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Chronic Illness, Vol. 4, No. 1, 13-27 (2008)
DOI: 10.1177/1742395307084404
© 2008 SAGE Publications

Promoting early presentation of breast cancer: development of a psycho-educational intervention

C.C. Burgess

Cancer Research UK London Psychosocial Group, Institute of Psychiatry, Kings College London Adamson Centre, St Thomas' Hospital, London SE1 7EH, UK, caroline.burgess{at}kcl.ac.uk

A.M. Bish

Cancer Research UK London Psychosocial Group, Institute of Psychiatry, Kings College London Adamson Centre, St Thomas' Hospital, London SE1 7EH, UK

H.S. Hunter

Cancer Research UK London Psychosocial Group, Institute of Psychiatry, Kings College London Adamson Centre, St Thomas' Hospital, London SE1 7EH, UK

P. Salkovskis

Department of Clinical Psychology & Applied Science, Institute of Psychiatry, DeCrespigny Park London SE5 8AF, UK

M. Michell

South East London Breast Screening Programme, Breast Radiology, King's College Hospital London SE5 9RS, UK

P. Whelehan

South East London Breast Screening Programme, Breast Radiology, King's College Hospital London SE5 9RS, UK

A.J. Ramirez

Cancer Research UK London Psychosocial Group, Institute of Psychiatry, Kings College London Adamson Centre, St Thomas' Hospital, London SE1 7EH, UK

Objectives: Women who delay presenting with breast cancer have a reduced chance of survival. Older women, who are at greater risk of developing breast cancer, are more likely to delay presenting with the disease. The aim of this developmental work was to design a psycho-educational intervention to promote early help-seeking by older women with breast cancer symptoms. We also aimed to demonstrate the feasibility of implementing the intervention with women attending for their final invited mammogram in the National Health Service (NHS) Breast Screening Programme.

Methods: The intervention was designed to address the factors associated with delayed presentation by women with breast cancer. These risk factors were placed in a theoretical framework to understand patient delay. The intervention incorporated behavioural change techniques that, according to previous research, have been demonstrated to be effective.

Results: The intervention was developed in two formats to be delivered by diagnostic radiographers: a booklet alone and a brief interview plus the booklet. The intervention was acceptable to both older women and healthcare professionals in the NHS Breast Screening Programme.

Discussion: The intervention will be tested ultimately in a multicentre randomized controlled trial to determine whether it can reduce the proportion of older women who delay their presentation and thereby save lives.

Key Words: Cancer • Delay • Help-seeking • Intervention

References

  • Richards MA, Westcombe AM, Love SB, Littlejohns P., Ramirez AJ Influence of delay on survival in patients with breast cancer: a systematic review. Lancet 1999; 353: 1119—26.[CrossRef][Medline] [Order article via Infotrieve]
  • Medical Research Council. A framework for development and evaluation of RCTs for complex interventions to improve health. 2000.
  • Ramirez AJ, Westcombe AM, Burgess CC, Sutton S., Littlejohns P., Richards MA Factors predicting delayed presentation of symptomatic breast cancer: a systematic review. Lancet 1999; 353: 1127—31.[CrossRef][Medline] [Order article via Infotrieve]
  • Burgess CC, Hunter M., Ramirez AJ A qualitative study of delay among women reporting symptoms of breast cancer. Br J Gen Pract 2001; 51: 967—71.[Medline] [Order article via Infotrieve]
  • Burgess CC, Potts HWW, Hamed H., et al. Why do older women delay presentation with breast cancer symptoms? Psycho-Oncology 2006; 15: 962—8.[CrossRef][Medline] [Order article via Infotrieve]
  • Grunfeld E., Ramirez A., Hunter M., Richards M. Women's knowledge and beliefs regarding breast cancer. Br J Cancer 2002; 86: 1373—8.[CrossRef][Medline] [Order article via Infotrieve]
  • Grunfeld E., Ramirez A., Hunter M., Richards M. Perceptions of breast cancer across the lifespan. J Psychosom Res 2003; 54: 141—6.[CrossRef][Medline] [Order article via Infotrieve]
  • Hunter M., Grunfeld E., Ramirez A. Help-seeking intentions for breast-cancer symptoms: a comparison of the self-regulation model and the theory of planned behaviour. Br J Health Psychol 2003; 8: 319—33.[CrossRef][Medline] [Order article via Infotrieve]
  • ICM Survey. Screening saves lives, Commissioned by Breakthrough Breast Cancer, 2006.
  • Macdonald S., Macleod U., Mitchell E., Weller D., Campbell N., Mant D. Factors influencing patient and primary care delay in the diagnosis of cancer: a database of existing research and its implications for future practice. Report to the Department of Health on Cancer Symptom Profiles and Referral Strategies for Primary Care Research Programme. 2004.
  • Corner J., Hopkinson J., Roffe L. Experience of health changes and reasons for delay in seeking care: a UK study of the months prior to the diagnosis of lung cancer. Soc Sci Med 2006; 62: 1381—91.[CrossRef][Medline] [Order article via Infotrieve]
  • Hewitt AK, Kainth A., Pattenden J., et al. Predictors of delay in seeking medical help in patients with suspected heart attack, and interventions to reduce delay: a systematic review. York: Centre for Reviews and Dissemination, University of York. York Publishing Service Ltd, 2004.
  • Hampson S. Illness representations and the self-management of diabetes. In: Petrie K, Weinman J, eds. Perceptions of health and illness, Amsterdam: Harwood Academic Publishers, 1997: 323—48.
  • Yoon S., Byles J. Perceptions of stroke in the general public and patients with stroke: a qualitative study. BMJ 2002; 324: 1065—71.[Abstract/Free Full Text]
  • Cameron L., Leventhal E., Leventhal H. Symptom representations and affect as determinants of care seeking in a community-dwelling, adult sample population. Health Psychol 1993; 12: 171—9.[CrossRef][Medline] [Order article via Infotrieve]
  • Sutton S., Wardle J., Taylor T., et al. Predictors of attendance in the United Kingdom flexible sigmoidoscopy screening trial. J Med Screen 2000; 7: 99—104.[CrossRef][Medline] [Order article via Infotrieve]
  • Champion V., Maraj M., Hui S., et al. Comparison of tailored interventions to increase mammography screening in nonadherent older women. Prev Med 2003; 36: 150—8.[CrossRef][Medline] [Order article via Infotrieve]
  • Michie S., Abraham C., Jones C. Achieving the `Fully Engaged Scenario': what works and why. Commissioned by the Public Health Division of the Department of Health as part of its Wanless Review II. HM Treasury, 2003.
  • Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process 1991; 50: 179—211.[CrossRef]
  • Turner J., Blaney R., Roy D., Odling-Smee, Irwins G., MacKenzie G. Does a booklet on breast self-examination improve subsequent detection rates? Lancet 1984; 324: 337—9.[CrossRef]
  • Philip J., Harris W., Flaherty C., Joslin C., Rustage J., Wijesinghe D. Breast self-examination: clinical results from a population based prospective study. Br J Cancer 1984; 50: 7—12.[Medline] [Order article via Infotrieve]
  • Waters W., Wheeller W., Fraser J., Hayes A., Nichols S. Evaluation of a health education campaign to reduce the delay in women presenting with breast symptoms. Community Medicine 1983; 5: 104—8.[Medline] [Order article via Infotrieve]
  • Aitken-Swan J., Paterson R. Assessment of the results of five years of cancer education. BMJ 1959; 1: 708—12.[Medline] [Order article via Infotrieve]
  • Doherty VR, Mackie RM Experience of a public education programme on early detection of cutaneous malignant melanoma. BMJ 1988; 297: 388—91.[Medline] [Order article via Infotrieve]
  • De Nooijer J., Lechner L., de Vries H. Tailored versus general information on early detection of cancer: a comparison of the reactions of Dutch adults and the impact on attitudes and behaviors. Health Educ Res 2002; 17: 239—52.[Abstract/Free Full Text]
  • Jepson R., Clegg A., Forbes C., Lewis R., Sowden A., Kleijnen J. The determinants of screening uptake and interventions for increasing uptake: a systematic review. Health Technol Assess 2000; 4.
  • Rakowski W., Ehrich B., Goldstein MG, et al. Increasing mammography among women aged 40—74 by use of a stage-matched, tailored intervention. Prev Med 1998; 27: 748—56.[CrossRef][Medline] [Order article via Infotrieve]
  • Clark MA, Rakowski W., Ehrich B., et al. The effect of a stage-matched and tailored intervention on repeat mammography (1). Am J Prev Med 2003; 22: 1—7.
  • Williams-Piehota P., Schneider TR, Pizarro J., Mowad L., Salovey P. Matching health messages to health locus of control beliefs for promoting mammography utilisation. Psychol Health 2004; 19: 407—23.[CrossRef]
  • Wardle J., Williamson S., McCaffery K., et al. Increasing attendance at colorectal cancer screening: testing the efficacy of a mailed, psychoeducational intervention in a community sample of older adults. Health Psychol 2003; 22: 99—105.[CrossRef][Medline] [Order article via Infotrieve]
  • Wardle J. Public health psychology: expanding the horizons of health psychology. Br J Health Psychol 2000; 5: 329—36.[CrossRef]
  • Michie S., Rothman AJ, Sheeran P. Current issues and new direction in psychology and health: advancing the science of behaviour change. Psychol Health 2008; 22: 249—53.
  • Michie S., Davies P. Review of the effectiveness of self-management strategies for promoting health behaviours in adults. Commissioned by the Public Health Division of the Department of Health as a submission to the Choosing Health consultation. 2004.
  • Bandura A. Self-efficacy: towards a unifying theory of behavioural change. Psychol Rev 1977; 84: 191—215.[CrossRef][Medline] [Order article via Infotrieve]
  • Williamson S., Wardle J. Increasing participation with colorectal screening: the development of a psycho-educational intervention. In: Rutter D, Quine L, eds. Changing health behaviour. Buckingham: Open University Press, 2002: 105—22.
  • Wroe AL, Salkovskis PM, Rimes KA The effect of nondirective questioning on women's decisions whether to undergo bone density screening: an experimental study. Health Psychol 2000; 19: 181—9.[CrossRef][Medline] [Order article via Infotrieve]
  • Department of Health. Breast. Department of Health Statistical Bulletin. Screening Programme. Bulletin 2001/10. London: Department of Health, 2000.
  • McPherson K., Steel CM, Dixon JM ABC of breast diseases. Breast cancer — epidemiology, risk factors, and genetics. BMJ 2000; 321: 624—8.[Free Full Text]
  • Quinn M., Babb P., Rock A., Kirby L., Jones J. Cancer trends in England and Wales 1950—1999. Studies on Medical and Population Subjects No. 66. London: The Stationery Office, 2001.
  • Nichols S., Waters WE, Wheller MJ The management of female breast disease by Southampton general practitioners. BMJ 1980; 281: 1450—3.[Medline] [Order article via Infotrieve]
  • Moss SM, Brown J., Garvican L., et al. Routine breast screening for women aged 65—69: results from evaluation of the demonstration sites. Br J Cancer 2001; 85: 1289—94.[CrossRef][Medline] [Order article via Infotrieve]
  • Threfall AG, Woodman CBJ. Risk of breast cancer in women who attend the NHS Breast Screening Programme: cohort study. BMJ 2001; 323: 140.[Free Full Text]
  • Banks E., Beral V., Cameron R., et al. Comparison of various characteristics of women who do and do not attend for breast cancer screening. Breast Cancer Res 2002; 4.
  • Sutton S. Using theories of behaviour change to develop and evaluate interventions. In: Stephenson JM, Imrie J, Bonell C, eds. Effective sexual health interventions, Oxford: Oxford University Press, 2002: 51—66.
  • Bish A., Ramirez A., Burgess C., Hunter M. Understanding why women delay in seeking help for breast cancer symptoms. J Psychosom Res 2005; 58: 321—6.[CrossRef][Medline] [Order article via Infotrieve]
  • Leventhal H., Nerenz D., Steele DJ Illness representations and coping with health threats. In: Baum A, Taylor SE, Singer JE, eds. Handbook of psychology and health, Vol. IV: Social psychological aspects of health. Hillsdale, NJ: Erlbaum, 1984: 219—52.
  • Gollwitzer PM Goal achievement: the role of intentions. Eur Rev Soc Psychol 1993; 4: 141—85.
  • Bartholomew LK, Parcel GS, Kok G., Gottlieb NH Planning health promotion programmes (an intervention mapping approach), 2nd edn. San Francisco, CA: Jossey-Bass, 2006.
  • Austoker J. Be breast aware. Department of Health and NHS Breast Screening Programme. London, 1991 (leaflet).
  • Strong V., Sharpe M., Cull A., Maguire P., House A., Ramirez A. Can oncology nurses treat depression? A pilot project. J Advanced Nurs 2004; 46: 542—8.[CrossRef][Medline] [Order article via Infotrieve]
  • Mannix KA, Blackburn IM, Garland A., et al. Effectiveness of brief training in cognitive behaviour therapy techniques for palliative care practitioners. Palliative Med 2006; 20: 579—84.[Abstract/Free Full Text]
  • Theunissen N., de Ridder D., Bensing JM, Rutten G. Manipulation of patient—provider interaction: discussing illness representations or action plans concerning adherence. Patient Educ Couns 2003; 51: 247—58.[CrossRef][Medline] [Order article via Infotrieve]
  • Bolman C., de Vries H., van Breukeler G. Evaluation of a nurse-managed minimal-contact smoking cessation intervention for cardiac inpatients. Health Educ Res 2002; 17: 99—116.[Abstract/Free Full Text]

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This Article
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Right arrow Articles by Ramirez, A.J.
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