Abstract
Despite declines in breast cancer mortality rates in developed countries, mortality rates remain high in Jamaica due to low levels of screening and lack of early detection. We hypothesized that a theory-based health educational intervention would increase awareness of breast cancer and intention to screen among women in Western Jamaica. Two hundred and forty six women attending hospitals or clinics were enrolled in an educational intervention consisting of a pretest, breast cancer presentation, and posttest if they had never been screened or had not been screened in 5 years or more. The questionnaires assessed attitudes and knowledge of risk factors and symptoms related to breast cancer. Participants were followed approximately 6 months after the intervention to determine whether they accessed breast cancer screening. There were statistically significant increases (p < 0.0001) in the percentage of correct knowledge responses and in participants’ intention to screen from pretest to posttest. The greatest posttest improvements were among items measuring knowledge of breast cancer screening tests and risk factors. Of the 134 women who were reached by phone for post-intervention follow-up, 30 women (22.4 %) were screened for breast cancer and 104 women (77.6 %) had not been screened. The use of a theory-based educational intervention positively influenced knowledge of breast cancer risk factors, symptoms, and types of screening and increased screening rates in screening-naïve women. This theory-based educational intervention may be replicated to promote awareness of breast cancer and further increase screening rates in other areas of Jamaica and other developing countries.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Anderson, B. O., Yip, C.-H., Smith, R. A., Shyyan, R., Sener, S. F., Eniu, A., & Harford, J. (2008). Guideline implementation for breast healthcare in low-income and middle-income countries. Cancer, 113, 2221–2243. doi:10.1002/cncr.23844.
Clover, K., Redman, S., Forbes, J., Sanson-Fisher, R., & Callaghan, T. (1996). Two sequential randomized trials of community participation to recruit women for mammographic screening. Preventive Medicine, 25, 126–134. doi:10.1006/pmed.1996.0038.
Danaei, G., Vander Hoorn, S., Lopez, A. D., Murray, C. J. L., & Ezzati, M. (2005). Causes of cancer in the world: Comparative risk assessment of nine behavioural and environmental risk factors. The Lancet, 366, 1784–1793.
Dullum, J. R., Lewis, E. C., & Mayer, J. A. (2000). Rates and correlates of discomfort associated with mammography. Radiology, 214, 547–552.
Ferlay J.S.H., Bray F., Forman D., Mathers C. and Parkin D.M. (2010). GLOBOCAN 2008 v2.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10 [Internet]. Lyon, France: International Agency for Research on Cancer. Retrieved 25 October, 2013, from http://globocan.iarc.fr.
Garne, J. P., Aspegren, K., Balldin, G., & Ranstam, J. (1997). Increasing incidence of and declining mortality from breast carcinoma. Trends in Malmo, Sweden, 1961–1992. Cancer, 79, 69–74.
Gibson, T., Hanchard, B., Waugh, N., & McNaughton, D. (2010). Age-specific incidence of cancer in Kingston and St Andrew, Jamaica, 2003–2007. West Indian Medical Journal, 59, 456–464.
Gürsoy, A. A., Mumcu, H. K., Çalık, K. Y., Bulut, H. K., Nural, N., Kahriman, I. L., & Yılmaz, F. (2011). Attitudes and health beliefs associated with breast cancer screening behaviors among Turkish women. Journal of Transcultural Nursing, 22, 368–375. doi:10.1177/1043659611414137.
Hafslund, B. (2000). Mammography and the experience of pain and anxiety. Radiography, 6, 269–272. doi:10.1053/radi.2000.0281.
Jenkins, C. N. H., McPhee, S. J., Bird, J. A., Pham, G. Q., Nguyen, B. H., Nguyen, T., & Davis, T. B. (1999). Effect of a media-led education campaign on breast and cervical cancer screening among Vietnamese-American women. Preventive Medicine, 28, 395–406. doi:10.1006/pmed.1998.0444.
Madigan, M. P., Ziegler, R. G., Benichou, J., Byrne, C., & Hoover, R. N. (1995). Proportion of breast cancer cases in the United States explained by well-established risk factors. Journal of the National Cancer Institute, 87, 1681–1685. doi:10.1093/jnci/87.22.1681.
McCree-Hale, R., Hale, T., Rutley, K., Aung, M., & Jolly, P. (2012). Evaluating a theory-based health education intervention to improve awareness of prostate cancer among men in Western Jamaica. West Indian Medical Journal, 61, 580–586.
Park, K., Hong, W., Kye, S., Jung, E., Kim, M.-H., & Park, H. (2011). Community-based intervention to promote breast cancer awareness and screening: The Korean experience. BMC Public Health, 11, 468.
Prochaska, J. O., & Velicer, W. F. (1997). The transtheoretical model of health behavior change. American Journal of Health Promotion : AJHP, 12, 38–48.
Richardson, A., Cox, B., Brown, T., & Smale, P. (2005). The impact of breast cancer screening on breast cancer registrations in New Zealand. New Zealand Medical Journal, 118, U1291.
Robles, S. C., & Galanis, E. (2002). Breast cancer in Latin America and the Caribbean. Revista Panamericana de Salud Pública, 11, 178–185.
Rosenstock, I. M., Strecher, V. J., & Becker, M. H. (1988). Social learning theory and the health belief model. Health Education & Behavior, 15, 175–183. doi:10.1177/109019818801500203.
Segura, J. M., Castells, X., Casamitjana, M., Macià, F., & Ferrer, F. (2000). Utilization of screening mammography as a preventive practice prior to initiating a population-based breast cancer screening program. Journal of Clinical Epidemiology, 53, 595–603. doi:10.1016/S0895-4356(99)00201-2.
Smith, R. A., Duffy, S. W., Gabe, R., Tabar, L., Yen, A. M. F., & Chen, T. H. H. (2004). The randomized trials of breast cancer screening: What have we learned? Radiologic Clinics of North America, 42, 793–806.
Soares, D., Kirlew, K., Johnson, P., & Reid, M. (2007). Mammographic referral patterns for two breast imaging units in Jamaica. West Indian Medical Journal, 56, 159–162.
Soares, D., Walters, N., Frankson, M., Kirlew, K., & Reid, M. (2009). Sociocultural deterrents to mammographic screening in Jamaica. West Indian Medical Journal, 58, 28–32.
Tfayli, A., Temraz, S., Abou Mrad, R., & Shamseddine, A. (2010). Breast cancer in low- and middle-income countries: An emerging and challenging epidemic. Journal of Oncology, 2010. doi:10.1155/2010/490631.
Valdez, A., Banerjee, K., Ackerson, L., & Fernandez, M. (2002). A multimedia breast cancer education intervention for low-income Latinas. Journal of Community Health, 27, 33–51. doi:10.1023/a:1013880210074.
Weir, H. K., Thun, M. J., Hankey, B. F., Ries, L. A. G., Howe, H. L., Wingo, P. A., & Edwards, B. K. (2003). Annual report to the nation on the status of cancer, 1975–2000, featuring the uses of surveillance data for cancer prevention and control. Journal of the National Cancer Institute, 95, 1276–1299. doi:10.1093/jnci/djg040.
Acknowledgments
This research was funded by the Minority Health International Research Training Program, grant no. T37-MD001448, from the National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA; The Cancer Research Experiences for Students Training Program, grant no. 5R25 CA76023, from the National Cancer Institute; and The University of Alabama School of Medicine and its Medical Alumni Association. The authors are grateful to Kyaw Lwin, the Epidemiology and Research Unit of Western Regional Health Authority, and Western Regional Health Authority health educators for their research assistance.
Conflict of Interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Anakwenze, C.P., Coronado-Interis, E., Aung, M. et al. A Theory-Based Intervention to Improve Breast Cancer Awareness and Screening in Jamaica. Prev Sci 16, 578–585 (2015). https://doi.org/10.1007/s11121-014-0529-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11121-014-0529-4