The effects of a breast health promotion program on breast cancer screening behaviors

This experimental study evaluates the effects of a breast health promotion program on frequency and proficieny of breast self-examination (BSE), rates of clinical breast examination (CBE) and mammography practices. The effects of program on breast cancer knowledge and breast cancer health beliefs were also evaluated. The sample consisted of women aged 40 or above, who were defined as not regularly performing BSE, and had not received a mammogram and CBE in the last 12 months (experimental group=97 and control group=93) in a health center area, in Istanbul. The intervention was based on health belief model and included health education, film, breast model, booklet, pamphlet, and card.  Data were collected with questionnaire; the screening behaviors’ form, breast self-examination proficiency rating instrument, breast cancer knowledge form and breast cancer health belief model scale. Related with BSE, the frequency of BSE three times in 3 months was considered as “proficient”, and with CBE and mammography, having had them at 6 months post-intervention was the outcome. Data were collected at before the intervention, after the intervention, at 3 month and 6 month following intervention, and analysed by descriptive statistics, Student-t, Mann-Whitney U, paired t-test, Wilcoxon test, and repeated measures of variance analysis, chi-square and Fisher’s exact test. The results demonstrated the rate of performing proficient BSE and the breast cancer knowledge score were significantly higher in experimental group; and no significant differences were found respect to mammography and clinical breast exam practices. Comparative analyses for health beliefs in both two groups revealed a statistically significant increase after the intervention in the experimental group in perceived susceptibility, seriousness, benefits-BSE, barriers-BSE, confidence and benefits-mammogram. In conclusion, the program was found effective in promoting BSE rates, in increasing breast cancer knowledge and health beliefs; but not found effective in increasing the rate of having CBE and mammograms.