1. Lindsay Abrigo MPH 515 – Principles of Health Behavior Dr. Kimberly Brodie October 22, 2013

2.  Increase awareness of breast cancer › All levels of society (i.e. family, friends, general public, medical professional community)  Emphasize importance of early detection › Education and implementation  Provide necessary information and basic knowledge › Gain understanding of breast cancer  Educate proper technique for breast self-exams

3.  Teenage girls aged 17-18 years › High school seniors › Attend a private, Catholic high school  Approaching age for having annual exams with gynecologist including clinical breast exam  Become familiarized with their bodies › Know what is normal for them  Learn how to perform breast self-exams

4.  “Test Your Breasts” Questionnaire › Distributed at the start of the program › Identifies participants who are related to/know of someone who has/has had and beat/died of breast cancer › Questions focused on knowledge of breast cancer/BSE, how/where knowledge was gained, individuals’ belief of risk, and susceptibility  Lecture Presentation › Delivers information about breast cancer: types/stages of rbeast cancer, early detection and screening, risk factors, and step-by-step guide to preform BSE (Instructional handout with steps provided)  Informational Brochure › Distributed during presentation and is supplemental to the BSE handout with step-by-step instructions

5.  “Test Your Breasts” Reminder Cards › Step-by-step to perform BSE and reminds participants of its importance  Quick, easily accessible, efficient, convenient  Easily distributed to friends/families of participants  Door Hanger › Displays statistics of breast cancer, can be displayed anywhere, and serves as another reminder › Place it wherever they choose and serves as another reminder tool  “Breastology Bag” › Provided to eat participant at start of the program › Teaches participants how to feel for changes in their breasts and how to properly perform BSE  Mammary Game › Designed similar to the game Jeopardy › Test participants’ learned knowledge gained through lecture/how well they retained information  “Test Your Breast Knowledge” Assessment › Final to determine how much information was retained/understood › Reassesses each participants’ risk perception and readiness to make intended behavioral changes › Assesses each participants’ confidence in performing BSE

6.  Uncontrolled growth of breast cells that undergo a mutation or abnormal change  1 out of 8 women in the United States will develop breast cancer  In 2007, CDC states 202,964 women were diagnosed with breast cancer › 40,598 of those women died  Women with a family history of breast cancer are two to three times more likely to develop breast cancer

7.  Option for females starting in their 20s  Checking breasts for lumps or changes › Looking and feeling  70% of all breast cancers found through self exams

8.  How to test your breasts › Apply different amounts of pressure › Three patterns to examine breast  What to look for when you Test Your Breasts › Lumps or thickening › Puckering › Inflammation › Nipple discharge  When to Test Your Breasts › Standing up › Laying down

9.  Perceived Susceptibility › Participant’s opinion of getting breast cancer › Questionnaire determines which participants have a family history or know of someone who has, has had, or died of breast cancer › Lecture discusses risk factors, symptoms, causes, and incidence  Perceived Severity › Participant’s opinion of the seriousness/consequences of breast cancer › Lecture discusses consequences/risk of getting breast cancer  Perceived Benefits › Participant’s belief in efficacy of BSE to reduce risk/know how their breasts feel normally › Lecture explains how/when/where to perform BSE › Brochure/other materials emphasize importance of performing BSE

10.  Perceived Barriers › Participant’s opinion of costs/barriers of performing BSE › Lecture allows participants to engage/share concerns/ask questions › Encourage others to get involved  Cues to Action › Strategies used to activate participant’s readiness to perform BSE › Brochure and handout provides step-by-step instructions on performing BSE › Reminder cards will remind participants and family/friends of the importance to perform BSE and promote awareness  Self-efficacy › Participant’s confidence in their ability to take action › Instructions train each participant on properly performing BSE

11.  Health Belief Model used as framework to guide formative research of risk perception for breast cancer › Silk et al. (2006) › Adolescent females/adult females in 4 Michigan counties › 10 focus groups conducted/analyzed based on HBM  Adolescent and mother groups recognized gender and heredity as relevant risk factors related to susceptibility › Detection as a strategy to decrease severity of breast cancer  Adolescent girls expressed more about efficacy issues  Mothers focused significantly more on role of government and industry in breast cancer prevention and treatment

12.  Descriptive, cross-section study › Karayurt, Özmen, and Çetinkaya (2008) › Target population: High school students at vocational high school for girls in Turkey, 2006-2007 academic year › 718 female students  Investigate knowledge and practice of BSE  Determine knowledge of risk factors for breast cancer  Instruments used for data collection: › Sociodemographic charactistics data form › Knowledge of BSE and risk factors for breast cancer form › BSE practice form

13.  6.7% performed BSE monthly; 20.3% irregularly  Female high school students had little knowledge of: › Risk factors for breast cancer › Appropriate time for BSE › Proper technique for performing BSE › Frequency of performing BSE  Most common reasons for not performing BSE: › “Not knowing how to perform BSE” › “Not expecting to get breast cancer” › “Not having a close relative with breast cancer”  Most widely known risk factors: › Personal history of breast cancer › Family history of breast cancer

14.  Although breast cancer in teens in rare, it is important for teenage girls to start thinking about breast cancer › Symptoms, risks, causes, and incidence  Teens must take necessary steps and precautions › Become familiar with their bodies, particularly their breasts  Know what is normal for them  These young women will be the first to recognize a difference  BSE education should be taught to teenage girls and further encouraged by medical professionals › How to properly perform BSE and what to look for

15.  Instructional methods selected specifically for target population and successfully delivered intended messages: › Informing females in high school about breast cancer symptoms, causes, and risk factors › Emphasizing importance of performing BSE › Encouraging and promoting good health behaviors  Carry into adulthood and pass on to others  Program participants were able to confidently perform BSE according to step-by-step instructions provided  Participants more knowledgeable about necessity of performing BSE › Involve other female family and friends by utilizing the materials provided during program