Improving Breast Self-Examination Compliance: A Southwest Oncology Group Randomized Trial of Three Interventions

• Published in: Preventive medicine 1997-05, Vol.26 (3), p.320-332
• Main Authors: Strickland, C.June, Feigl, Polly, Upchurch, Christine, King, David K., Pierce, H.Irving, Grevstad, Patra K., Bearden, James D., Dawson, Meredith, Loewen, William C., Meyskens, Frank L.
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Attitude to Health; Breast Neoplasms - prevention & control; Breast Neoplasms - psychology; Breast Self-Examination - statistics & numerical data; breast self-examination and physicians; breast self-examination and reinforcement; breast self-examination and training; Chi-Square Distribution; Female; health education; Health Education - methods; Health Education - standards; Humans; Logistic Models; Middle Aged; Multivariate Analysis; Patient Compliance; Patient Dropouts; Physician's Role; Program Evaluation; Prospective Studies; Psychological Theory; Reinforcement (Psychology); Treatment Outcome; United States; Women's Health
• ISSN: 0091-7435; 1096-0260
• DOI: 10.1006/pmed.1997.0147

Background.Only 20–40% of U.S. women conduct breast self-examination (BSE). This Southwest Oncology Group experimental study compared the impact of three interventions on BSE compliance. Methods.Subjects were randomly assigned to one of three arms: (1) physician message; (2) physician message and BSE class; or (3) physician message, BSE class, and reinforcement (phone and postcard). Compliance (frequency and accuracy) was measured by interview at intake and at 6 months and by phone contact at 1 year. Logistic and multiple regression were employed. Results.This analysis included 2,233 subjects from six institutions. At 1 year the percentages of women doing BSE were 59, 62, and 78% for Arms 1–3, respectively; gains over intake frequency (27% average) were significant within each arm (P≤ 0.0001). At both 6 months and 1 year the differences between Arm 1 and Arm 2 average accuracy scores and the differences between Arm 2 and Arm 3 in the percentage of women doing BSE were significant (P≤ 0.0001). Findings within institutions were consistent with the overall findings. Conclusions.The addition of a BSE class increased accuracy over physician message alone; physician message, BSE class, and reinforcement gave the highest percentage of women doing BSE.