The effectiveness of educational intervention based on the Health Action Model (HAM) in improving breast cancer screening behaviors.

INTRODUCTION: Breast cancer disease is known as the most common cancer among women. Lack of knowledge and awareness is a leading cause of breast cancer, and since nearly all women are increasingly susceptible to this disease, training screening behaviors for early detection is proven essential in order to reduce breast cancer mortality. Therefore, the present study was designed to determine the effect of educational intervention based on the Health Action Model in improving breast cancer screening behaviors in women aged 30 to 69 in Kashan, Iran. METHODS: This quasi-experimental study was conducted on 162 women aged 30-69 years old among the clients of Comprehensive health service centers in Kashan, Iran and they were assigned to intervention and control groups. The research instrument included a questionnaire assessed within three phases: baseline, 3-months, and 6-months, containing Health Action Model (HAM) structures and also three screening behaviors. The intervention consisted of a model-based education package and was carried out over 2 months. To evaluate the effect of the intervention, the mean of model structures and proportion screening behaviors in the third and sixth months were compared with the baseline phase. All analyses were carried out using SPSS, version 22. RESULTS: The intervention and control groups were homogeneous regarding the structures of the HAM and the proportion of screening behaviors in the baseline phase (p > 0.05). In the 3-month (p < 0.05) and 6-month (p < 0.05) phases, the mean scores of the HAM constructs in the intervention group were found higher compared with the control group. Moreover, the proportion of clinical breast examinations in the intervention group was statistically higher than in the control group in the 3-month (p < 0.001) and 6-month (p < 0.001) phases. In addition, the proportion of mammography performed in the 3-month (p = 0.002) and 6-month (p < 0.001) phases were reported to be higher in the intervention group compared with the control group. CONCLUSION: Overall, these results provide important insight into the effectiveness of the interventions based on the Health Action Model in promoting breast cancer screening behaviors and the determinants of such behaviors.

Design and psychometric evaluation of the breast cancer screening behaviors scale based on the health action model (HAM).

BACKGROUND: Breast cancer is known as the most common cancer and the first-rank malignancy among women. Screening plays a crucial role in early diagnosis and timely treatment. This paper presents the results of design, evaluation and analysis of a questionnaire based on the health action model to investigate breast cancer screening behaviors and their relevant factors. METHODS: The study is based on using a combination of quantitative and qualitative approaches for optimal design and development of research tools. In order to design the structure of the health action model and screening behaviors related factors, both qualitative methods such as semi-structured interviews and quantitative approaches studied. Psychometric properties of the research tool were investigated through literature review. The research population consisted of 210 30-69 years old females based in Kashan who were selected through simple random sampling. The relative and content validity indexes were calculated to judge the content of the tool. Also, the confirmatory factor analysis was used to evaluate the construct validity. Additionally, intra-class correlation coefficient and Cornbrash's alpha coefficient were calculated to evaluate the reliability of the instrument. The data were analyzed using the SPSS 22 and AMOS 22 software packages. RESULTS: The mean age of the participants was 43 ± 9.82 Years old. The final version of the questionnaire was prepared in four sections, namely demographic factors (15 items), knowledge (12 items), constructs of the health action model or the factors related to breast cancer screening behaviors (67 items), and behavior (6 items). Factor analysis confirmed that the health action model fits in measuring breast cancer screening behaviors. CONCLUSION: The tool designed for measuring breast cancer screening behaviors showed acceptable psychometric properties amongst females and can be used as a valid tool in conducting research in health studies.