""""""""Increasing the Community's Role in Breast Cancer Detection"""""""" is a program of community interventions to increase the use of the most advanced secondary prevention technologies available to screen women 50 and older for breast cancer. The long term objective of the program is to decrease breast cancer mortality through early detection.
The specific aims of the project are (i) to increase the knowledge about cancer risk factors, screening measures and available screening sources on the part of women 50 and older, health care professionals, and the public; (ii) increase the proportion of women using mammography and breast palpation routinely; (iii) increase the number of women who encourage others to obtain annual screening; (iv) increase the frequency of referrals for mammography screening by primary care clinicians; (v) increase the frequency and quality of breast palpation by primary care physicians; (vi) increase the quality of mammogram readings by radiologists; and (vii) increase the commitment of community groups to encourage early breast cancer screening. The methodology for achieving this goal is development of a community role for intervention which is practical, effective, and readily replicable by others. The theoretical framework for the multiple intervention strategy is based on a framework of secondary prevention variables adopted from Green (1980) which in turn is based on a more general model of the utilization of professional services (Anderson, 1968) and education planning (Green, 1980). Using this model, intervention strategies can be understood as addressing the predisposing, enabling, or reinforcing factors that influence the behavior of individuals who could benefit from screening procedures or the health service providers who recommend them. A central assumption that guided the design of the intervention programs is that addressing only one of these factors is not sufficient to effect change. Consequently, each of the six targeted intervention programs address the attitudes, beliefs, and knowledge (predisposing factors), the accessibility to appropriate resources (enabling factors) and the possibility of using peer influence to ensure that new knowledge is acted upon and new behavior becomes habitual (reinforcing factors). Target audiences include: primary care clinicians; radiologists; low income Hispanic women; women over 60 referred to VNA Clinics; women who responded to a national media campaign; and third party payers of health care.
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