The goals of the proposed study are: to inform young Black women about the advantage of systemically examining their own breasts for early detection of breast cancer; to train young Black women to perform breast self-examination (BSE) while ensuring a high level of proficiency in their performance of the exam; and to assess the relative efficacy of specific strategies (self- management and positive reinforcement) in maintaining the long term practice. A total of 200 Black women will be recruited from community colleges and Black churches by means of free lectures on breast cancer and BSE. All will be exposed to the same training procedures (a group meeting and an individual session). The group meeting will include a discussion of barriers to BSE performance and ways to overcome them; a demonstration by the BSE Instructor of a complete self-exam; and an opportunity for each participant to practice the self-exam on breast models with lumps. During the individual training session, each participant will have her breasts examined by the Instructor, will practice with the Instructor's feedback on herself and on a breast model, and will be asked to demonstrate her technique on herself and on breast models for evaluation of her competency by the Instructor and the Project Manager. Competency will be assessed in terms of number of components of the self-exam included in the participant's demonstration performance and number of lumps correctly located in the models. After training, participants will be randomly divided into four groups differing in type of maintenance strategies. A self-management group will receive a calendar on which the ideal time to perform BSE should be marked each participant at every menstrual cycle, and a BSE reminder stricker. A reinforcement group will receive gifts and congratulatory cards for reporting performance of BSE. A control group will receive no explicit maintenance treatment, and a self- management-plus-reinforcement group will receive the same treatments as the first two groups. All participants will receive BSE Record Cards which should be completed and returned after BSE is performed on months 1,2,4,6,7-9 after training. In addition, all will be asked to return for two individual follow-up sessions (three and six months after training), where their competency will be reassessed by the BSE Instructor and Project Manager. Data from the returned BSE record cards and follow-up sessions will be analysed to determine whether the groups differ in competency and frequency of BSE performance after training.
| Lippman, S M; Benner, S E; Hong, W K (1993) Chemoprevention. Strategies for the control of cancer. Cancer 72:984-90 |
| Jacob, T C; Penn, N E; Kulik, J A et al. (1992) Effects of cognitive style and maintenance strategies on breast self-examination (BSE) practice by African American women. J Behav Med 15:589-609 |
