Abstract P4-17-05: A school-based breast health (BH) educational program to increase breast cancer awareness in a rural Mexican community: A qualitative comparative analysis of students', relatives' and teachers' perceptions
Authors: Soto-Perez-de-Celis E , Rojo-Castillo MP , Chavarri-Guerra Y 
Published: March 2017

Abstract
Background: In order to increase breast cancer awareness, we implemented a school-based educational program for female adolescents in a rural Mexican community, aimed at increasing knowledge and promoting intergenerational transmission of information to their female relatives. Here we report the perspective of the students, their female relatives and the school teachers on the program's impact on the adolescents and their community, as well as the major emergent themes related its implementation.
Methods: Adolescents enrolled in a public rural Mexican middle school were invited to participate in the program. They received age-appropriate, culturally sensitive sessions from expert educators focused on transmitting BH knowledge in their household. The students' opinions of the program were evaluated using open ended questions immediately after its completion. The opinion of the students' female family members and of the school teachers were recorded four months after the intervention using open ended surveys and semi-structured interviews. The interviews were conducted at the school by two oncologists who designed and implemented the program and were recorded in video and audio formats. Data was coded using a narrative research approach, and a constructivist paradigm was used to explore emerging themes. NVivo software was used for qualitative data analysis.
Results: The surveys were answered by 126 students, 185 family members and 18 teachers. Seven teachers then participated in semi-structured interviews. The following major themes were identified as related with the BH educational program by students: (1) the importance of breast self-examination; (2) the power obtained through knowledge and learning; and (3) the importance of disseminating the obtained information. The following major themes were identified by female relatives: (1) the importance of disease prevention; (2) knowledge to perform self-examination and seek medical attention and (3) empowerment through information. An analysis of the teachers' opinions identified the following major themes: (1) the program aided in discussing intimate topics; (2) the relevance of disseminating information in the community; (3) training other teachers and survivors for implementation; and (4) the importance of the acquisition of new knowledge. The relevance of obtaining and disseminating new knowledge was a common emerging theme among the three groups. Interestingly, both the students and their relatives highlighted the power of knowledge in empowering women and allowing them to prevent diseases and take care of their own health.
Conclusions: Obtaining feedback from the relevant stakeholders and promoting active participation of the community is essential for the implementation of successful school-based education programs in cancer. We identified relevant themes related to BH education which could be useful for designing and implementing future programs. Providing adolescents from underserved populations with new knowledge and tools to take care of their health can empower them and aid them not only in preventing disease but in disseminating that knowledge in their communities.
Citation Format: Soto-Perez-de-Celis E, Rojo-Castillo MP, Chavarri-Guerra Y. A school-based breast health (BH) educational program to increase breast cancer awareness in a rural Mexican community: A qualitative comparative analysis of students', relatives' and teachers' perceptions [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-17-05.