Promote Breast Cancer Screening Research Articles

The effects of educational intervention on breast self-examination and mammography behavior: Application of an integrated model.

BACKGROUND:Breast cancer is the most common type of cancer among women and it is the second leading cause of mortality among cancers in women and a major health issue in developed countries. Although there are simple and effective screening methods, just minority of women use them. Given the high prevalence of breast cancer in Isfahan women and the low prevalence of screening behavior, the present study aimed to determine the impact of theory-based educational intervention on breast self-examination (BSE) behavior and mammography.MATERIALS AND METHODS:The present experimental study was conducted on 93 women referred to comprehensive health centers in Isfahan through convenience sampling, and by this way 46 women were included in the control group and 47 in the intervention group. Data collection was done by a valid and reliable questionnaire. Furthermore, educational interventions were performed for the intervention group in three sessions. Furthermore, the data were completed in the intervention group before, immediately after, and 3 months after intervention and before and 3 months after intervention in the control group. The data were analyzed by SPSS (16); and paired t-test and repeated measure test were used for analysis in the intervention group and also independent t-test and paired t-test were employed to analyze data of the control group.RESULTS:The results showed significant changes in perceived benefit constructs (P = 0.023), knowledge (P < 0.001), self-efficacy (P < 0.001), and behavioral intention regarding BSE (P = 0.035) in the intervention group over time, but changes were not significant in both perceived susceptibility and severity in the intervention group. As far as mammography behavior is concerned, only the perceived benefit construct in the intervention group had significant changes. In terms of the screening behavior, only BSE behavior significantly changed before and after intervention.CONCLUSION:The study showed that theory-based education by applying of constructs such as perceived benefits and self-efficacy and intention for BSE model could promote breast cancer screening behavior such as BSE. Therefore, it is suggested that health educators utilize educational texts based on these constructs to increase their influence on individuals via screening behavior for breast cancer.

Abstract PO-052: Teens for Screens: Implementation of a breast cancer awareness education program among high school students from minority communities in San Francisco

Abstract Introduction: Racial/ethnic and socioeconomic (SES) disparities in breast cancer (BC) risk and survival are well documented. In a study of the BC population in San Francisco (SF), we identified neighborhood and racial/ethnic differences in stage of diagnosis, molecular subtype, and survival. Women that resided in low SES areas of SF were diagnosed with more advanced BC stage and had lowest screening rates. With the goal of narrowing observed disparities, the SF Cancer Initiative (SFCAN) created Teens for Screens (T4S). T4S is an education program aimed to educate and empower high school students (HS) to promote BC screening and healthy behaviors in their families and communities. Methods: T4S was developed using a continuous- stakeholder-engagement approach, including HS partners and the SFCAN BC task force. The program was advertised via dissemination of flyers among public schools of SF. Applicants were selected to represent a diverse group of HS based on self- reported race/ethnicity, different public high schools, and teens who reside within neighborhoods with lowest screening rates. Selection was limited to 10th and 11th graders and priority was given to those with a close experience with BC. During phase 1 (P1), participants attended 4 weekly half-day educational sessions focused on: introduction to BC, risk factors, health disparities, and community resources. P1 sessions integrated the participation of healthcare professionals, survivors, and community partners, as well as interactive exercises on communication and leadership skills. Participants were provided with an online educational video created by HS and the SFCAN website as resources for dissemination during phase 2 (P2). Results: After 3-weeks of advertisement, T4S received 76 applications. We accepted 39 sophomore and junior HS from 10 different SF public high schools based on the program’s selection criteria. Among 39 recruited HS, 64% self-identified as Asian/Asian American, 20% Hispanic/Latino, 8% African American, and 5% non- Hispanic White. The majority of participants were female (74%), identified as bilingual (64%; 15% trilingual), and resided in neighborhoods of northeastern and southern SF, consistent with areas of lowest BC screening rates. Thirty-five (90%) participants completed P1 of the pilot. Most participants were satisfied or very satisfied with T4S (95.5%). Ninety two percent of HS reported their understanding of BC increased, and 83% expressed confidence in their ability to discuss the importance of BC screening with others. Preliminary results of P2, show that 83% of HS remain engaged reporting their dissemination efforts. Conclusions: Implementing a BC educational program for HS from diverse targeted communities is feasible and acceptable. The T4S program increased HS knowledge on BC and empowered them to disseminate their knowledge to peers and other community members. Our ongoing efforts during P2 of this pilot include evaluating the dissemination, adaptation, and impact of T4S. Citation Format: Ana I. Velazquez, Leela Wong, Tania Dugatkin, Bianca Dal Bo, SFCAN Breast Cancer Task Force, Laura Fejerman. Teens for Screens: Implementation of a breast cancer awareness education program among high school students from minority communities in San Francisco [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-052.

Organizational Transformation to Improve Breast Cancer Screening Behaviors in Iranian Women: A Qualitative Study.

Breast cancer is the most common cause of premature mortality among women, and screening is one of the most important means of early diagnosis of breast cancer. This qualitative study was conducted to explore strategies for promoting breast cancer screening behaviors from the perspective of health volunteers in south-east Iran. Data collection was performed through focus groups. Using the purposive sampling method, 35 participants were selected and data were analyzed using a specific qualitative content analysis framework. By analyzing the data to provide strategies for promoting breast cancer screening behaviors, the main theme of "organizational transformation" with five subthemes including the promotion of health-centered beliefs in society, the development of culture-based training, the media revolution, financial support, and the provision of efficient health-care providers were extracted. According to the results of the study, the development of organizational transformation plays an important role in planning for the promotion of breast cancer screening.

Factors associated with receipt of mammogram among caregivers: a comparison with non-caregivers

Backgroundcaregiving responsibilities significantly impact females’ decisions on adhering to preventive mammography. The purpose of this study is to examine (1) the levels of mammogram receipt, (2) the role of caregiving factors on the receipt of mammogram in caregiving group, and (3) the role of cancer beliefs on mammogram screening in caregivers and non-caregivers.Methodsthe 2017 Health Information National Trends Survey (HINTS) provides samples of 1228 women aged 40 to 75 years old for this secondary analysis. By using Andersen’s Behavioral Model of Health Services Use, a binomial logistic regression model was used to analyze associations between mammography and socioeconomic factors, caregiving factors, and cancer belief factors.Resultscaregivers who provided more caregiving hours per week (OR = 0.749, 95% CI = 0.564–0.94) and caregivers who had the belief of rather not knowing the likelihood of getting cancer (OR = 0.673, 95% CI = 0.496–0.914) were less likely to use mammogram. However, caregivers who believed cancer is more common than heart disease (OR = 1.490, 95% CI = 1.302–2.151) were more likely to use a mammogram. Non-caregivers who worried about getting cancer (OR = 1.158, 95% CI = 0.793–1.691) were more likely to use mammogram, but non-caregivers who had the belief of rather not know the likelihood of getting cancer (OR = 0.825, 95% CI = 0.713–0.955) were less likely to use mammogram.Conclusionsto support caregivers’ breast cancer prevention, caregiving-related policies based on caregiving hours should be developed. Particularly, effort to promote breast cancer screening education and care support among older primary caregivers will likely increase their adherence to preventive mammography uptake. The development of targeted cancer prevention interventions on specific cancer beliefs held by both groups are also urgently needed to promote mammography.

Theory-based training to promote breast cancer screening among women with breast cancer worries: randomized controlled trial.

Breast cancer worries are important determinants in relation to behavior favoring breast cancer screening. To determine the effect of theory-based training to promote breast cancer screening among women with high and low levels of breast cancer worries. Randomized controlled trial, conducted in two family health centers. In total, 285 women were recruited. Women with low levels of breast cancer worries were included in the first intervention group (112 women) and the first control group (112 women), while women with high levels of breast cancer worries were included in the second intervention group (37 women) and the second control group (43 women). Theory-based training to promote breast cancer screening was given to intervention groups. The women's willingness to undergo breast cancer screening and breast cancer worry scores were evaluated at 1, 3 and 6 months. The women in the low cancer-worry intervention group performed breast self-examination more in months 1 and 6 following the training, and the women in the high cancer-worry control group performed breast self-examination more in month 3 (P < 0.05). No difference between the women who had low or high levels of breast cancer worries were observed in relation to breast self-examination, clinical breast examination or mammography (P > 0.05). The level of worry did not affect the success of theory-based training, and the training was partially effective with regard to willingness to undergo breast cancer screening.

Theory-based Training to Promote Breast Cancer Screening

Theory-based Training to Promote Breast Cancer Screening

MOBILE APP INTERVENTION TO PROMOTE BREAST CANCER SCREENING IN OLDER KOREAN AMERICAN WOMEN

To promote breast cancer screening behavior in older Korean American women, a mobile phone multimedia messaging intervention (mMammogram) was developed. The current study explored how the mMammogram intervention can be applied and improved for wide dissemination and implementation in other older racial/ethnic immigrant populations. Three focus groups were conducted with 14 older Korean American women who completed the mMammogram. Three themes emerged: (1) emphasis on knowledge improvement (understanding of breast cancer screening); (2) assistance of bilingual health navigators to promote mammography (e.g., setting up appointment and transportation); and (3) consideration of technology literacy (e.g., training for use of smartphone and connectivity issues). Mobile app intervention combined with bilingual health navigation services can be an acceptable and effective intervention medium to promote mammogram, which will bring about a positive change in women’s health screening behavior, especially for newly arrived immigrant populations.

Relationship of Health Locus of Control with Breast Cancer Screening Belief of Iranian Women

Promoting breast cancer screening (BCS) behavior of women can lead to a reduction in mortality. The health locus of control affects cancer screening behavior of women; however, there is not sufficient evidence regaring this issue in Iran. The overall goal of our study is to determine the relationship of the health locus of control with the breast cancer screening belief of Iranian Women. This is a cross-sectional study carried out on 325 women in Tehran. The Multidimensional Health Locus of Control (MHLC), Breast Cancer Screening Belief Questionnaire (BCSBQ), and Demographic questionnaire were used for collecting data. Statistical analyze was performed by the SPSS version 17 software. The Pearson correlation and regression model were used for data analyze. In this study, 325 women, age 18 to 75 years, participated in this study. The mean±SD of BCSBQ and MHLC score was 40.72±10.41 and 67.78±17.67 respectively. The regression analysis showed that for the one-unit increase in the Internal Health Locus of Control (IHLC), Powerful others Health Locus of Control (PHLC), and Chance Health Locus of Control (CHLC) score (dimensions of Health Locus of Control), the total BCSBQ scores increased 0.54, 0.31, and 0.57 respectively. For each unit increase in age and education, the knowledge and perceptions of the BC score increased 0.05 and 0.23 units respectively. For the one-unit increase in the IHLC, PHLC, age, and education dimensions, the attitudes towards the general health check-up score increased 0.17, 0.1, 0.05, and 0.188 respectively. The current study provided new insights about the BCSB of Iranian women with MHLC. In the study, all the dimensions of the health locus of control were useful in predicting the breast cancer screening belief of the participants.

Promoting Breast Cancer Screening Take-Ups with Zero Cost: Evidence from an Experiment on Formatting Invitation Letters in Italy

We ran a randomized field experiment to ascertain whether a costless manipulation of the informational content (restricted or enhanced information) and the framing (gain or loss framing) of the invitation letter to the breast cancer screening program in Messina, Italy, affects the take-up rate. We show that giving enhanced loss-framed information about the risks of not having a mammography increases the take-up. This manipulation is especially effective among subjects with lower baseline take-ups – those living farther away from the screening site, residing in municipalities with low education, or with no recent screening experience – contributing to reduce socio-economic inequalities in screening. When we investigate the mechanisms behind our findings, we show that subjects exposed to our proposed manipulation are also less likely to postpone the appointment, signaling enhanced awareness about the risks related with delayed participation.

Raising awareness of organised breast cancer screening

Student nurses in eastern France have organised, in collaboration with local nonprofit organisations, awareness raising actions to promote breast cancer screening. Working very closely with female populations, undertaking highly personal questioning, diverging representations and beliefs were some of the difficulties these students had to manage as part of these preventive and educational care missions.

Use of Social Media in Breast Cancer Awareness: GCC Countries’ Experience

Background: Breast cancer is the highest incident cancer among women in the world today as well as in the Gulf Cooperation Council (GCC) countries. Improving the public awareness is significant in decreasing the overall morbidity and mortality of breast cancer. Social media brings a new dimension to healthcare as it offers a medium to communicate to be used by the public, patients, and health professionals to communicate health-related issues with the possibility of potentially improving health outcomes. According the Arab Social Media Report 2017 , the GCC countries largely dominate the top five spots in terms of penetration rates of key social media platforms among their populations, including Facebook, Twitter, LinkedIn, and Instagram. Social media platforms are now frequently used on a large adoption rate by the public to address health-related issues especially in GCC countries. Compared with the rest of the Arab region, the Gulf countries largely have more balanced age breakdowns of young users who are under 30 and those who are over 30 years old, indicating the maturity of usage across age groups in society. Aim: This paper aims to provide an overview of the available evidence concerning the use of social media platforms in breast cancer awareness campaigns in GCC. Methods: A literature search was conducted using PubMed and Google Scholar databases for articles published between 2010 and March 2018. Several keywords have been used. Search was limited to articles in English and Arabic describing the use of social media platforms in breast cancer awareness campaigns in any of the GCC countries. Results: More than 500 studies have been identified in the initial search. Fifteen articles have been deemed eligible. The majority are discussing the importance of using media (mass and social) as the main source of breast cancer information, however, a multilevel intervention should be considered as many interventions should be used to create culturally appropriate breast cancer awareness campaigns in the GCC countries. Conclusion: Apparently, media have been used to raise breast cancer awareness to promote breast cancer screening programs including self-exam and mammogram, benefits of early detection, and modifiable risk factors. However, social media should not be viewed as a solution to the complexities of behavior change and improved health outcomes; instead, use of social media in health promotion should be valued for its potential to engage with audiences for enhanced communication and improved capacity to promote programs, products, and services. The use of various social media platforms is variable across age, educational, and socioeconomic groups; therefore, breast cancer awareness campaigns utilizing social media should be tailored according to the target group, however public communication in the GCC still considered as a significant challenge due to the cultural diversity and language barriers.

Development and Evaluation of Culturally and Linguistically Tailored Mobile App to Promote Breast Cancer Screening.

Background: While a significant breast cancer burden exists for Korean American immigrant women, their cancer screening behavior is strikingly poor, and few interventions have focused on this population. To promote breast cancer screening behavior in Korean American immigrant women, a mobile phone multimedia messaging intervention (mMammogram) was developed. Objective: The current study explores the impact of mMammogram on changes to study participants’ screening behavior and proposes suggestions for how the intervention can be improved for wide dissemination and implementation in the Korean American community. Material and Methods: Data were collected through qualitative research methods. Three focus groups were conducted with 14 Korean immigrant women who completed the mMammogram. Findings: Three themes emerged: (1) better understanding of breast cancer and screening through mMammogram (e.g., increased knowledge on breast cancer and screening methods, increased understanding of the importance of regular mammography, and reduced anxiety about mammography); (2) health navigators as a trigger to promote mammography (e.g., providing resources for free or low-cost mammograms and scheduling mammogram appointments); and (3) suggestions for mMammogram (e.g., technical issues and program period). Conclusions: Mobile app intervention that is culturally tailored, along with health navigation services, can be a feasible, effective, and acceptable tool to promote breast cancer screening behaviors in underserved immigrant women. A mobile app can cover a broad range of breast cancer health topics and the health navigator can further help women overcome barriers to screening. A health navigation service is critical in overcoming language, transportation, and health accessibility barriers and triggering a positive change in their health screening behavior, especially for newly arrived immigrant populations.

Abstract B25: Empowering Latinas to obtain breast cancer screenings: Comparing intervention effects, part 1

Abstract Purpose: Latinas suffer disproportionately from breast cancer relative to non-Latina Whites (NLWs), partially due to lower guideline-concordant screening. In response, a significant body of work first sought to characterize disparities and associated determinants. Second, multiple approaches were developed to address this disparity, including community health worker (CHW)-driven education to the target population and empowerment interventions, wherein CHWs train a subset of the population to disseminate education to other members of the target population and mobilize in the context of health. The next logical step is to compare the relative effectiveness of interventions for future large-scaled implementation. Objective: We report emerging evidence from an ongoing, quasi-experimental trial that compares the effects of education and empowerment approaches on Latinas who are nonadherent to US Preventive Services Task Force breast cancer screening guidelines. Methods: The setting for this trial is in two Latino, lower-income communities in Chicago (Pilsen/Little Village, East Side/Chicago). Women are recruited via two community-based organizations (The Resurrection Project, Centro Comunitario Juan Diego) and snowball sampling. Eligibility criteria include: 1) age of 50-74; 2) lack of screening within past 2 years; 3) no previous breast cancer diagnosis; and 4) no prior health volunteerism experience. After screening and providing informed consent, women are assigned to a cohort (6-10 sessions) and participate in a three-week intervention (three 2-hour sessions). The education intervention is administered in East Side/Chicago and the empowerment intervention is administered in Pilsen/South Chicago to avoid contamination effects. The education intervention consists of a session focused on breast cancer and methods of early detection, a session focused on diet as a method of prevention, and a session focused on physical activity as a method of prevention. The empowerment intervention consists of a session focused on breast cancer and methods of early detection, a session focused on one-on-one conversations with family and friends about breast cancer, and a session focused on health-related volunteerism. For women who wish to obtain mammography (from either arm), study team provides navigation to free/low-cost services and tracks participants throughout the continuum of care. Three questionnaires are given: baseline (before Session #1), postintervention (after Session #3), and a follow-up (6 months after Session #3). Receipt of screening is confirmed by study and medical records for women who have completed HIPAA forms. Participants are compensated $80 for their participation. As well, during and after the intervention, participants may refer other nonadherent Latinas to the study for a small incentive ($15). Results: Our current sample is 37 women (20 education; 17 empowerment). The average age was 61.62 years old (SD = 6.02). Approximately 89% of participants were born in Mexico and approximately 81% had less than a high school education. The median annual household income was &amp;lt;$15,000. A greater proportion of empowerment participants have scheduled a mammogram relative to education participants (20% vs. 76%; p=.001). Relative to education participants, a greater proportion of empowerment participants have discussed breast cancer with other nonadherent Latinas and referred them to the study (5% vs 33%; p = .05). Discussion: Preliminary findings suggest the empowerment approach may be more effective in promoting breast cancer screening among nonadherent Latinas and disseminating information to their peers. Limitations concern generalizability due to a non-probability based sample and limited ability for causal inferences due to a lack of randomization. Next steps include comparing receipt of screening and characterizing diffusion of information throughout participants' social networks. Citation Format: Yamile Molina, Liliana G. San Miguel, Lizeth Tamayo, Sylvia Gonzalez, Rosa de la Torre, Kryztal Peña, Araceli Lucio, Oliva Hernandez, Juanita Arroyo, Maria C. Medina, Nora Coronado. Empowering Latinas to obtain breast cancer screenings: Comparing intervention effects, part 1 [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B25.

Promoting breast cancer screening after multiplex genetic panel testing (MGPT) and genetic counseling.

1581Background: Cancer screening guidelines recommend that germline carriers with a pathogenic variant (PV) in a breast cancer susceptibility gene undergo more intensive breast screening including ...

Intention to Receive Breast Cancer Screening and Related Factors of Influence Among Vietnamese Women in Transnational Marriages.

Breast cancer is a major global health issue. Receiving regular breast cancer screenings aids in the early detection and treatment of breast cancer. Numerous factors influence whether a Vietnamese woman receives breast cancer screening. The aims of this study were to understand current rates of breast cancer screening and explore the factors that influence intention to undergo breast cancer screening among Vietnamese women in transnational marriages. This was a cross-sectional, community-based study. Data were collected via snowball sampling. We enrolled 250 women aged 18 years and over from September to December 2015. The percentage of participants who had received a breast self-examination, breast palpation, or breast ultrasound within the past year were 25.6%, 9.6%, and 21.2%, respectively. Moreover, only 6.8% of participants had received a mammography within the past 2 years. Participants with strong perceptions of breast cancer being a serious illness, who had fewer barriers to obtaining a breast cancer screening, or who had been advised by healthcare personnel to undergo screenings were more likely to report an intention to receive periodic breast self-examinations during the subsequent 1-year period. Participants who had lived in Taiwan for a longer period, had higher levels of perceived susceptibility to breast cancer, had prior experience with breast diseases, or had fewer barriers to obtaining a breast cancer screening were more likely to report an intention to receive a breast ultrasound during the subsequent 1-year period. Finally, participants who were older, perceived greater benefits from receiving breast cancer screening, and had not entered menopause were more likely to report an intention to receive a mammography during the following 2 years. Medical care personnel should promote breast cancer screening among Vietnamese women in transnational marriages. The results may be useful in promoting greater awareness among medical care personnel of breast cancer issues and efficacy in performing breast cancer screening for Vietnamese women in transnational marriages and provide references for the establishment of breast cancer prevention and control policies.

Effects of Model-Based Interventions on Breast Cancer Screening Behavior of Women: a Systematic Review

Background:Breast cancer is a great concern for women’s health; early detection can play a key role in reducing associated morbidity and mortality. The objective of this study was to systematically assess the effectiveness of model-based interventions for breast cancer screening behavior of women.Methods:We searched Scopus, PubMed, Web of Science, Science Direct, Cochrane library and Google scholar search engines for systematic reviews, clinical trials, pre- and post-test or quasi-experimental studies (with limits to publication dates from 2000-2017), Keywords were: breast cancer, screening, systematic review, trials, and health model. In this review, qualitative analysis was used to assess the heterogeneity of data.Results:Thirty six articles with 17,770 female participants were included in this review. The Health belief model was used in twenty three articles as the basis for intervention. Two articles used both the Health belief model and the Health Promotion Model, 5 articles used Health belief model and The Trans theoretical Model, 2 used Hthe ealth belief model and Theory planned behavior, 2 used the Health belief model and the Trans theoretical Model, 2 used the Trans theoretical Model, 1 used social cognitive theory, and 1 used Systematic Comprehensive Health Education and Promotion Model. The results showed that model-based educational interventions are more effective for BSE and CBE and mammography screening behavior of women compare to no model based intervention. The Health belief model was the most popular model for promoting breast cancer screening behavior.Conclusions:Educational model-based interventions promote self-care and create a foundation for improving breast cancer screening behavior of women and increase policy makers’ awareness and efforts towards its enhancement breast cancer screening behavior.

A Culturally Tailored Intervention for Promoting Breast Cancer Screening Among Women From Faith-Based Communities in Israel: A Randomized Controlled Study

Lower rates of screening for early detection of cancer were reported among ethnic minorities and faith-based communities. The purpose of the article is to assess the effect of a culturally based intervention program intended to increase breast cancer screening adherence among two groups in Israel: ultra-Orthodox Jewish and Arab women. Using a randomized controlled study design, 598 participants completed the 3-month follow-up questionnaire regarding adherence to screening and perceived effect of intervention. Results show that having a lower level of religious beliefs and gaining a better understanding of the importance of screenings were significant predictors of performing breast awareness practice (BAP) and undergoing clinical breast examination (CBE) in both groups. We conclude that interventions should be specifically tailored to cultural groups to reduce barriers stemming from unique beliefs and perceptions, which prevent individuals in these groups from undergoing screening. Special efforts should be made to increase CBE among young women.

Mobile Phone Multilevel and Multimedia Messaging Intervention for Breast Cancer Screening: Pilot Randomized Controlled Trial.

BackgroundDespite the increasing breast cancer incidence and mortality rates, Korean American immigrant women have one of the lowest rates of breast cancer screening across racial groups in the United States. Mobile health (mHealth), defined as the delivery of health care information or services through mobile communication devices, has been utilized to successfully improve a variety of health outcomes.ObjectiveThis study adapted the principles of mHealth to advance breast cancer prevention efforts among Korean American immigrant women, an underserved community.MethodsUsing a randomized controlled trial design, 120 Korean American women aged 40 to 77 years were recruited and randomly assigned to either the mMammogram intervention group (n=60) to receive culturally and personally tailored multilevel and multimedia messages through a mobile phone app along with health navigator services or the usual care control group (n=60) to receive a printed brochure. Outcome measures included knowledge, attitudes, and beliefs about breast cancer screening, readiness for mammography, and mammogram receipt. The feasibility and acceptability of the mMammogram intervention was also assessed.ResultsThe intervention group showed significantly greater change on scores of knowledge of breast cancer and screening guidelines (P=.01). The intervention group also showed significantly greater readiness for mammography use after the intervention compared with the control group. A significantly higher proportion of women who received the mMammogram intervention (75%, 45/60) completed mammograms by the 6-month follow-up compared with the control group (30%, 18/60; P<.001). In addition, the intervention group rated satisfaction with the intervention (P=.003), effectiveness of the intervention (P<.001), and increase of knowledge on breast cancer and screenings (P=.001) significantly higher than the control group.ConclusionsA mobile phone app–based intervention combined with health navigator service was a feasible, acceptable, and effective intervention mechanism to promote breast cancer screening in Korean American immigrant women. A flexible, easily tailored approach that relies on recent technological advancements can reach underserved and hard-to-recruit populations that bear disproportionate cancer burdens.Trial RegistrationClinicaltrials.gov NCT01972048; https://clinicaltrials.gov/show/NCT01972048 (Archived by WebCite at https://clinicaltrials.gov/archive/NCT01972048/2013_10_29)

Training Community Health Workers to promote breast cancer screening in Brazil

Although it has been show that early detection through mammograms is the most effective way to reduce breast cancer mortality, breast cancer is the leading cause of cancer deaths among women worldwide with survival rates being even lower in low- and middle-income countries as compared to high-income countries. Despite the availability of breast cancer screening programs in Brazil through the public health system, some women do not participate in these programs due to structural and/or inter/intrapersonal barriers. The Community Health Worker (CHW) model is a promising approach to reach these women who have not been reached through other efforts. This paper describes a participatory approach for capacity building of CHWs to promote breast cancer screening among low-income women 50 years of age and older in a southern city in Brazil as a combined effort between two academic institutions, the municipal health care system, and a local non-profit organization. The capacity building program consisted of an 8-hour training focusing on knowledge (e.g., breast cancer and screening) and skills (e.g., communication skills, basic principles of behavior change) to promote breast cancer screening among community members. Pre- and post-test questionnaires assessed changes in breast cancer knowledge and self-perceived knowledge and confidence (N=44). There was a significant increase in objective knowledge regarding breast cancer overall, risk factors, and behavior change strategies between pre- and post-test. There was also a significant increase in self-perceived knowledge and confidence, items related to knowledge about breast cancer, breast cancer early detection methods, and the ability to solve problems between pre- and post-test as well as a significant increase in their confidence to motivate women to get a mammogram. Overall, this study demonstrates the importance of welldeveloped capacity building programs to promote breast cancer screening among health care professionals, especially those with limited educational attainment, such as CHWs.

Interventions Promoting Breast Cancer Screening Among Turkish Women With Global Implications: A Systematic Review.

Breast cancer is a major health concern and remains the most common malignancy in women worldwide and in Turkey. Mammography, clinical breast examination (CBE), and breast self-examination (BSE) are recommended methods to detect early breast cancer in women. Many strategies have been developed to increase the rates of mammography, CBE, and BSE among Turkish women. Despite the benefits of breast cancer screening, these modalities are still underutilized by the majority of Turkish women. To systematically review the scientific evidence on the effectiveness of various strategies aimed at improving screening behaviors for breast cancer in Turkish women. A systematic review of the literature published between 2000 and 2015 was conducted, searching 10 databases of Ovid MEDLINE, PubMed, Cochrane CENTRAL Register of Controlled Trials, CINAHL, PsycINFO, Web of Knowledge, Scopus, Google Scholar, ULAKBIM Turkish Medical Database, and Council of Higher Education Thesis Center. Twenty-three studies were included in the final review. The majority of the studies investigated the effects of multiple strategies to improve BSE. Group education comprised educational sessions, printed and audiovisual materials, which significantly improved BSE, CBE, and mammography screening rates at 3 months, 6 months, and 12 months after the intervention. One-to-one education demonstrated no significant difference in BSE rates at 6-month and 12-month follow-up. However, one-to-one education demonstrated significant differences in CBE and mammography rates at the 3-month follow-up. The use of group education comprising a multicomponent intervention demonstrated an increase in breast-screening behaviors among Turkish women. Further research investigating the duration of educational interventions is needed in order to suggest a "dose response."