Introduction
A research carried out on clients of inner-city drop-in centers about women of the age between 50 to 70 years aimed at investigating the effectiveness of intervention in promoting screening mammography to women who were mentally ill and homeless. The results obtained were to be compared to the screening rates among women in the previous years.
A luncheon was used to motivate the subjects in participating in the study. Despite the various hitches experienced during the exercise, the study was undertaken and compared to the past few years’ results. The results indicated an increase in the number of women that undertook breast cancer screening.
Identification of the learner needs
It is indicated that in order for a woman to be considered homeless, she had to be living outdoors or in a homeless shelter. In addition to this, the diagnosis of the substance abuse of the learner was retrieved and based on the documented record system (Heyding, Cheung, Mocarski, Hwang, 2005 p. 26). The writers indicated that major barriers to screening are composed of competing priorities that include food, shelter, and problems in negotiating the health care system (Heyding, et al, 2005 p.3).
Factors considered in assessing the learner’s needs
Financial factor
Finance is a major factor considered in the assessment of the learner’s needs. The writers indicate that the study conducted took place at a no-profiting agency that provided services to women of low- income. The situation of the woman whose cost of mammography was paid for despite the existence of universal health insurance indicates the level of finance within the learners (Heyding, Cheung, Mocarski, Hwang, 2005 p.5).
Health insurance
Although the writers indicated that lack of primary care was not a major barrier to providing preventing health services, they also indicated that a factor like a difficulty in negotiating the health care system is considered major. In Canada, most of the women were insured due to the universal insurance although, in the United States, lack of health insurance is considered a major barrier (Heyding, Cheung, Mocarski, Hwang, 2005, p.9)
Social status
The study evolved around learners of low social status either due to their mental illness or due to homelessness. In their conclusion, the writers indicated that the highlights achieved from the study indicate the need to come up with ways of filling the gaps in the medical care of women affected by homelessness or mental illness (Heyding, Cheung, Mocarski, Hwang, 2005, p. 10).
Theoretical framework
The theoretical framework applied in this study is based on the Health Belief Model (HBM). Glanz, Rimer, and Viswanath (2008) indicate that there are different theories suited for different units e.g. groups, individuals and organizations. They go on to suggest that in the case of women trying to overcome barriers that are personal in order to obtain mammograms, the HBM might come in hand.
In addition to this, physicians may use The Transtheoretical Model (TTM) while deciding on their individual patient getting the first or annual mammogram. HBM is used to comprehend why individuals accept preventive health care services and do not pay attention to other health care regimens. Moreover, it has been used in early disease prevention, illness, early disease detection, and sick-role behavior (Glanz, Rimer, and Viswanath, 2008).
The study undertaken concerns a public health problem with behavioral implications, hence HBM brings out the understanding of selected concepts, their strength, their weakness and their relationship. Moreover, this study tries to detect breast cancer early by undertaking the mammogram program.
Relevant research article
The article entails a research study undertaken for the sole purpose of determining the effectiveness of a community-based intervention in increasing the use of screening mammography among women who are disadvantaged at an inner-city drop-in center. During the study, it was noted that majority of the screening mammography programs were conducted in urban areas among urban women thus indicating that only few of these programs are conducted for the less fortunate or disadvantaged women.
Women of the ages between 50-70 years who were clients of inner city drop center participated in the study. The women were selected were among the ones present in the center in that particular day, and they gave verbal consent of participation in the mammography, hence the research group did not obtain consent from the women to participate in the research.
This hence leaves a window for debate. On gathering the results, it was noted that the number of women had increased since the introduction of intervention. This drew the conclusion that the small groups are vital in promotion of breast cancer screening.
Contribution/learning and nursing process
The overall contribution of the study is increase in number of disadvantaged women attaining mammogram services. This will lead to early detection of breast cancer that can be tackled medically hence reducing casualties of breast cancer. According to Gehlert and Browne, “among the people experiencing physical illness, mental health can play an important role in physical outcomes a cross the life ….” this means that the mentally ill one way or the other has a greater role to play in their health.
They should not let depression and low self-esteem affect their health (Gehlert and Browne, 2006 p.196). Corcoran writes that an individual’s behavior can be determined by how vulnerable he/she considers himself to be; in this case, “vulnerability” is expressed as risk in HBM (Corcoran, 2007, p.15). This therefore indicates that if the women in our case study can learn the consequences of having breast cancer, then their decision of undertaking mammogram will be based on the aftermath of this weighting up process.
In the case scenario where one woman was found to have breast cancer, the nursing of the cancer will follow suit through lumpectomy. Moreover, abnormal mammogram should also be followed up seriously in order to be on the safe side.
Research problem and theoretical framework
The problem popping up from the study is the difficulty of the disadvantaged women i.e. the homeless and the mentally ill to access health services like the mammogram. The study indicates that most of the programs of mammogram are conducted in the urban areas among the urban women. This hence means that less of these programs are conducted for the disadvantaged women in the community (Heyding, Cheung, Mocarski, Hwang, 2005, p3).
The study was undertaken in a bid to establish the value of a community-based program in relation to screening mammography among needy women at an inner-city drop-in center, based on the health belief model. In their book, Glanz, Rimer, and Viswanath write that HBM has been used in the health sector in early disease detection, disease prevention, and sick role behavior (Glanz, Rimer, Viswanath (2008)).
The society of public health education suggests that in the health belief model, factors like age, gender, and personality are normally considered because they can influence a person’s change of behavior. Self-efficacy is also a factor that deals with the person’s belief that he/she can get involved in a behavior (The society of public health education, 2010).
In the study conducted, age and gender are some of the key factors considered. For instance, the study tells of the women of the ages 50-70 years considered for the study, and the fact that the women accepted to participate in the mammogram indicates the self-efficacy factor.
Implication to health promotion
The study implications on the health promotion (breast health teaching for homeless women) will have a positive impact. Lack of equal consideration of the disadvantaged women as compared to the urban women has been clearly brought into the limelight. In addition to this, the initiatives and roles of the inner-city drop-in center have clearly been defined as a refuge to the disadvantaged in the community. The success of the of community-based intervention in increasing the use of screening mammography among the disadvantage women also reveals new measures could be adopted in sensitizing and preventing breast cancer.
Results usage in health promotion activity
The results attained in the study can be useful to the government in tackling the breast cancer in the country. Non-governmental organizations may also find the information attained from the study useful in situations of aiding the fortunate in the society. The results may also be used in other health promotion activities apart from breast sensitization teachings. It can be used in HIV/AIDS teachings as the situations are almost the same from the preventive nature of the diseases to the factors to be considered e.g. age and gender.
Conclusion
Generally, the purpose of the study, which is to find the effectiveness of community based intervention in increasing screening mammography among the disadvantage, was positively achieved. According to the results of the study, the number of women undertaking the mammography program increased as compared to the previous years preceding the initiation of the intervention.
The need to focus on the less fortunate in the society is also imminent when dealing with the fight against breast cancer mainly because a lot of focus had been issued to the well off in the society thereby neglecting the less fortunate. The role of model is crucial in persuasion of the less fortunate to undertake the mammogram program.
In reflection to the topic of health promotion activity (breast health teaching) for homeless women, the study has relevantly synchronized with it. Accepting to attend the mammogram programs by randomly selected disadvantaged women is one crucial step in breast teaching and fight against breast cancer. In addition, the study is based on the health belief model, which is used in the situation of early detection or prevention of diseases in a bid to ensure it does not become complicated as time lapses. Moreover, the age and gender are some of the factors that are greatly considered while using the health belief model.
References
Corcoran, N. (2007). Communicating health: Strategies for Health promotion. Web.
Gehlert, S. and Browne, T. A. (2006). Handbook of health social work. Web.
Glanz, K., Rimer, K. B. and Viswanath, K. (2008). Health behavior and health education: Theory, Research, and Practice. Web.
Heyding, K. R., et al. (2005). A Community-Based Intervention to Increase Screening Mammography Among disadvantaged Women at an Inner-City Drop-In Center. Women & Health, Vol. 41, Iss. 1; p. 21.
Society for Public Health Education. (2010). Health promotion programs: From Theory to practice. Web.