Objectives: The purpose of our study was to develop and evaluate an educational program for health care providers and patients on the topics of general breast cancer risk factors, breast cancer genetics, and breast cancer screening recommendations. The program was designed with specific emphasis on addressing the needs of medically underserved Hispanic women in Southern Texas. We also identified and compared perceptions of potential barriers to breast cancer screening. Methods: The educational program was piloted with patient and health care provider focus groups. After incorporating modifications suggested by the focus groups, 103 patients and 94 health care providers (HCPs) from community health clinics in Harris County, Tex., were recruited to participate in the study. Changes in knowledge were measured through the use of pre- and postseminar questionnaires. Results: The program identified various misconceptions about breast cancer in representative groups of patients and HCPs. Comparison of pre- and post-test scores indicated that both groups made significant gains in knowledge about breast cancer and breast cancer screening. Participant evaluations indicated that the seminar was informative and interesting. Both patients and HCPs agreed that the cost of breast cancer screening and the lack of sufficient bilingual HCPs were ‘major’ barriers to obtaining breast cancer screening, but had differing opinions regarding other potential barriers. Conclusions: We have developed an effective method of education about breast cancer risk factors and screening for two groups: Hispanic women of lower educational and socioeconomic levels, and the HCPs who serve them. Based on the successful reception of our program, we propose extending it to other areas of Texas with demographics similar to those of the study population.

Keywords:
Breast cancer, Genetic predisposition, Patient education, Hispanic women, Medically underserved populations, Risk perception
1.
American Cancer Society: Cancer Facts and Figures. Atlanta, American Cancer Society, 2000.
2.
Hubbell AF, Chavez LR, Mishra SI, Valdez RB: Differing beliefs about breast cancer among Latinas and Anglo women. West J Med 1996;164:405–409.
3.
Zaloznik AJ: Breast cancer stage at diagnosis: Caucasians versus Hispanics. Breast Cancer Res Treat 1997;42:121–124.
4.
Bailey S, Bennett P, Hicks J, Kemp C, Warren S: Cancer detection activities coordinated by nursing students in community health. Cancer Nurs 1996;19:348–352.
5.
Breen N, Kessler L, Brown M: Breast cancer control among the underserved – An overview. Breast Cancer Res Treat 1996;40:105–115.
6.
Kerner J: Breast cancer prevention and control among the medically underserved. Breast Cancer Res Treat 1996;40:1–9.
7.
Englisbe B, Jimpson G, Harper G, Cohen M: Encouraging mammography use among underserved women through a celebration of breast health. Am J Public Health 1995;85:1446–1447.
8.
Hiatt RA, Pasick RJ: Unsolved problems in early breast cancer detection: Focus on the underserved. Breast Cancer Res Treat 1996;40:37–51.
9.
Valdini A, Cargill L: Access and barriers to mammography in New England community health centers. J Fam Pract 1997;45:243–249.
10.
Frazier E, Jiles R, Mayberry R: Use of Screening Mammography and Clinical Breast Examinations among Black, Hispanic and White Women. Prev Med 1996;25:118–125.
11.
Bailey S, Bennett P, Hicks J, Kemp C, Warren SH: Cancer detection activities coordinated by nursing students in community health. Cancer Nurs 1996;19:348–352.
12.
Richardson JL, Marks G, Solis JM, Collins LM, Birba L, Hisserich JC: Frequency and adequacy of breast cancer screening among elderly Hispanic women. Prev Med 1987;16:761–774.
13.
Taplin SH, Mantano DE: Attitudes, age, and participation in mammographic screening: A prospective analysis. J Am Board Fam Pract 1993;6:13–23.
14.
US Census Population Estimates: http://factfinder.census.gov
15.
Zimmerman S: Factors influencing Hispanic participation in prostate cancer screening. Onc Nurs Forum 1997;24:499–504.
16.
The National Institutes of Health: Cancer Rates and Risks, ed 4. Bethesda, National Cancer Institute, 1996. http://seer.cancer.gov/publications/raterisk
17.
Wonderlick A, Fine B: Knowledge of breast cancer genetics among breast cancer patients and first degree relatives of affected individuals. J Genet Couns 1997;6:111–130.
18.
Ford M, Martin RD, Hilton LW, Ewert-Flannagan T, Corrigan GK, Johnson G, Hernandez MA, Sbach A, Loppman SM: Outcomes study of a course in breast-cancer screening. J Cancer Educ 1997;12:179–184.
19.
Federal Register, vol 64, No 52, March 18, 1999, pp 13428–13430.
20.
Baines CJ: Women and breast cancer: Is it really possible for the public to be well informed? Can Med Assoc J 1992;146:2417–2418.
21.
Phillips K, Glendon G, Knight J: Putting the risk of breast cancer in perspective. N Engl J Med 1999;340:141–144.
22.
Feuer EJ, Wun LM, Boring CC, Flanders WD, Timmel MJ, Tong T: The lifetime risk of developing breast cancer. J Natl Cancer Inst 1993;85:892–897.
23.
Dolan NC, Lee AM, McDermott MM: Age-related differences in breast carcinoma knowledge, beliefs, and perceived risk among women visiting an academic general medicine practice. Cancer 1997;80:413–420.
24.
Hebert-Croteau N, Goggin P, Kishchuk N: Estimation of breast cancer risk by women aged 40 and over; a population-based study. Can J Public Health 1997;88:392–396.
25.
National Institutes of Health Consensus Development Panel: National Institutes of Health Consensus Development Conference Statement: Breast cancer screening for women ages 40–49. J Natl Cancer Inst 1997;89:1015–1026.
26.
Hallowell N, Statham H, Murton F: Women’s understanding of their risk of developing breast/ovarian cancer before and after genetic counseling. J Genet Couns 1998;7:345–364.
© 2002 S. Karger AG, Basel
2002
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.