Educational Intervention Targeting Breast Cancer Knowledge and Awareness Among Women in Cusco, Peru: A Pre- Post-Test Intervention Open Access

Abstract

Breast cancer is the most common cancer diagnosis worldwide and the second leading cause of cancer death for Peruvian women. Increased adverse effects and mortality from breast cancer in Latin America, and in Peru specifically, are in part caused by delayed diagnosis and treatment. In Peru, 50-75% of breast cancer diagnoses have already progressed to phase III or IV. To address this disparity, a pre- post-test intervention was conducted by a group of United States based researchers in collaboration with CerviCusco, a Peruvian non-profit organization committed to improving the health and quality of life of Peruvian women through primary and secondary cancer prevention, to obtain baseline data on breast cancer knowledge and awareness for women in Cusco, Peru and evaluate the effectiveness of an educational intervention (a 2.5- minute animated video and pamphlet). The survey instrument, BreastCAM, was adapted for cultural relevancy and translated to be used for data collection. Seventy-five self-identifying adult women who understood Spanish or English were recruited for the pre-test, and 31 were retained for the intervention and post-test. Results indicated that knowledge and awareness significantly increased in relation to risk factors (p-value=0.017) and confidence in self-breast examinations (p-value=0.001), but not early warning signs (p=0.10) and local resource utilization (p-value=0.246). The results of this study, limited in generalizability, provide baseline data on knowledge and awareness to inform future interventions with our partner organization and others. The study also validates the use of the educational video and pamphlet to inform on risk factors of breast cancer. Results indicate a need to improve access to local resources and educate on early warning signs differently. Closing the gap in knowledge and awareness in the population is the first step to reducing the disparity in breast cancer mortality that is fueled by systemic and structural barriers to accessing and utilizing health care.

Table of Contents

Chapter 1: Introduction…………………………………………………………………………1

Introduction and Rationales…………………………………..…………………………...1

Problem Statement…………………………..…………………………………………….4

Purpose Statement………………………….……………………………………………...5

Objectives……………………………..…………………………………………………..6

Significance Statement………………………………………..…………………………...6

Definition of Term…………………………………………………………………..…….7

Chapter 2: Literature Review…………………………………………………………………...9

Breast Cancer Burden………………………………………………………..……………9

Primary Prevention of Breast Cancer………………………………………..…………..13

Secondary Prevention of Breast Cancer…………………………………………..……..15

Breast Cancer Knowledge and Awareness…………………………………..…..………17

Peruvian Context……………………………………………………..…………………..21

Chapter 3: Manuscript…………………………………………………………………………27

Abstract……………………………………………..……………………………………27

Introduction………………………………………………………..……………………..28

Methods……………………………………………………………..……………………31

Results………………………………………..…………………………………………..38

Discussion………………………………………………………………..………………40

References……………………………………..…………………………………………47

Table 1…………………………………………………………………………..……….53

Table 2…………………………………………………………..……………………….54

Table 3……………………………………………………………..…………………….57

Table 4…………………………………………………………………………………...57

Table 5…………………………………………………………………………………...58

Table 6…………………………………………………………………………………...58

Appendix A………………………………………………………………………………60

Appendix B………………………………………………………………………………61

Appendix C………………………………………………………………………………63

Chapter 4: Conclusion and Recommendations……………………………………………….71

Summary of Main Findings………………………………………………………..…….71

Strengths and Limitations……………………………………………………..…………73

Implications for Future Research and Programs……………………………………..…..74

Implications to Partners…………………………………………………..……………...75

Implications to Global Health Partnerships…………………………………..………….76

Human Rights Implications of Results……………………………………..……………76

Conclusion……………………..……………………………...…………………………77 

References……………………………………………………………………………………….79

About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Education, Health Health Sciences, Public Health Health Sciences, Public Health Education
Keyword	risk education Peru early detection knowledge health women breast cancer public health awareness
Committee Chair / Thesis Advisor	Dr. Ghada Farhat, Emory University
Committee Members	Dr. Quyen Phan, Emory University

Last modified

Primary PDF

Thumbnail	Title	Date Uploaded	Actions
	Educational Intervention Targeting Breast Cancer Knowledge and Awareness Among Women in Cusco, Peru: A Pre- Post-Test Intervention ()	2022-04-21 14:54:36 -0400	Press to Select an action Download

Supplemental Files

Thumbnail	Title	Date Uploaded	Actions
	Appendix A: Educational Video (Appendix A: Educational Video)	2022-04-21 14:54:44 -0400	Press to Select an action Download