10,681 in the intervention group and 8,854 in the control group) were included in the final analysis. The results of the meta-analysis showed that the probability of screening behavior in the intervention group is 1.4 times of that in the control group. Furthermore, subgroup analysis by the type of screening behavior indicates that the probabilities of conducting breast self-examination and mammography in the intervention group are 1.9 and 1.4 times of those in the control group. The health education program has a significant impact on breast cancer screening behaviors, particularly breast self-examination. Thus, given the positive effects of the educational screening programs in women, it is suggested that these programs must be continuously pursued with long-term follow-up and increasing rates of screening behaviors should be monitored.
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Affiliation(s)
- Saeed Bashirian
- Department of Public Health, School of Public Health, Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Iran
| | - Younes Mohammadi
- Department of Epidemiology, School of Public Health, Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Iran
| | - Majid Barati
- Department of Public Health, School of Public Health, Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Iran
| | - Leila Moaddabshoar
- Department of Radiation Oncology, School of Medicine, Hamadan University of Medical Sciences, Iran
| | - Mitra Dogonchi
- Department of public health, School of Public Health, Hamadan University of Medical Sciences, Iran
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Yurt S, Saglam Aksut R, Kadioglu H. The effect of peer education on health beliefs about breast cancer screening. Int Nurs Rev 2019; 66:498-505. [PMID: 31184372 DOI: 10.1111/inr.12517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
AIM The aim of this study was to evaluate the effect of peer education about breast cancer screening on the health beliefs of female university students. BACKGROUND The breast self-examination method is an effective technique that is also simple and inexpensive. INTRODUCTION In recent years, besides the classic methods of providing education on breast self-examination, it has been observed that the use of the technique of peer education is increasing and more and more studies are being conducted on this method and its effectiveness. METHODS This study is of quasiexperimental design using a single group, pretest/post-test model. The study was conducted with 742 university first-year students. The data for the study were collected using a Sociodemographic Questionnaire, the Breast Cancer Knowledge Questionnaire, Peer Education Satisfaction Questionnaire and Champion's Health Belief Model Scale. RESULTS It was found that the students' perception of barriers to performing the breast self-examination had declined and their self-efficacy had increased, and that the level of perceived barriers to having a mammogram had decreased and 98% of the students were satisfied with the peer education. CONCLUSION It was seen in this study that the level of knowledge of the students about breast cancer, perceived severity, barriers, benefits and self-efficacy as well as the rate of performing BSE displayed a significant increase after the peer education programme. IMPLICATIONS FOR NURSING AND HEALTH POLICY The method of peer education may be utilized in the effort to increase young women's awareness about breast cancer and ensure that they learn about breast self-examinations. The peer education model can be useful in providing breast self-examination education to young people in school. The results of the present study may be beneficial in developing policies on health education on university campuses.
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Affiliation(s)
- S Yurt
- School of Nursing, Maltepe University, Istanbul, Turkey
| | | | - H Kadioglu
- Department of Public Health Nursing, Faculty of Health Science, Marmara University, Istanbul, Turkey
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Ifediora CO, Azuike EC. Sustainable and cost-effective teenage breast awareness campaigns: Insights from a Nigerian high school intervention study. J Eval Clin Pract 2019; 25:312-322. [PMID: 30663203 DOI: 10.1111/jep.13101] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/23/2018] [Accepted: 12/26/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND With limited government-sponsored breast screening programmes in developing countries, breast awareness remains the only realistic survival hope for millions. Poor levels of knowledge and preventive practices remain in these countries, and early enlightenment to empower teenage high school girls has been advocated for, recently. This study evaluates ways to ensure sustainability for such an approach. METHOD A 6-month longitudinal, interventional cohort study of 432 high school female students in South-eastern Nigeria. The efficacies of a video-assisted face-to-face intervention, as well as the use of printed handouts, were evaluated. RESULTS A total of 317 (73.4%) and 301 (69.7%) valid responses were received from the pre-intervention (16.8 ± 1.5 years) and post-intervention (17.2 ± 1.6 years) surveys, respectively. Logistic regression revealed that participants who were "engaged" with the campaigns, either through symposium attendance or by reading handouts, showed significant improvements on most aspects of knowledge regarding the cancer's early symptoms and risk factors, as well as breast self-examination (BSE). However, the monthly practice of BSE was not significantly increased (Attendees: OR = 1.44, P = 0.18; Handout-readers: OR = 1.52; P = 0.17). Also, when "engagement" to the respective empowerment activities was disregarded, a chi-squared analysis comparing the pre-intervention and post-intervention groups showed significant improvements on specific knowledge regarding risk factors and early symptoms of breast cancer, as well as BSE techniques and regular monthly practice: χ2 (1, N = 596) = 46.703, P < 0.001. Across multiple parameters, the impact of exclusive face-to-face participation was not different to that from the reading of handouts. CONCLUSION Face-to-face and handout were both effective and of similar impact. However, sustained impact on monthly BSE is doubtful. To surmount this, strategies to ensure ongoing engagements are vital. Perhaps adjusting existing high school curricula to allow repeated yearly teachings on breast cancer and BSE, along with in-built-in evaluation systems like examinations and quizzes, are ways of ensuring engagement.
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Affiliation(s)
- Chris O Ifediora
- Senior Lecturer (Clinical Skills), Griffith University Medical School, Gold Coast, Australia
| | - Emmanuel C Azuike
- Lecturer and Consultant Community Physician, Department of Community Medicine, Chukwuemeka Odumegwu Ojukwu University/University Teaching Hospital, Awka, Nigeria
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