Adoption of breast self-examination in socio-economically disadvantaged women: the effect of prompting, self-management, feedback, and supplementary training
Increased breast cancer mortality among socio-economically disadvantaged women is well documented. Also well documented is the utility of BSE as an economical means of early detection and, therefore, decreased breast cancer mortality. This study assessed health beliefs and breast cancer screening practices among a sample of women recruited from local public health clinics as well as a sample of women recruited from a federally-subsidized housing development in Roanoke, Virginia. In addition, this study concomitantly examined the efficacy of an intervention promoting BSE through standard face-to-face training, written prompts, self-management, and personalized feedback within the housing development sample. The feasibility of recruiting and intervening with predominately minority, low SES, women living in public housing is also addressed. The clinic sample consisted of 42 women who ranged in age from 20 to 44 (X=24.9 years), 88.1% had earned their high school diploma or equivalency, and the sample was predominantly (83.3%) Caucasian. The housing sample (n=30) was largely African-American (87%), ranged in age from 20 to 57 (X=35 years), and had a mean educational attainment of 11th grade. Both samples reported relatively low levels of BSE frequency, quality, and knowledge; however, the clinic sample was significantly more likely to have tried a BSE than women in the housing sample (p < .05) and reported a significantly higher perception of benefits of BSE (p < .001). Analyses of variance revealed a significant effect of the intervention on BSE frequency (p < .05), although not on BSE quality or knowledge. Results of stepwise multiple regressions varied depending on the dependent measure used for BSE frequency; however, number of project-initiated contacts uniformly appeared as a significant predictor of BSE frequency whereas knowledge was the largest significant predictor of BSE quality. The study demonstrated the potential utility of the intervention to promote the adoption of BSE; however, BSE proficiency must also be addressed for the intervention to succeed in achieving health benefits.