April 30, 2009 (Portland, Ore.) A brief intervention program – consisting of one counseling session and two follow-up phone calls – boosted by tenfold the number of women correctly performing breast self- exams. These are the findings of a Kaiser Permanente Center for Health Research study in the American Journal of Health Promotion.
Funded by the National Cancer Institute, this study is one of the first to show intervention programs can be effective in increasing breast self-exams. Most previous studies have failed to show an increase in the number of women conducting BSEs correctly.
This intervention program is a model that can be used to encourage patients' participation in their own health care, and can be modified to educate patients about other self-screening techniques for cancers such as melanoma and testicular cancer, say the researchers.
"Many women avoid breast self-exams because they are worried about doing them correctly; however, our study showed that with a relatively simple intervention, women can learn the proper technique, and once they feel confident they will continue to do their exams." said Nangel Lindberg, Ph.D., lead author and investigator at the Kaiser Permanente Center for Health Research in Portland, Ore. "This is an excellent opportunity for women to participate in their own health care. Self-exams allow women to become familiar with their breasts, so they can report any changes to their health care provider. "
Breast cancer is the most common form of cancer in women. Every year, more than 1 million cases are diagnosed around the world, including more than 200,000 in the United States. The American Cancer Society estimates that nearly 40,000 American women will die this year from breast cancer.
This Kaiser Permanente Center for Health Research study, conducted from 1998 through 2001, involved more than 600 women, aged 40 to 70, who had a negative mammogram screening within the last two months. The women were randomized to a group that received dietary counseling with no mention of BSE, or the study group that received a 30 to 45-minute counseling session in which they watched an educational video, practiced BSE on a silicone model, and discussed possible barriers to doing self- exams. At one and two months after the session, the women also received follow-up phone calls. Before the intervention about six percent of women in both groups were performing adequate self exams – defined as lasting at least five minutes, occurring every month, and fulfilling specific criteria taught during the counseling sessions. One year after the program, 59 percent of women in the intervention group were performing adequate self-exams, compared to only 12 percent of women who received dietary counseling.
Early detection is an important factor in the success of breast cancer treatment. While some studies have shown that BSE does not reduce the number of deaths from breast cancer, it may help familiarize women with their normal breast tissue –which aids in identifying new or unusual changes in their breasts. Many experts believe along with regular mammography and clinical breast exams BSE can play an important role in early detection.
Study limitations include the fact that the results are based on self-reported data, and that all the participants in the study had health insurance, so results may not be applicable to populations without health insurance.
Authors include Nangel M. Lindberg, Ph.D., Victor J. Stevens, Ph.D., and K. Sabina Smith, BA, all of the Kaiser Permanente Center for Health Research in Portland, Ore.; Russell E. Glasgow, Ph.D., Kaiser Permanente in Denver; and Deborah Toobert, Ph.D., the Oregon Research Institute in Eugene, Ore.
About the Kaiser Permanente Center for Health Research (http://www.kpchr.org)
Kaiser Permanente's Center for Health Research, founded in 1964, is a nonprofit research institution dedicated to advancing knowledge to improve health. It has research sites in Portland, Ore., Honolulu, Hawaii and Atlanta.
About Kaiser Permanente Research
Kaiser Permanente's eight research centers comprise one of the largest research programs in the United States and engage in work designed to improve the health of individuals everywhere. Kaiser Permanente HealthConnect™ , Kaiser Permanente's electronic health record, and other resources provide population data for research, and in turn, research findings are fed into KP HealthConnect™ to arm physicians with research and clinical data. Kaiser Permanente's research program works with national and local health agencies and community organizations to share and widely disseminate its research data. Kaiser Permanente's research program is funded in part by Kaiser Permanente's Community Benefit division, which in 2007 directed an estimated $1 billion in health services, technology, and funding toward total community health.
About Kaiser Permanente
Kaiser Permanente is shaping the future of health care. We are America's leading health care provider and not-for-profit health plan. Founded in 1945, our mission is to provide high-quality, affordable health care services to improve the health of our members and the communities we serve. We currently serve 8.6 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to www.kp.org/newscenter.
Journal
American Journal of Health Promotion