ADDRESSING MULTIPLE BREAST CANCER RISK: RESULTS

Data were entered and verified for 30 women who completed the and postintervention and one-year follow-up interviews. Nine women did not complete the postintervention interview, and 14 did not return for the one-year follow-up.

Table 1. Sociodemographic and Anthropometric Characteristics (N=30)

CharacteristicM Baseline SD      n

%

Three-Week Intervention One-Year Follow-Up M       SD                M       SD
Age                                  51.1 7.9
Number of Children                1.8 1.2
Body Mass Index                  31.4 6.0 32.3      6.2               35.9       6.3
Hours of TV per day                3.4 1.7 3.0      1.5                3.5        1.7
Education
High school 3

10.0

Some college 15

50.0

College graduate 12

40.0

Marital Status
Single, never married 6

20.0

Currently married 6

20.0

Divorced/Separated/Widowed 18

60.0

Income
$5,001-$ 11,999 1

3.3

$12,000-$ 15,999 5

16.7

$16,000-$24,999 4

13.3

$25,000-$34,999 00

26.7

$35,000-$49,999 6

20.0

$50,000 or more 6

20.0

Subjects

Table 1 shows the baseline sociodemographic and anthropometric characteristics of the women. Although it was required that women have a minimum BMI of 25 to participate, the mean BMI for the 44 women at baseline was 31.0, indicating that a large percentage of the women were already obese. The BMI range for this sample was 25.71-47.46.

Acceptability and Feasibility Retention. Forty-four women completed the baseline interview and agreed to participate in the program. Of these, 35 women completed the postintervention interview, reflecting a retention rate of 80%. Over 95% attended all three sessions and the focus group.

Table 2. Dietary Intake (N=30)

Baseline Three-Week Intervention

One-Year Follow-Up

Food Group

M

SD

Ma

SD

Effect Size

Mb

SD   Effect Size
Animal protein

1.39

0.88

1.29

0.78

0.02

1.37

0.86

0.00

Vegetable protein

0.54

0.63

0.60

0.67

0.01

0.70

0.70

0.03

Low-fat dairy

0.33

0.49

0.58

0.59

0.11

0.50

0.50

0.08

High-fat dairy

0.66

0.54

0.51

0.71

0.03

0.35*

0.45

0.16

Non-whole grains

1.12

0.91

0.79

0.76

0.12

0.98

0.97

0.03

Whole grains

0.56

0.63

1.23**

1.22

0.21

0.67

0.58

0.02

Vegetables

1.25

0.65

1.61*

0.79

0.15

1.43

0.83

0.05

Fruits

1.02

0.93

1.38

0.91

0.12

1.12

0.94

0.01

Fat added in cooking

0.79

0.69

0.77

0.70

0.00

0.66

0.75

0.04

Fried foods at home

0.31

0.40

0.18*

0.27

0.17

0.16*

0.21

0.20

Add fat at table

0.60

0.57

0.50

0.48

0.03

0.49

0.58

0.04

Fast food

0.27

0.28

0.23

0.23

0.02

0.18

0.28

0.05

High fat snacks

0.42

0.30

0.46

0.38

0.01

0.34

0.29

0.09

Desserts

0.32

0.33

0.28

0.30

0.01

0.28

0.25

0.01

Carbonated beverages

0.56

0.80

0.47

0.59

0.02

0.62

1.12

0.02

Water

4.02

2.98

5.57**

2.85

0.22

5.20*

2.25

0.17

Behavioral Variables

Dietary Patterns. Food-frequency data at baseline, postintervention, and follow-up are shown in Table 2. Postintervention results revealed health-promoting changes. Significantly higher intakes were seen for whole grains, vegetables, and water, with lower intakes noted for fried foods prepared at home. Lower intake of fried foods, and increased water intake were maintained at one year, and a significant decrease in high-fat dairy intake was also noted.
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Physical Activity Patterns. Fifty-seven percent of the women reported participating in no regular physical activity designed to improve their physical fitness at baseline, whereas 67% reported that they did participate in physical activity at postintervention (See Table 3). The most popular mode of activity was walking, with dancing and exercise tapes also commonly used. Mean duration for exercise time postintervention was 30 minutes, and intensity was six of 10 on the Borg exertion scale. Unfortunately, physical activity behaviors were not maintained at the one-year follow-up.

Table 3. Physical Activity Patterns (N=30)

Baseline       Three-Week Intervention       One-Year Follow-Up
Behavior                                       %                %                 Г             %              Zb
Currently participate in any regular activity designed to improve or maintain your physical fitness? Yes                                             43.3              66.7              2.11*          46.7            0.30 No                                               56.7              33.3                               53.3
How many times during the last week did you engage in an activity designed to improve your physical fitness?Less than one time                        58.6              37.9              1.75           58.6           0.23 Onetime                                      3.4               3.4                               3.4 Two- to three times                        10.3              17.2                              17.2 Four or more times                         27.6              41.4                              20.7
How many minutes during the last week did you participate in activity to improve your physical fitness? No minutes                                   58.6              37.9              1.10           58.6            0.54 One-to 30 minutes                        13.8              37.9                              20.7 More than 30 minutes                     27.6              24.1                              20.7
a Wilcoxon signed ranks test for change from baseline to 3 week intervention. b Wilcoxon signed ranks test for change from baseline to one-year follow-up. * p<0.05   ** p<0.01

Breast Health and Screening Behaviors (CBE, Mammogram). Tables 4 and 5 reflect data related to CBE, mammography, and BSE. Baseline results showed a high level of compliance with the public health recommendations that women receive an annual clinical breast exam and, for women over 40, an annual mammogram. Ninety-seven percent had undergone CBE at some time in their lives, and nearly 76% had received CBE in the last year. Over 93% of women ages 40 and over had had a mammogram at some time in their lives, but only 52% had had one in the last year. Approximately 35% of the women reported doing BSE at the recommended once-per-month interval. However, based on the BSE proficiency examination, only 9% of the women performed BSE correctly, and only 2.3% of the women found the accurate number of lumps (five) in the breast model. More than half (54%) reported they found no lumps in the model. At postintervention, significant improvements were noted for intention to receive CBE and practice BSE, as well as for frequency of BSE and BSE proficiency. Specifically, significantly more women moved their fingers in a circular motion (t(29)=2.55, p<0.05); used deep, medium, and light touch (t(34)=5.22, pO.OOl); used one of two systematic patterns (t(29)=2.22, p<0.05); and found lumps in the model (97%) (z=3.74, pO.OOl). All changes in breast health behaviors were maintained at the one-year follow-up, with the exception of using a systematic pattern in practicing BSE. Furthermore, significantly more women ages 40 and over had received a mammogram in the past year (72% at the one-year follow-up versus 52% at baseline). cheap phentrimine

Satisfaction With Intervention

Satisfaction Questionnaire. Thirty-six of the 44 women attended the focus groups and completed the satisfaction questionnaire. Data from this measure reflect that 96% of these 36 women reported high satisfaction with the intervention. One-hundred percent indicated that the program affected their motivation to do BSE, but only 69% indicated that they had increased confidence (self-efficacy) to actually perform BSE regularly. Similarly, over 90% reported that they were more motivated to exercise, while only 69% were confident they would be able to follow-through with exercise. The majority of the women (90%) would have liked additional classes in order to continue exercising. Related to eating, 89% said they were now more motivated to make healthy eating changes, and 75% reported they were more confident they could make the changes.

Table 4. Breast Health Behaviors • Clinical Breast Exam and Mammography (N=30)

Baseline Three-Week Intervention One-Year Follow-Up
Behavior % %

Za

% Zb
Ever Received CBEYes

No

96.7 3.3 96.7 3.3

0.00

96.7 3.3

0.00

Lasf Time CBEOne year ago or less

1-2 years ago

3-4 years ago

5-6 years ago

More than 6 years ago

75.9 13.8 6.9 0.0 3.4 75.9 13.8 10.3 0.0 0.0

0.00

75.9 20.7 0.0 3.4 0.0

0.60

intention to Hove CBE in Future Probably will Definitely will 23.3 76.7 3.3 96.7

2.45*

6.7 93.3

2.24*

Ever received mommogromYes

No

93.3 6.7 93.3 6.7

0.00

96.7 3.3

1.00

Lost Time of Mammogram (Age 40 and Above; n=29) One year ago or less                     51.7             69.0 1-2 years ago                               31.0             20.7 3-4 years ago                              10.3              6.9 5-6 years ago                                3.4              0.0 More than 6 years ago                     3.4               3.4

1.17

72.4 27.6 0.0 0.0 0.0

2.36*

Intention to Have Mammogram in Future Probably will                                 10.0 Definitely will                                90.0

3.3 96.7

1.14

6.7 93.3

0.58

Focus Groups. Participation in the focus group was very high, with all of the women contributing at least one comment. The primary skills they reported learning were: how to change eating pat­terns and shop for healthy food, the importance of exercise in weight management, the relationship between obesity and risk, and learning the correct way to perform BSE. The women emphatically voiced their appreciation for including culturally appropriate foods and music, addressing the importance of family and spirituality in behavior-change efforts, providing opportunities to exercise, and offering viable options to overcome barriers to health-promotion behaviors. Many participants related previous involvement in weight-loss programs that did not consider cultural aspects of their current lifestyles. Finally, a prominent theme of the focus groups was the women’s gratitude for having access to a program that addressed breast cancer risk in African-American women and offered information that might potentially decrease their own risk.