Women with first-degree relatives with breast cancer have a two- to ten-fold excess risk of developing this disease. Despite this, a substantial proportion of these women are misinformed about their personal breast cancer risk and are inadequately screened. The purpose of the proposed research is to develop and test a program for Breast Cancer Risk Counseling (BCRC) which is designed to: (1) improve comprehension of personal breast cancer risk, (2) enhance psychological adaptation, and (3) increase adherence to recommended guidelines for mammography, clinical breast examination, and breast self-examination. In addition, we will compare the relative impact of two alternate health appeals delivered in BCRC (i.e., """"""""wellness"""""""" appeals which emphasize the potential positive consequences of adherence to breast screening vs. """"""""threat"""""""" appeals which emphasize the potential adverse consequences of nonadherence). Also, we will evaluate the impact of these alternate forms of BCRC on subgroups of women with different coping styles (i.e., """"""""monitors"""""""" who cope by information_seeking vs. """"""""blunters"""""""" who cope by avoidance). Subjects in this study will be 1800 women aged 35-65 who have a positive family history of breast cancer in at least one first-degree relative. A stratified randomization will be used to assign subjects to one of three conditions: (1) General Health Counseling Control, (2) BCRC with Wellness Appeals, and (3) BCRC with Threat Appeals. The BCRC intervention will involve an individual health education session which emphasizes communication of individualized breast cancer risks, health appeals to motivate adherence, and specific action plans for protective behaviors (i.e., breast screening). Telephone interviews will be conducted one-month preintervention to collect risk factor data to calculate individualized breast cancer risks, and to assess baseline risk comprehension and screening practices. Data on coping styles and baseline psychological. adaptation will be collected using mailed questionnaires. Follow-up interviews and mailed assessments will be conducted at 3, 12, and 24 months post-intervention to assess the short- and long-term impact of the interventions on risk comprehension, psychological adaptation, and breast screening adherence. -The interventions proposed are replicable, and, if effective, can be applied to improve adherence among persons at high risk for a variety of cancers.
Showing the most recent 10 out of 12 publications
