Breast Cancer Literacy Research Articles

Insufficient Knowledge of Breast Cancer Risk Factors Among Malaysian Female University Students.

Background:Despite continuous argument about the efficacy of breast self-examination; it still could be a life-saving technique through inspiring and empowering women to take better control over their body/breast and health. This study investigated Malaysian female university students’ knowledge about breast cancer risk factors, signs, and symptoms and assessed breast self-examination frequency among students.Method:A cross-sectional survey was conducted in 2013 in nine public and private universities in the Klang Valley and Selangor. 842 female students were respondents for the self-administered survey technique. Simple descriptive and inferential statistics were employed for data analysis.Results:The uptake of breast self-examination (BSE) was less than 50% among the students. Most of students had insufficient knowledge on several breast cancer risk factors.Conclusion:Actions and efforts should be done to increase knowledge of breast cancer through the development of ethnically and traditionally sensitive educational training on BSE and breast cancer literacy.

Association between Family Communication and Health Literacy among Underserved Racial/Ethnic Women

Health literacy and the family can be used to promote cancer screenings. We examined the associations of socio-demographic factors, family communication, and cancer literacy in a diverse population. Baseline data from the Kin Keeper(SM) Cancer Prevention randomized controlled trial were analyzed for Black (n=216), Latino (n=65), and Arab (n=235) women. Key variables were based on the Family Adaptability and Cohesion Scale IV, and the Cancer Literacy Assessment Tool. Among Blacks, cervical cancer literacy was positively associated with family communication. Cancer literacy was associated with higher educational level, employment, and family self-rated health status among Black and Arab women. Among Latinas, who were the least educated and had the lowest literacy scores, family communication was inversely related to breast cancer literacy. Family-centered networks may be a viable resource for the transmission of health cancer literacy information, inform health care decision-making, and contribute to decreasing breast and cervical cancer mortality.

Answering the Call: A Tool That Measures Functional Breast Cancer Literacy

There is a need for health care providers and health care educators to ensure that the messages they communicate are understood. The purpose of this research was to test the reliability and validity, in a culturally diverse sample of women, of a revised Breast Cancer Literacy Assessment Tool (Breast-CLAT) designed to measure functional understanding of breast cancer in English, Spanish, and Arabic. Community health workers verbally administered the 35-item Breast-CLAT to 543 Black, Latina, and Arab American women. A confirmatory factor analysis using a 2-parameter item response theory model was used to test the proposed 3-factor Breast-CLAT (awareness, screening and knowledge, and prevention and control). The confirmatory factor analysis using a 2-parameter item response theory model had a good fit (TLI = .91, RMSEA = .04) to the proposed 3-factor structure. The total scale reliability ranged from .80 for Black participants to .73 for total culturally diverse sample. The three subscales were differentially predictive of family history of cancer. The revised Breast-CLAT scales demonstrated internal consistency reliability and validity in this multiethnic, community-based sample.

Assessment of breast cancer literacy among female students in a Pakistani university

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Murtaza G, Abbasi S, Irum H, Jadoon M, Hussain I. Assessment of breast cancer literacy among female students in a Pakistani university. Contemporary Oncology/Współczesna Onkologia. 2011;15(6):387-390. doi:10.5114/wo.2011.26441. APA Murtaza, G., Abbasi, S., Irum, H., Jadoon, M., & Hussain, I. (2011). Assessment of breast cancer literacy among female students in a Pakistani university. Contemporary Oncology/Współczesna Onkologia, 15(6), 387-390. https://doi.org/10.5114/wo.2011.26441 Chicago Murtaza, Ghulam, Sadaf Imtiaz Abbasi, Hina Irum, Mehreen Khan Jadoon, and Izhar Hussain. 2011. "Assessment of breast cancer literacy among female students in a Pakistani university". Contemporary Oncology/Współczesna Onkologia 15 (6): 387-390. doi:10.5114/wo.2011.26441. Harvard Murtaza, G., Abbasi, S., Irum, H., Jadoon, M., and Hussain, I. (2011). Assessment of breast cancer literacy among female students in a Pakistani university. Contemporary Oncology/Współczesna Onkologia, 15(6), pp.387-390. https://doi.org/10.5114/wo.2011.26441 MLA Murtaza, Ghulam et al. "Assessment of breast cancer literacy among female students in a Pakistani university." Contemporary Oncology/Współczesna Onkologia, vol. 15, no. 6, 2011, pp. 387-390. doi:10.5114/wo.2011.26441. Vancouver Murtaza G, Abbasi S, Irum H, Jadoon M, Hussain I. Assessment of breast cancer literacy among female students in a Pakistani university. Contemporary Oncology/Współczesna Onkologia. 2011;15(6):387-390. doi:10.5114/wo.2011.26441.

Abstract A22: New instrument to measure functional breast cancer literacy

Abstract A critical undertaking in designing research interventions that study effective ways to reduce health disparities among racial/ethnic and underserved women is to have instruments that are linguistically and culturally appropriate. Traditionally, when instruments are developed, even those that are used in health disparities, they have been normed using Caucasians and then used with other populations. We were funded by the National Institutes of Health, National Institute of Nursing Research to use traditional rigors of psychometric methods in the context of a community-based participatory research intervention to validate cancer literacy assessment tools (CLAT) that measure a woman's functional understanding of breast and cervical cancer in English, Spanish, and Arabic. With a sample size of 543 women, the reliability, factor structure, validity of the Breast Cancer Literacy Assessment Tool (BCLAT) was determined by exploratory and confirmatory factor analysis. We examined differential item functioning (DIF) with nonparametric IRT Multiple regression was used to identify variables predictive of performance on the BCLAT. Results: A confirmatory factor analysis (CFA), using a 2-parameter IRT model, had a good fit (CFI = .81, RMSEA = .05) to the proposed three factor structure. Maximum likelihood exploratory factor analysis of tetrachoric correlations and examination of scree plots also indicated a 3-factor solution. No items were eliminated as a result of the DIF analysis. The three scales, Awareness, Screening, and Prevention/Control, were moderately difficult with 63%, 62%, and 68% correct, respectively, with internal consistency reliability of .53, .62, and .63, respectively. The scales were only weakly inter-correlated (r's < .40). The total scale reliability was .70. Income, education and self-rated health were positively associated with Awareness but not related to Screening or Prevention/Control. Age was positively associated with Prevention/Control. Seventy seven participants were in a family with a history of breast cancer. This was associated with higher scores on Screening and Prevention/Control. Having friends with a history of breast cancer was unrelated to any of the BCLAT scales. The BCLAT scales have demonstrated internal consistency reliability and validity in this multiethnic community based sample. Even when implementing the Kin KeeperSM Cancer Prevention Intervention to deliver cancer education to Black, Latina and Arab women as the context in which we validated our cancer literacy assessment tools, we were still able to adhere to the rigorous of psychometric testing. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A22.

Abstract A3: Design and model for breast cancer literacy outcomes among medically underserved females in Michigan

Abstract Statistical theory requires that analysis of study outcomes be conducted conditional on the design process. Ignoring this process may result in severely biased estimates, leading to false inferences, especially when the outcome variable is associated with design variables. We propose in this paper a class of hierarchical models to investigate the dependence between the design process and the study outcomes of primary interest. We discuss a fully parametric and a semiparametric formulation of the hypothesized model and propose the EM algorithm to obtain maximum likelihood estimates. Our numerical results show that the semiparametric approach outperforms the fully parametric model with respect to some key features of the model. The methodology is used to gain insight into the mechanism that generates breast cancer literacy outcomes in a study conducted among medically underserved females in Michigan. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A3.

Evaluating the Knowledge of Breast Cancer Screening and Prevention among Arab-American Women in Michigan

Arab-American women are more likely to be diagnosed with advanced staged breast cancer. We analyzed data from 100 women utilizing a breast cancer literacy assessment tool aimed at understanding functional literacy levels about breast-self exams (BSE), clinical breast exams (CBE), and mammograms. The educational program improved women's knowledge of BSE (OR = 0.15; 95% CI = 0.04, 0.50) and CBE (OR = 0.15; 95% CI = 0.04, 0.54), more for women with higher education. Consideration of women's educational status is an important factor in planning educational programs to improve knowledge on breast cancer screening and prevention in this minority population.

Longitudinal analysis of domain-level breast cancer literacy among African-American women

Functional breast cancer literacy was assessed among African-American women and measured at the domain level over time. We used the Kin Keeper(SM) Cancer Prevention Intervention to educate 161 African-American women on three domains of breast cancer literacy: (i) cancer awareness, (ii) knowledge of breast cancer screening modalities and (iii) cancer prevention and control. A breast cancer literacy assessment was administered pre- and post-educational intervention at two time points followed by another assessment 12 months after the second intervention. Generalized estimating equations were specified to predict the probability of correctly answering questions in each domain over time. Domain-level literacy differentials exist; at baseline, women had higher test scores in the breast cancer prevention and control domain than the cancer awareness domain (odds ratio = 1.67, 95% confidence interval 1.19-2.34). After Kin Keeper(SM) Cancer Prevention Intervention, African-American women consistently improved their breast cancer literacy in all domains over the five time stages (P < 0.001) though at different rates for each domain. Differences in domain-level breast cancer literacy highlight the importance of assessing literacy at the domain level. Interventions to improve African-American women's breast cancer literacy should focus on knowledge of breast cancer screening modalities and cancer awareness domains.

A Community-Based Approach to Translating and Testing Cancer Literacy Assessment Tools

To address the issue of cancer disparities among women whose first language is not English, researchers and public health educators are challenged to develop culturally and linguistically appropriate material and instruments. This study documents the process used to linguistically and culturally translate breast and cervical cancer literacy assessment tools from English to Spanish and from English to Arabic by using a community-based method. Results from field testing the assessments demonstrated good reliability for overall cancer literacy in English (Cronbach's alpha .99), Spanish (Cronbach's alpha .99), and Arabic (Cronbach's alpha .81). Using a community-based approach to translate the cancer assessments helped to insure they were culturally appropriate.

Breast Cancer and Cervical Cancer Control Program Enrollees Inform the Kin Keeper Curriculum

The purpose of this study is to present the methodology of developing the Kin Keeper Cancer Prevention Curriculum Guide and Workbook through participatory engagement of women from underserved communities. It was developed to cross train community health workers (CHWs) from public health programs to deliver cancer education. Data collection included review of existing educational materials, a 10-minute telephone survey of 146 women enrolled in a Breast and Cervical Cancer Control Program and a pair of pre-post training assessments of 31 African American, Latina, and Arab CHWs. The enrollees adequately informed the curriculum and the CHWs increased their scores by 7% (14%) in breast (cervical) cancer literacy; P-values <0.01. The methodology was validated; the curriculum was well-informed and CHWs were effectively cross trained using the curriculum.

A hierarchical model for binary data with dependence between the design and outcome success probabilities

Statistical theory requires that analysis of study outcomes be conducted conditional on the design process. Ignoring this process may result in severely biased estimates, leading to false inferences, especially when the outcome variable is associated with design variables. We propose in this paper a class of hierarchical models to investigate the dependence between the design process and the study outcomes of primary interest. We discuss a fully parametric and a semi-parametric formulation of the hypothesized model and propose the EM algorithm to obtain maximum likelihood estimates. Our numerical results show that the semi-parametric approach outperforms the fully parametric model with respect to some key features of the model. The methodology is used to gain insight into the mechanism that generates breast cancer literacy outcomes in a study conducted among medically underserved females in Michigan.

Moving from theory to practice: implementing the Kin KeeperSM Cancer Prevention Model

This paper presents the rationale and findings of a feasibility and process study of the Kin Keeper(SM) Cancer Prevention Intervention. An observational cohort study design was implemented with African-American women in synergistic female family relationships. Community health workers (CHWs) from two Michigan public health programs recruited women to serve as 'kin keepers' who in turn recruited their female family members. In total, 161 kin keepers and female family members were sampled. Trained CHWs led kin keepers and family members in learning about breast cancer. Data methods included baseline and post-training administration of a breast cancer literacy assessment, post-training focus groups and review of personal action plans. To validate the feasibility of the process, a linear mixed-effects regression with 97% power was identified and differences in pre-post scores were detected at 5% significance level. Adjusting for family random effects, breast cancer literacy scores increased for all participants recruited (P-value = 0.0004) suggesting that the process was feasible. Analysis of focus groups and action plans indicated that participants valued the instruction and planned to act upon it. This experience with kin keepers and their families offers encouragement that the theoretical model and its community-based delivery can continue to enhance scholarship dedicated to ameliorating health care disparities.