Increasing breast cancer awareness and breast examination practices among women through health education and capacity building of primary healthcare providers: a pre-post intervention study in low socioeconomic area of Mumbai, India

OBJECTIVES: The present study aimed to improve breast cancer (BC) awareness and practices using Information, Education and Communication (IEC) modules and health educational sessions for women and primary healthcare providers in low socioeconomic community of Mumbai. DESIGN: Pre-post quasi-experimental design. SETTING: The study was conducted in a lower socioeconomic area of G-South ward of Mumbai, Maharashtra. The baseline and endline survey was conducted using structured interview schedules. PARTICIPANTS: 410 women were selected, aged between 18 and 55 years who were not pregnant, lactating or diagnosed with BC. INTERVENTION: A health education-based intervention module was developed to educate women through group and individual sessions. OUTCOMES: Summative indices were constructed to understand the net mean difference in knowledge of signs, symptoms and risk factors. Analysis of variance (ANOVA) and paired t-test were used to check the significant improvement of intervention. RESULTS: Our results showed statistical significance in difference in mean knowledge scores for both signs and symptoms (mean difference (MD) 4.09, SD 4.05, p<0.00)) and risk factors of BC knowledge (MD 5.64, SD 4.00, p<0.00) among women after intervention. There was a marked improvement in the knowledge of BC among women with low education category. A significant improvement in knowledge of symptoms and risk factors among health workers was also observed. Our interventions resulted in positive change in breast examination practices. The breast self-examination (BSE) practices improved from around 3% to 65% and around 41% additional women went for clinical breast examination after intervention. CONCLUSIONS: This study found a significant improvement in knowledge of BC signs and symptoms, risk factors and BSE practices among study participants following our health education interventions among these subpopulations. This evidence calls for inclusion of similar interventions through health education and capacity building of primary healthcare providers in national programmes.