Editor’s Note: This article is adapted from the research paper “Implementation of Breast Cancer Awareness Programs in the Community Involving Nursing Students,” presented by the author at the Oncology Nursing Society’s Cancer Prevention and Early Detection Program for HBCU/MSI Nurses: Dissemination Colloquium, May 3-4, 2002 in Miami.
According to estimates released in 2000 by the American Cancer Society (ACS), approximately 19,300 new cases of breast cancer were expected to occur among African-American women in 2001, and about 5,800 black women were expected to die from the disease. Even though the incidence rate for breast cancer is approximately 13% lower in African-American women than in white women, mortality rates for black women are 28% higher than those of their white counterparts. Furthermore, the five-year relative survival rate for breast cancer is 86% among white women, compared to only 71% for African Americans.
To help address these troubling disparities in my local community, I decided to implement a series of three breast health awareness programs targeted to African-American women in the Houston area. As an instructor in the College of Nursing at Prairie View A&M University, one of the most respected historically black universities in Texas, I was in an ideal position to carry out this project because I was able to draw upon a unique and powerful resource: my students.
Our first breast health program took place during the spring semester of 2000. Students in my “Basic Concepts in Nursing” course are required to complete six hours of nursing community service on a project of their own choice. I announced to the class that I was planning an upcoming Breast Cancer Awareness Seminar for African-American women and that if any student wanted to participate and help with the seminar, I would allow them to receive the full six credit hours of required community service coursework.
The seminar was held in the sanctuary of a local African-American church and drew an audience of about 75 women. The students pinned handmade pink ribbons on each participant as they entered. We distributed educational materials we had ordered from ACS and the National Cancer Institute (NCI), including pamphlets, booklets and other handouts containing cancer statistics and information on mammography, clinical breast examination and breast self-exams. The women also watched a video entitled “Keep in Touch: Mammography & Breast Self-Examination.” Other visual aids included poster presentations and breast models for practicing self-exams.
To evaluate how much the participants had learned, we played games (e.g., Breast Cancer Awareness Bingo) and asked simple questions related to the content that was covered, with prizes awarded for correct answers. The response from the participants was very positive. They thanked us for conducting the seminar and expressed their appreciation that student nurses from Prairie View A&M University were involved in the program.
Based on this success, the second program, held at Mt. Sinai Baptist Church in the fall semester, included participation by both nursing students and faculty members. It was designed to tie in with the American Cancer Society’s designated Pink Ribbon Sunday. As the congregation entered the church, they were greeted by a display table draped with a Prairie View A&M University banner. Our display included candy, Pink Ribbon Day balloons and breast cancer awareness materials, such as pamphlets, flip charts, breast models, poster sessions and more.
Faculty members spoke to the congregation and explained the purpose of Pink Ribbon Sunday. Ushers and greeters passed out pink ribbons. Nursing students distributed literature and answered questions.
Our display table stayed in the church for the entire month of October, which is National Breast Cancer Awareness Month. Each Sunday, faculty members provided a breast cancer information handout that was passed out to the congregation along with the church bulletin. Faculty and students also went to another church, The Shrine of the Black Madonna #10 of the Pan African Orthodox Christian Church, and conducted a Pink Ribbon seminar with a smaller group of about a dozen participants.
The third program was held about two weeks later on October 26, 2000. This time, the College of Nursing sponsored a Breast Cancer Awareness Day on campus. The program was structured as a luncheon event, lasting from noon to 1:30 p.m.
We decorated the College of Nursing with breast cancer awareness posters and pink balloons. Three students conducted a PowerPoint presentation on breast health. We invited a guest speaker, a six-year breast cancer survivor, who told her story to two different audiences. Another speaker gave a presentation on “Health and Beauty From the Inside Out,” which is a breast health program developed by UTMB HealthCare Systems, an HMO that serves employees of the University of Texas System and other Texas schools. Participants took a Breast Health Challenge Pre-Test and Post-Test so that we could measure the effectiveness of the presentation.
Like the previous two seminars, this program included pink ribbons for all participants, poster presentations, exhibits, informational handouts, breast models, etc. The “Keep in Touch” video ran continuously in the foyer. Faculty and student volunteers were on hand to answer questions. We took pictures during the event, which faculty members used later in the semester to make a poster presentation about the Breast Cancer Awareness Day activities. This poster was on display for two weeks at the College of Nursing for all faculty, staff, students and visitors to view.
In September 2000, I traveled to Atlanta to attend one of the Oncology Nursing Society’s Cancer Prevention and Early Detection Programs for nurse educators at historically black colleges and universities. This inspired me to become involved in several other breast cancer awareness activities in my community. Once again, I encouraged the participation of my students as much as possible.
One particularly memorable program was “Celebrating, Embracing and Promoting Breast Health,” a faith-based initiative involving two churches in the local African-American community. Faculty and students from the Prairie View A&M University College of Nursing were invited to participate in this event. Held at a local hotel in September 2001, the conference was attended by 85 people, including two male participants. To ensure a large turnout, we promoted the event six weeks in advance, distributing flyers at the churches and elsewhere in the community.
The conference opened with a welcome, followed by a song and prayer from the First Lady of each church. After a fellowship buffet breakfast, the breast health program began. Speaker Cheryl Ivory gave a presentation on the Christian Women’s Wellness breast health program, developed by Sandra Millon Underwood, RN, PhD, FAAN, of the University of Wisconsin-Milwaukee. I also gave my own breast health presentation.
In one of the conference’s most moving moments, a panel of breast cancer survivors shared their stories. This prompted one of the male participants, who was a nursing student, to tell the audience his own heartfelt story. “My mother died of breast cancer,” he said, through tears. “She was a Registered Nurse with a master’s degree. She felt a lump in her breast but she did not go to see a doctor, because she was afraid. I begged my mother to go to the doctor but she wouldn’t. When she finally went, it was too late. The cancer had spread. It was in an advanced stage.”
This young man urged the women in the audience to do monthly breast self-exams and get annual mammograms and clinical breast exams. He also challenged them to encourage the men in their lives to do breast self-exams, because breast cancer can strike men, too. “My friends would laugh at me for checking my breasts,” he said, “but I continued to do it anyway.” One day, he discovered a lump in his breast. He had it checked by a physician and, fortunately, it was benign.
The conference also included a presentation from an American Cancer Society representative about breast health resources available in the Houston area. Participants received breast health literature and pink ribbon gift items. Our school’s nursing students played an active role, serving as hostesses, setting up displays, passing out giveaways and helping to teach the participants how to perform breast self-exams and how to palpate lumps using the breast teaching models. The conference closed out with prayer.
One thing I have learned from my involvement in efforts to help close the breast cancer mortality gap between African-American women and their Caucasian counterparts is that the opportunities for nurses to spread the word about the importance of prevention and early detection are virtually unlimited.
For example, as a member of the Houston Chapter of the NCI’s National Black Leadership Initiatives on Cancer, I participated in the first annual Ride for the Cure, a bicycle marathon, in October 2001. I conducted a breast health presentation for the trail riders at one of the scheduled stops. I brought along my laptop computer, posters, literature and giveaways for the riders. Breast models were also available on site for demonstration and practice.
Later that month, I participated in an on-campus Breast Cancer Awareness Week sponsored by Prairie View A&M University’s Nursing Students’ Association. The five-day event included a breast health presentation, Breast Cancer Awareness Bingo, food, door prizes and giveaways. In addition, the students held a memorial service to honor those who had died from breast cancer as well as breast cancer survivors.
Meanwhile, news of the successful “Celebrating, Embracing and Promoting Breast Health” conference had spread by word of mouth to other African-American women in the community. A woman who worked for the local Internal Revenue Service office called me and told me that she had heard about the conference. She invited me to come to their workplace and provide a breast health presentation for the employees in recognition of National Breast Cancer Awareness month.
On October 25, 2001, I conducted a “Lunch and Learn” breast health awareness program sponsored by the Federally Employed Women of the Internal Revenue Service. A culturally diverse group of 68 IRS employees attended the program, including both men and women. The event included a PowerPoint presentation, Breast Cancer Awareness Bingo, informational handouts, breast self-exam demonstrations and giveaways. I also allotted time for questions, answers and comments.
The response from the employees was extremely positive. One participant wrote on the evaluation form: “This was the most detailed and informative presentation on this topic I’ve ever had. Everyone should attend and experience this factual awareness. The pass-around breast samples were most beneficial. This has been a gift of significant importance and love.”
In December 2001 I was a featured speaker at the “Stay Beautiful, Stay Alive” breast and cervical cancer education program, sponsored by our National Black Leadership Initiatives on Cancer chapter. The program was held at a local beauty salon for African-American women and was hosted by the salon owner. Twenty-five participants attended.
Based on what I have accomplished, I believe that even a single nurse educator, with a little help from her/his students and colleagues, can truly make a difference in helping to ensure that a diagnosis of breast cancer in African-American women doesn’t have to be a death sentence. If even one life can be saved as a result of these conferences and presentations, then my labor has not been in vain. Imagine what you could do to promote breast health in your community!