The Effects of Training on Knowledge and Beliefs About Breast Cancer and Early Diagnosis Methods Among Women

Effectiveness of a Health Educational Program in Enhancing Breast Cancer Knowledge Among Women in Rural Karnataka, South India

INTRODUCTION AND AIM

Breast cancer is one of the significant causes of mortality in India, ranking second only to cervical cancer among women. Annually, the country has witnessed the detection of 200,000 new cases, with 60% identified in the early stages. This study aimed to assess the effectiveness of a health education intervention program designed to enhance knowledge about breast cancer among women in rural Karnataka.

MATERIALS AND METHODS

A descriptive study design was employed and a total of 320 women were selected through multi-stage sampling. The educational intervention involved a PowerPoint presentation by the investigator, which was followed by group discussions that culminated with plenary sessions for clarifying the doubts of respondents. At the end of every educational session, pre-designed, pre-tested, and validated questionnaires, comprising a mix of structured and semi-structured questions, were completed by the respondents as part of the post-test.  Results: Among the participants, 44.7% were educated up to the primary level, a majority (64.1%) were employed, and most (90.3%) were married. Additionally, 56.9% reported a monthly income below 3000 Indian rupees (₹), with the majority (86.3%) falling below the poverty line (BPL) category. A statistically significant improvement (p = 0.0001) in knowledge related to breast health, breast self-examination, clinical breast examination, and mammography was observed in the post-intervention phase when compared to the pre-test. 86.2% of the respondents showed an increase in knowledge level about breast health (either from poor to moderate or from moderate to good) and the practice of breast self-examination increased from 4.7% (pre-test) to 60.3% (post-test).  Conclusion: The study demonstrated a significant enhancement in women's knowledge levels after implementing the health education intervention program. These findings underscore the importance of health education strategies in raising awareness of lifestyle diseases, particularly breast cancer, among women.

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.

Effect of breast cancer education based on the health belief model on knowledge, health belief, and breast self-examination among female students of Debre Markos University, Northwest Ethiopia, in 2021

Background

Breast cancer is the primary cause of mortality in female patients around the world and the second most common cancer after lung cancer in both sexes. Socio-cultural factors contribute to the development, maintenance, and change of health behavior; knowledge, attitudes, and motivation are important individual determinants of health behavior change. Therefore, this study aims to evaluate the effect of health belief model-based breast cancer education on knowledge, health belief, and breast self-examination among female students of Debre Markos University, Ethiopia, in 2021.

Methods

A quasi-experimental study was conducted on 210 samples selected by simple random sampling; samples were assigned to an intervention group and a control group based on their cluster. Data were collected by self-administration questionnaire before and after intervention and then entered into Epi data version 3.1 and analyzed by SPSS version 25. A dependent t-test and an independent t-test were used. Difference in difference was used to assess the effect of the intervention.

Results

Statistically significant differences were observed between groups’ knowledge about breast cancer after educational intervention; monthly breast self-examination practice changes from 20.0% to 57.58% and 17.14% to 24.27% in intervention and control groups, respectively; and average scores of all health belief model constructs show a statistically significant change in the intervention group relative to controls after intervention. Overall knowledge increased by 6.24, perceived susceptibility increased by 4.67, perceived seriousness increased by 6.93, benefit of breast self-examination increased by 3.51, self-efficacy increased by 9.45, cues for action increased by 2.74, barriers of breast self-examination decreased by 3.61, and breast self-examination increased by 2.26 due to educational intervention.

Conclusion

The health belief model-based education is an effective and efficient way to enhance students’ breast self-examination and promote knowledge and health beliefs about breast cancer. Based on the findings of this study, implementing a health belief model-based educational intervention about breast cancer at different phases of life is important to fight the disease.

Breast cancer knowledge among health professionals: A pre-post-knowledge-based intervention study

Introduction

Breast-cancer-related morbidity and mortality can be reduced by following worldwide-accepted screening guidelines and by appropriate education and training of health professionals on risk identification and screening. The study aimed to determine the significance of educational sessions in improving health professionals' knowledge about breast cancer, particularly screening modalities that can benefit the patients.

Method and Materials

An interventional study was conducted among 260 health professionals, including medical students, nurses, and allied health professionals. The intervention was an educational session on breast cancer risks and screening guidelines. Health professionals' knowledge about breast cancer risk, presentation, and screening were tested by a structured questionnaire before and after the educational session. Data were analyzed using Statistical Package for the Social Sciences 26. Chi-square was used to identify differences in pre and post-test. P value was considered significant at <0.05.

Results

There is a significant difference between pre-session and post-session responses in all areas of knowledge about breast cancer, with much improved outcomes after the educational session.

Conclusion

Health professionals lack knowledge about breast cancer risk factors, screening tools, presentation, and management. Regular education sessions improve these knowledge gaps and help early detection and treatment of women at risk of breast cancer.

Breast Cancer Awareness Based on Health Information Literacy and Influential Factors among Female Nursing Students in China

This investigation aimed to study breast cancer awareness based on health information literacy and influential factors of breast cancer awareness among female nursing students in Changchun city in China. A four-part self-report questionnaire including the participants' general demographic characteristics, the participants' specialized characteristics concerning breast cancer screening, the Chinese version of the Breast Cancer Awareness Measurement (C-BCAM), and the Chinese version of the Health Information Literacy Self-rating Scale (HILSS) was designed to investigate breast cancer awareness and health information literacy and influential factors of breast cancer awareness among 205 female nursing students in Year 1-Year 3 using convenience sampling. The data were analyzed with SPSS 26.0 using descriptive statistics, nonparametric tests, and multiple regression analysis. The nursing students had an average level of HIL (median = 101.00, (93.00, 107.00)) and a good level of breast cancer awareness (median = 82.00, (76.00, 88.00)). A significant positive correlation was found between the HILSS and total C-BCAM score (r = 0.439, P < 0.01). Multivariate logistic regression analysis demonstrated that grades (P < 0.001), training in BSE (P = 0.025), and intention of undergoing breast cancer screening (P = 0.028) were three predictive factors for breast cancer awareness among female nursing students. The female nursing students' HIL was at an average level, and breast cancer awareness was at a good level. Health information literacy and breast cancer awareness among female nursing students in Changchun were significantly positively correlation, as demonstrated by this survey. Therefore, nursing education has the responsibility to improve female nursing students' awareness of breast cancer at different grades and to cultivate health information literacy. More training in BSE is needed. Greater efforts may be needed to develop targeted nursing education to strengthen female nursing students' awareness of breast cancer and HIL.

Evaluation of Breast Self-examination Training in Turkish Women Living in Northwestern Turkey

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.

Effectiveness of educational intervention on breast cancer knowledge and breast self-examination among female university students in Bangladesh: a pre-post quasi-experimental study

BACKGROUND

Breast cancer is a global health issue and a leading cause of death among women. Early detection through increased awareness and knowledge on breast cancer and breast cancer screening is thus crucial. The aim of the present study was to assess the effect of an educational intervention program on breast cancer knowledge and the practice of breast self-examination among young female students of a university in Bangladesh.

METHODS

A quasi-experimental (pre-post) study design was conducted at Jahangirnagar University in Bangladesh. Educational information on breast cancer and breast self-examination (BSE), demonstration of BSE procedure and leaflets were distributed among 400 female students after obtaining written informed consent. The stepwise procedures of BSE performance were demonstrated with images. Pre-intervention and 15 days post-intervention assessments were conducted to assess the changes in knowledge on breast cancer and practices of BSE. Mc-Nemar's tests and paired sampled t-tests were performed to investigate the differences between pre- and post-test stages.

RESULTS

A total of 400 female university students aged 18-26 years were included in the sample. Significant changes were found in knowledge and awareness about breast cancer and BSE practices after the educational intervention. The significant differences were measured in the mean scores of pre-test vs. post-test: breast cancer symptoms (2.99 ± 1.05 vs. 6.35 ± 1.15; p < 0.001), risk factors (3.35 ± 1.19 vs. 7.56 ± 1.04; p < 0.001), treatment (1.79 ± 0.90 vs. 4.63 ± 0.84; p < 0.001), prevention (3.82 ± 1.32 vs. 7.14 ± 1.03; p < 0.001), screening of breast cancer (1.82 ± 0.55 vs. 3.98 ± 0.71; p < 0.001) and process of BSE (1.57 ± 1.86 vs. 3.94 ± 0.93; p < 0.001). Likewise, a significant percentage of change in BSE practices was obtained between pre-test and post-test (21.3% vs. 33.8%; p < 0.001).

CONCLUSIONS

Study findings confirm that the study population had inadequate awareness and knowledge at baseline which was improved significantly after educational intervention. A nationwide roll-out with community-based interventions is recommended for the female population in both rural and urban areas.

The Effectiveness of Educational Interventions on Breast Cancer Screening Uptake, Knowledge, and Beliefs among Women: A Systematic Review

There have been various systematic reviews on the significance of educational interventions as necessary components to encourage breast cancer screening (BCS) and reduce the burden of breast cancer (BC). However, only a few studies have attempted to examine these educational interventions comprehensively. This review paper aimed to systematically evaluate the effectiveness of various educational interventions in improving BCS uptake, knowledge, and beliefs among women in different parts of the world. Following the PRISMA guidelines, a comprehensive literature search on four electronic databases, specifically PubMed, Scopus, Web of Science, and ScienceDirect, was performed in May 2019. A total of 22 interventional studies were reviewed. Theory- and language-based multiple intervention strategies, which were mainly performed in community and healthcare settings, were the commonly shared characteristics of the educational interventions. Most of these studies on the effectiveness of interventions showed favorable outcomes in terms of the BCS uptake, knowledge, and beliefs among women. Educational interventions potentially increase BCS among women. The interpretation of the reported findings should be treated with caution due to the heterogeneity of the studies in terms of the characteristics of the participants, research designs, intervention strategies, and outcome measures.

Knowledge, Attitude and Practice Around Breast Cancer and Mammography Screening Among Jordanian Women

Background

Breast cancer is the most common occurring cancer in women worldwide. To guide current breast cancer screening program, the level of knowledge about breast cancer should be evaluated. This study aims to ascertain the level of breast cancer knowledge including risk factors, signs and symptoms, and early detection methods, especially mammography screening.

Methods

The study was conducted among 1353 Jordanian women from the public using a self-administered questionnaire. Responses to the knowledge test were summed for an overall knowledge score. Comparisons between socio-demographics and knowledge, attitude and practice were also measured using a Chi-square test.

Results

About 76% of participants were aware that breast cancer is the most common cancer among women in Jordan. About 53.7% of our participants were rated as having an intermediate level of knowledge regarding risk factors, and 44% were rated as having a good to an excellent level of knowledge about breast cancer signs and symptoms. The participants' level of education was the main factor identified as influencing the participants' knowledge of the risk factors, signs and symptoms, and knowledge of early detection methods of breast cancer. The study sample was rated as having an intermediate level of knowledge regarding mammography screening; however, their participation in this screening method was low.

Conclusion

Although Jordanian women had an acceptable level of knowledge of breast cancer, the screening rates for mammography were low. These findings suggest that there is a need to provide extra awareness programs for Jordanian women to improve their breast cancer knowledge and practice.

The relationship of socio-demographic characteristics and knowledge of breast cancer on stage of behavioral adoption of breast self-examination

Background/aim

In Malaysia, breast cancer is the most common cancer among women. As such, early diagnosis and screening practices are important to increase the survival rate. Breast self-examination (BSE) is one of the main screening methods for breast cancer. Socio-demographic characteristics and knowledge of breast cancer are amongst the crucial roles in determining women's behavioral adoption in performing BSE. This study aims to assess the relationship of socio-demographic factors and knowledge of breast cancer on the stage of behavioral adoption of BSE among Malaysian women in Kuantan, Pahang.

Materials and methods

A cross-sectional study was conducted on 520 women from three different government health clinics in Kuantan and IIUM Family Health Clinic from February to April 2018. Data were collected using a self-administered questionnaire on socio-demographic factors and knowledge of breast cancer and its effect on the behavioral adoption of BSE.

Results

Significant difference was found between socio-demographic characteristics and behavioral adoption of BSE. However, only breast screening and the best time for screening were found to be significant with the behavioral adoption of BSE and knowledge of breast cancer.

Conclusion

It is found that most women in Kuantan, Pahang perform BSE but were still unaware of the importance of performing BSE for early breast cancer detection. This study was expected to enhance women's awareness of the benefits of performing BSE.

The Effect of Health Education Given to Syrian Refugee Women in Their Own Language on Awareness of Breast and Cervical Cancer, in Turkey: a Randomized Controlled Trial

In general, refugees have an increased cancer burden because of living in difficult conditions and having low income. Refugee women may have difficulty in accessing healthcare services because of the fear of uncertainty, security concerns, language barriers, cultural differences, and economic problems. For this reason, it is thought that health education given to Syrian refugee women by overcoming the language problem (given in their own language-Arabic) increases the awareness of breast and cervical cancer. The aim of this study is to evaluate the effect of health education given to refugee women in their own language on the awareness of breast and cervical cancer. This is a randomized controlled trial with one control and one intervention group. The research sample consisted of 60 Syrian women (30 experiments, 30 controls), at least 18 years old, married, and literate women who were refugees in Hatay/Turkey. The research data were collected via the questionnaire form developed by the researchers. At the beginning of the study, there was no statistically significant difference in terms of age, education, economic status, gravida, and parity among the women in the experimental and control groups (p > 0.05). There was no statistically significant difference between the pre-test mean scores of the experimental and control groups (p > 0.05). However, there was a statistically significant difference between the post-test mean scores of the experimental and control groups (p < 0.005). In this study, it was determined that health education given to refugee women in their own language had a significant effect on breast and cervical cancer awareness. The attitudes and motivations are shaped, not only by personal information but also by the cultural changes within the community.

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 Counseling on Breast Cancer Awareness in Rural Iranian Women: a Randomized Controlled Clinical Trial

In a community such as Iran where late presentation is predominant and the majority of breast cancer patients are diagnosed at advanced stages of the disease, there is an urgent need for improving the level of awareness about breast cancer and early detection measures. Given that rural residents are at higher risk for late diagnosis of breast cancer because they have less education, income, and access to advanced screening technologies, this study was conducted to determine the effect of counseling on breast cancer awareness of rural Iranian women. This randomized clinical trial was conducted on 60 rural women from the Abish Ahmad area in northwestern Iran in 2017. The randomized cluster method was used for sampling. From 20 rural health houses and centers, about one third were selected randomly. From the six selected clusters, three were randomly allocated as the control group and three as the intervention group. Using convenience sampling, 30 women between the ages of 40 and 69 were selected from the control group and 30 from the intervention group. The intervention group attended six group counseling sessions. Data was gathered using a demographic and obstetrical information questionnaire and breast cancer awareness measures. The chi-square, independent t test and ANCOVA by controlling for the baseline scores were used to analyze the data. After counseling, the mean knowledge about breast cancer score was significantly higher in the intervention group than in the control group (adjusted mean difference, 17.02; confidence interval (CI) 95%, 15.44 to 18.59; p < 0.001). The mean barriers to breast cancer screening score showed a significant decrease in the intervention group compared to the control group (AMD, - 1.74; 95% CI - 3.12 to - 0.36, p < 0.001). After intervention, the frequency of breast self-exam showed a significant difference between groups (p < 0.001); but for confidence about noticing breast changes, no significant difference was observed between groups (p = 0.08). Group counseling had a significant effect on enhancing breast cancer awareness of rural Iranian women, except for confidence about noticing breast changes.

Educational Study to Increase Breast Cancer Knowledge Level and Scanning Participation among Women Working at a University

OBJECTIVE

The aim of the study is to increase the participation level of women in screening programs by increasing the level of knowledge about early diagnosis and screening methods for breast cancer (BC).

MATERIALS AND METHODS

This was a pretest-posttest one group design study held in Eskişehir Osmangazi University, Turkey. The sample consisted of 405 women in all departments of the University. Data were collected using socio-demographic forms and questionnaires. Training about BC was provided for participants. The questionnaire used prior to the training to measure levels of knowledge about BC was re-administered 3 weeks after the training.

RESULTS

The women were most commonly aware of the breast self-examination (68.1%). The ratio of women who had had mammography in the previous year was 11.4%. The BC knowledge level significantly increased after the training (p=0.001).

CONCLUSION

This study determined that the level of knowledge about BC in terms of early detection and screening was low and that the percentage of participation in screening was also low.