Breast Cancer Screening Behavior Intervention Based In Gulou District Of Nanjing

Objective:Through the implemention of breast cancer screening behavior intervention based among communitity women and assessment of its effectiveness to explore the implication of health belief model to the change of mammogram behavior.Methods:4 communities in Gulou district of Nanjing were included in this study,2 of which were assigned to the intervention group and 2 to the control group based on the principle of avoiding contamination, general demographic information, knowledge related to risk factors and screening for breast cancer, health beliefs and screening behavior were investigated at baseline; The intervention group (n=214) received systematic breast cancer early detection intervention based on health belief model, whereas the control group (n=204) was provided with general self-health care education, awareness and health beliefs were measured again after the field intervention; telephone follow-up of all subjects was implemented six months later to investigate the screening behavior. Data analysis was conducted by SPSS 18.0.Results:1.The awareness rate of knowledge related to breast cancer risk factors and screening methods was 32.8%, respectively 57.1%,82.3%,12.2% of them had received BSE, CBE and MMG, and the perception of self-susceptibility was between "not sure" and "impossible" Multivariate binary Logistic regression analysis indicated that previous CBE behavior, previous MMG behavior and better awareness of knowledge were protective factors of BSE behavior; regular check-up and previous BSE behavior were protective factors of CBE behavior, doctor’s advice, previous BSE behavior and higher health beliefs were significant predictors of MMG behavior.2.After intervention concerning the intervention group, the awareness rate of each item assessing knowledge increased (P<0.01) and was statistically significant compared with the control group (P<0.01); increased score occurred when regarding to the parameters of health belief model "perceived susceptibility", "perceived severity", "perceived benefits of action", "perceived barriers" and "self-efficacy" (P<0.05),when compared to the control group, the change of parameter "perceived severity" was not statistically significant while the increase of the other four was statistically significant; the participation rate of BSE and MMG were 85.0% and 73.8%, and the increase was statistically significant compared to baseline, while there was no significant change of CBE participation rate (P>0.05)3.Univariate Logistic regression analysis indicated that the parameter "perceived benefits of action", "perceived barriers" and "self-efficacy" were positively correlated to MMG behavior at baseline (OR=1.393, OR=2.742, OR=1.474) and also postintervention (OR=1.610, OR=1.551, OR=1.941), and were statistically significant after demographic characteristics was adjusted (P<0.05). Parameter "perceived susceptibility" was not correlated to MMG behavior at baseline (P>0.05), but was correlated to MMG behavior (OR=1.591) at postintervention and was statistically significant after demographic characteristics was adjusted(P<0.01).There was no correlation between "perceived severity" and MMG behavior neither at baseline nor postintervention (.P>0.05). Multivariate Logistic regression analysis indicated that MMG behavior at baseline was influenced by parameter "perceived barriers" (OR=2.750) and "self-efficacy" (OR=1.333), and was influenced by parameter "perceived susceptibility" (OR=1.383), "perceived barriers" (OR=1.267), "self-efficacy" (OR=1.631) at postintervention.Conclusions:There were considerable inadequacy in breast cancer risk factors and screening knowledge, weak perception of susceptibility and low uptake rate of screening behavior among community women in Nanjing. Systematic intervention theoretically based on health belief model could result in increased knowledge and beliefs, enhance the consciousness of active breast cancer screening, thus increase the participation rate of BSE and MMG. Health belief model has significant implications for improving active MMG behavior of Chinese women.