2

Breast Cancer Health Promotion

Florida National University

Jose Cardentey

Health Promotion and Role Development in Advanced Nursing Practice

Professor: Alexander Garcia Salas

April 10, 2022

Breast Cancer Health Promotion

Health promotion program

Breast cancer is the most frequently diagnosed cancer among women worldwide and is the second-highest cause of cancer deaths. Despite the constant improvements in breast cancer diagnosis and treatment, the fate of African American women when it comes to this disease remains in a very disadvantaged position. One of the interventions described is the provision of mass media awareness of cancer screening services. Surviving a cancer disease relies highly on early detection and treatment from previous studies. Hence, structured programs to engage many African American women to have regular mammography and timely treatment help close the gap between black and white communities. Studies have shown that the possibility of an African American returning to follow-up checking after an inconclusive mammogram screening is far less than that of a white American. There are efforts in place to reduce the mortality rate of breast cancer patients, which primarily lie in the promotion of modifiable risk factors. These factors include encouraging physical activity, low alcohol consumption, and early detection through regular mammography. (Reeder-Hayes et al. 2017)

The use of mass media to render educational and motivational information about breast cancer is a crucial strategy toward averting the current trend of the healthcare state of African American women. Mass media used include radio, television, newspapers, and billboards. The use of mass media usually comes hand in hand with other approaches that aid in ensuring more people respond to the information being shared. These approaches include offering free screening services, vouchers, and same-day appointments to help cut the expenses, especially for low-income women. There is also an increased interest in using cell phone mass messaging and smartphone applications when passing or receiving information about breast cancer among young black women. The use of smartphones has become an ever-present part of modern life. More than 85% of the entire population own a smartphone. This statistic is crucial because it makes it easier to disseminate information. Text messages reminding users to undergo a mammogram exam every six months can easily be generated and sent to a significant number of people at the same time. This saves time and cost for the organization running the campaign. Emails and social media communications also have a significant impact on reaching out to African American women to do their breast cancer screening. (Hoppe et al. 2019)

In addition to that, applications that have essential information about breast cancer can be developed that allow any African American woman to access all the information she needs about breast cancer and make an appointment for an exam through the programming interfaces. The applications have the purpose of creating awareness about cancer that is giving out accurate information about breast cancer, providing educational information about breast cancer that can aid in early detection of breast cancer, and giving out the information on prevention of the disease. The app also promotes non-profit organizations that aim to aid breast cancer awareness in black communities. To execute this, smartphone application developers have to be hired to create the application and ensure the continual update of information. Radio stations can also be used to disseminate information about breast cancer. The radio stations that target African American audiences are typically referred to as Black radio. They are viewed as a trusted source of information by African American audiences. Black radio will be used to share information and create awareness about breast cancer. The strategy to ensure wide and fruitful dissemination of information is to have personal on-air interviews and allow call-ins through the show to get feedback from the audience. This approach promotes social learning and allows the women to learn from each other about their different experiences with cancer. Black radio is an important approach as it reaches all the different age groups of the African American community. (Sheppard et al. 2016)

Another essential step in closing the racial gap in breast cancer is increasing the health literacy level of the African American community. Health literacy refers to the capacity levels of an individual to get, process, and understand the basic health information and services needed to make an appropriate health decision. Low health literacy is commonly linked to reduced use of preventive measures like screening, decreased or no knowledge of the importance of early detection, and poor adherence to treatment plans. This causes the individuals to have a greater sense of fatalism of the disease, no participation in breast cancer control programs, and late detection of the disease. Therefore, to ensure increased health literacy, the information being shared through the different means need to be clear and simple to understand. The members of African American ethnicity are less likely to receive preventive health services and more often receive lower-quality care compared to the whites. This disparity directly impacts breast cancer treatment in African American women. To combat this variance, health professionals should undergo training on the role of racial bias in patients' treatment plans. Health professionals need to take time to explain to patients their diagnosis and all the options they have regardless of race. The nursing should help the patients closely when undergoing their cancer treatment. They should make a follow-up in cases where a patient misses an appointment. This is to investigate the reason the patient missed the appointment and also offer help with common issues like financial constraints related to insurance clearances, family schedules, or pain handling. The medical staff should also prepare a journal of resources that could be useful to the patient. This aids in improving the health literacy levels of the African American community and also empowers individuals to reach out. Medical staff also have a role in providing moral support to the patients undergoing treatment. (Yedjou et al. 2017) They ought to spread a word of hope to the patients as they undergo treatment. The medical workforce also should keep tabs on patients to ensure that they stick to medication and maintain a healthy lifestyle. This will raise the treatment completion rate of the African American community. Racial bias also exists in mammography referrals. This is a disparity that medical practitioners need to level. Proper and extensive awareness among medical health practitioners needs to be done since they hold a much greater influence on the patients' experience with breast cancer. African American communities have the church as the most important social institution. Therefore, it becomes an important setting to conduct breast cancer promotion for African American women. The action plan in reaching out to African American women in their churches is by conducting reach-out campaigns that include distributing literature, holding community events hosted by the church, and also blending health session within church programs. Unemployment is also a barrier to bridging the racial gap between African Americans and white communities. There is a higher unemployment rate among the African American communities, which directly impacts individuals' ability to get medical insurance, which affects their access to health care. The financial strain among African American women can be linked to the higher breast cancer mortality rate since they will have delays in diagnosis and treatment of the disease. Women with financial problems face challenges in accessing comprehensive breast cancer management since the regular visits for treatments generate costs. Patient navigation is another model that works to reduce the disparities in breast cancer care. This model is a patient-oriented method involving coordination among health workers working in helping them overcome the barriers to receiving breast cancer care. The program emphasizes saving patients' lives by ensuring patients receive timely breast cancer care between the stage of suspicious finding and the conclusion of the finding. This is achieved by eliminating all the barriers patient encounters between the two stages. The barriers to receiving timely treatment are communication, finances, the medical system, fear, and emotions. This model aims to ensure every black woman receives all the necessary as soon as possible. Patient navigation also has the feature of offering free cancer screening to African American women. This will greatly impact the statistics showing the disparity across the racial divide. Allostatic load also increases the racial gap in breast cancer statistics. Allostatic load refers chronic stress state caused by the experiences of racism and associated environmental challenges. This stress causes increased neural and neuroendocrine responses, which cause more health-damaging effects. In breast cancer, the allostatic load leads to biologically aggressive tumours and a worse quality of life. Thus, to increase the outcomes of breast cancer treatment among African American women, more understanding of different patients' psychological states plays an important role in their recovery. (Yedjou et al. 2019)

Outcomes

This research will change the current trends in cancer care for the African American community. The first outcome expected of this research is that misconceptions about breast cancer and its treatment plan will no longer exist. With proper dissemination of accurate and up-to-date information on breast cancer, the African American community will have the correct information about the disease. This will have an influence on attracting more African American women to undergo breast cancer screening. The second outcome of this research is that the mortality rate of the African American community will improve compared to that of white Americans. The survival chance of a breast cancer patient highly relies on the early detection of the disease, which can be achieved by creating awareness targeted to African American community. When the communities know that there is an importance of having regular mammography, they will turn up for testing, thereby ensuring early detection, translating to a higher chance of survival. The survival chance of patients is also improved from the implementation of patient navigation which allows fast delivery of treatment to African Americans. The third outcome of this research is a racism-free cancer care system. This is achieved by training all medical practitioners to adopt changes that ensure all patients are treated equally. Another outcome of this research is improved Physician and patient communication. This relation is key in helping the patient get the confidence she needs to undergo painful cancer treatments. This was from a statistic that patient who has a good relationship with the medical staff has a lower chance of declining to undergo surgery. Medical staff is to be trained on how to maintain communication with the patients and to avoid showing bias during their encounters.

Evaluation of outcomes

Evaluation of clearing misconceptions of breast cancer outcomes will entail checking the effectiveness of various mass media in reaching the African American community. This involves getting feedback from a community sample to see if they have the correct information about breast cancer. In addition, it serves to check if people understood the information that was shared. Evaluation of improvement of the mortality rate of African American community compared to the white American community involve taking statistics of both ethnic divides and comparing the numbers. This will obtain from health records in the regions the promotion is conducted. This evaluation will take time since the treatment timeline for breast cancer does vary for different patients according to factors like detection and others. This evaluation serves to indicate the main objective of the research, which was to bridge the racial gap in the mortality rate of breast cancer patients. Evaluation of having a racism-free health care system is to be done by running random interviews with patients from minority ethnic groups. They are asked about their experience while undergoing breast cancer screening and treatment. This stands to give the impact of having the training programs for the medical staff on maintaining racism-free services. This evaluation will also give the way the physicians relate with patients; that is, the kind of communication they share. This is a critical feature that shows the professionalism of the medical staff in the eyes of patients. It also shows if there is any bias in the various disciplines within a healthcare facility.

Possible barriers

One of the barriers to implementing this research is limited knowledge of research methods. Conducting research is a complex process that requires dynamic support from individuals, organizations, and colleagues. This process also requires specific individual skills like proper time management, critical thinking, and multitasking, among others, which are hard to possess. Another barrier is the lack of adequate time to conduct the necessary literature review. This will limit the knowledge I possess regarding the subject matter. Over-reliance on scholarly articles to guide the planning and evaluation of the implementation of the research can also sabotage the credibility of the process. The success of the implementation relies on healthcare staff believing in the findings and agreeing that adopting new strategies could positively impact the health care of African American communities.

Reference

Hoppe, E. J., Hussain, L. R., Grannan, K. J., Dunki-Jacobs, E. M., Lee, D. Y., & Wexelman, B. A. (2019). Racial disparities in breast cancer persist despite early detection: analysis of treatment of stage 1 breast cancer and effect of insurance status on disparities. Breast Cancer Research and Treatment, 173(3), 597-602.

Reeder-Hayes, K. E., Troester, M. A., & Meyer, A. M. (2017). Reducing Racial Disparities in Breast Cancer Care: The Role of'Big Data'. Oncology (08909091), 31(10).

Sheppard, V. B., Hurtado-de-Mendoza, A., Talley, C. H., Zhang, Y., Cabling, M. L., & Makambi, K. H. (2016). Reducing racial disparities in breast cancer survivors' ratings of quality cancer care: the enduring impact of trust. The Journal for Healthcare Quality (JHQ), 38(3), 143-163.

Yedjou, C. G., Sims, J. N., Miele, L., Noubissi, F., Lowe, L., Fonseca, D. D., … & Tchounwou, P. B. (2019). Health and racial disparity in breast cancer. Breast cancer metastasis and drug resistance, 31-49.

Yedjou, C. G., Tchounwou, P. B., Payton, M., Miele, L., Fonseca, D. D., Lowe, L., & Alo, R. A. (2017). Assessing the racial and ethnic disparities in breast cancer mortality in the United States. International journal of environmental research and public health, 14(5), 486.