Interventional Strategies for Early Detection of Breast Cancer
Breast cancer is the most common and second leading cause of cancer deaths among women in the United States. (American Cancer Society, 2013) Among all the deaths that occur in women with cancer, 20 percent of them are attributed to breast cancer. The approximate number of patients who died from this disease in 2011 is estimated at 39, 520 (American Cancer Society, 2013). Although overall breast cancer mortality rates have declined in the U.S., since the 1990s, most of this benefit has been experienced by white. Breast cancer incidence rates are lower in African-American women than in white women. However, mortality rates are higher among African American women compared to other racial and ethnic groups (Centers for Disease Control and Prevention, 2013). In addition, African-American women are more likely to have a greater risk of recurrence, develop histologically more aggressive tumors that are at a more advanced stage and have lower relative five-year survival rates compared to white women (Rugo, et al., 2013) (Ghafoor, et al., 2003).This racial disparity is in part attributed to late diagnosis. Survival rates are higher when cancer is detected in earlier stages of diagnosis. As stated by the CDC (2013), mammograms are the best method used for the early detection of breast cancer. Therefore, it is important to implement intervention strategies that promote early detection by increasing breast cancer screening rates and potentially reducing disparities.
The Community Preventive Services Task Force (Task Force) is an independent, nonfederal, program consisting of public health and prevention experts supported by the CDC (2013). The Task Force develops evidence-based recommendations and findings on intervention strategies that work toward increasing breast cancer screening rates. Small media publications such as pamphlets, brochures and fact sheets are easy to distribute and are readily available to the public. Group education is another type of intervention strategy which provides an interactive component. Information is disseminated through presentations from a trained public health professional (Sabatino et al, 2014). Both types of intervention strategies provide information about breast cancer and encourage women to obtain screenings.
Primary question and response variable
According to the 2012 Florida Behavioral Risk Factor Surveillance System (BRFSS) surveillance data, 59.8% of non-Hispanic black women 40 years of age and older received a mammogram in the past year. Based on the most recent U.S. Preventative Services Task Force (USPSTF) guidelines, one of the Healthy People 2020 goals is to increase the proportion of non-Hispanic black women who receive a breast cancer screening to 81.1%. The objective of this study is to compare the effectiveness of small media alone to a combination of small media and online group session webinars as an intervention strategy to increase breast cancer screening rates for non-Hispanic black women 40 years of age and older. The primary research question is as follows:
1.Which intervention strategies are more effective for promoting an increase from 59.8% to 81.1% in breast cancer screening (mammography) among non-Hispanic black women 40 years of age and older residing in Florida? (note: professor states my research question has nothing to do with my objective – reword/revise)
The response variable for the primary questions is breast cancer screening rate.
Secondary question and response variables
2.Did breast cancer screening rates increase in Florida from 59.8% to the target Healthy People 2020 goal of 81.1%?
3.What percentage of women adhered to participating in the group session?
4.What percentage of women showed an increase in knowledge of breast cancer screening after the group session?
DESIGN OF THE STUDY
This study is designed as a multicenter, phase III, randomized control trial. For this clinical trial, the control group for this study will receive small media publications, brochures and factsheets. Published materials aim to inform women about breast cancer and the need to conduct early screening through mammography. The intervention group will receive the small media publications in addition to receiving access to a group session webinar.
I need to follow the format below (Typical clinical trial information):
A.Background of the study
i.Primary question and response variable
ii.Secondary questions and response variable
C.Design of the study
A.Study population (African-American women age >40)
B.Sample Size assumptions and estimates
C.Enrollment of participants
ii)Assessment of eligibility
iv)Intervention allocation (randomization method)
i)Description and schedule
ii)Measures of compliance
E.Follow up visit description and schedule