Application Of Health Behavior Theory As A Guide For Explaining Or Predicting Breast Self-Examination Practice Among Chinese Women

Breast cancer is one of the leading causes of death throughout the world. Early detection, early diagnosis and timely treatment have currently proved the most powerful weapon in the fight against breast cancer. It has significant value in ameliorating the prognosis of the disease, improving the quality of life and reducing the mortality rate from breast cancer. Nevertheless, many studies concerning the implementing of breast cancer screening methods demonstrate that these health-promoting programs are regrettably underutilized. Given the concrete condition of China, It is therefore necessary to explore factors that influence the performance of breast self-examination (BSE) among Chinese women in order to promote the early detection of breast caner with the only available screening tool, i.e. BSE, in the future cancer prevention and control program. Objectives:To improve the breast cancer early detection awareness and breast self-examination performance among Chinese women through promoting knowledge concerning breast caner and propagandizing the techniques of breast self-examination, evaluation was then made to assess the effectiveness of the health educational program. KABP Model(nowledge, Attitude, Belief, Practice) and Health Belief Model (HBM) were introduced to explore and identify the potential factors that influence the practice of BSE and to provide reference for developing productive health education strategies in future health-promoting activities. Methods:In 2004, An intervention study was conducted among a convenient sample of 1395 women recruited to receive an intensive health educational program withregard to the early detection of breast cancer, mainly focusing on the BSE practice, data were collected through a self-administered questionnaire both at baseline and three month follow-up. Results:Significant improvement was observed concerning the knowledge, BSE attitude and practice after the health education program. Utilizing the KABP model to analyze the factors related to BSE practice, Findings showed that mastery of relevant knowledge was not indicative of the practice of BSE, which was, instead, statistically associated with personal history of breast disease (Pre-intervention: OR=2.069, 95%CI: 1.340 — 3.193; Post-intervention: OR=1.920, 95%CI: 1.119—3.295) and BSE attitude ( Pre-intervention: OR=7.652, 95%CI: 5.426—10.790; Post-intervention: OR=4.275, 95%CI: 3.206—5.701) . Results from univariate analysis between the four parameters of HBM and the BSE behavior demonstrated that perceived susceptibility> perceived benefits^ perceived barriers were statistically associated with BSE performance at baseline (with OR: 1.231 > 1.401 > 1.367, respectively) and perceived susceptibility, perceived severity n perceived benefits^ perceived barriers at follow-up (with OR 1.267 ^ 1.074 > 1.478 > 1.302, respectively). Adjusted with such demographic characteristics as ageN educational background > vocation marital status > personal history of breast disease > experience with breast caner of relatives or friends, the relation remained significant both at baseline and follow-up, which indicates that belief in and attitude toward BSE determines whether one would adopt this health-promoting behavior and some socioeconomic factors might exert slight influence on the BSE practice. The results of further Multi-Logistic regression revealed that perceived barriers were statistically associated with BSE performance at baseline (with OR: 1.345, 95%CI: 1.287—1.405) and perceived...