Download Public health messages impact on adolescent girls: misperceptions

Public health messages impact on
adolescent girls: misperceptions and
fears
Carolee Polek RN, PhD, AOCNS
Thomas Hardie, RN, EdD, PMHCNS-BC
Aims
Breast health recommendations change with
expanding evidence including:
• self-breast exam timing, mammography, and
rates of alcohol consumption.
Women left with lingering concerns regarding the
reliability of public health messages which may be
most impactful in adolescent women.
This study explores the ambient perceptions/
misperceptions of adolescent girls and of breast
health risks.
Background
• 226,870 new cases of invasive breast cancer
will be diagnosed 2012 (ACS, 2012).
• The etiology of a portion of these are
modifiable behaviors.
• Risk and protective behaviors are learned,
adopted, or experimented with during
adolescence.
• Behaviors are a function of misperceived or
misunderstood personal risk.
Cancer prevention, public health and
media messages.
Breast cancer screening messages have been
successful in enhancing rates of screening at the
population level.
These are targeted at adult women.
These efforts encourage programs for BSE in younger
women.
Breast cancer risk are often in the news and
provide a changing landscape of things to avoid.
For some this is mind numbing, mixing fear and an ever
increasing number of current or future risks.
Breast cancer
1.7-4% (mother, any age)
2-3% (sister, any age)
3.6-5% (sister, premenopausal)
2% (sister, postmenopausal)
11% (sister, bilateral)
Ovarian cancer
3.9-4% (first-degree relative)
Colon cancer
3-4% (mother or father)
3-7% (brother or sister)
Prostate cancer
2-5% (first-degree relative)
Malignant melanoma
2.7% (first-degree relative)
Risks expressed are relative risks (the increased
risk as compared to a control population), not
absolute risks (the actual likelihood of developing
the disease). These risks do not apply to families
with a known familial cancer syndrome.
Source: Adapted from Clinical Cancer Genetics By Ken Offit ISBN 0-471-25154-2 Copyright
January 1998 by Wiley-Liss, Inc. Adaptation of Table 6-1 on page 217
Common misperceptions
Adolescent misperceptions
(Weiss 2008)
• 23% infection, drug use,
stress, and tanning
• 10-20% caffeine,
antiperspirant, or getting
bumped or bruised
• 7% breastfeeding , (author’s
finding ~22%)
• 30% of girls have perceived
a normal change as breast
cancer
Adult misperceptions
• African American women
have a fatalistic beliefs.
• Broad confusion about
personal risks, genetics and
heredity
• Underwire bra
• Abortion
• Deodorant
• Implants
Methods:
Nine piloted questions to 636 girls (14 to 19 Yrs.) from
13 high schools
Results:
> 50% injury to breast
> 50% tanning breasts
> 50% thought ETOH/drug consumption no risk
40% thought all lumps were breast cancer
40% tobacco caused breast cancer
30% healthy weight and exercise had no impact
20% scared by public health breast cancer messages.
Follow up study of 336 HS girls
Discussion
• Similar to Weiss our findings suggest ongoing
misperceptions that may increase cancer risks.
• Ongoing analyses suggest race/ethnic
differences.
• Currently evaluating if these are associated
with SES or cultural differences.
• 1/3 of girls fear (and potentially avoid) public
health messages.
Conclusions
Find a more effective way to talk about risk to all
women but perhaps more importantly to
adolescent girls.
• Yesterday the vitamins were a cure today they are a risk
• Two drinks good for your heart but you will loose your
breast to cancer if too much ETOH
Attempt to simplify complex health risks to sound
bites may help or support misperceptions and or
junk science.
Current recommendations suggest messages for
adolescents should emphasize an understanding of
breast development/breast health.
Misperception Questions
1. Tanning my breast will cause breast cancer.
2. Drinking coffee causes breast cancer.
3. Getting an infection will cause breast cancer.
4. Breast cancer can be caused by a sports related injury
to your chest.
5. Alcohol and drug use can cause breast cancer.
6. If your mother or sister has breast cancer, you will get
breast cancer.
7. Stress causes breast cancer.
8. Breast feeding increases my risk for breast cancer.
9. Smoking causes breast cancer.
References
• American Cancer Society. (2012). Cancer Facts
& Figures 2012
• Weiss, M. C., & Friedman, I. (2008). Taking
Care of Your Girls: A Breast Health Guide for
Girls, Teens, and In-Betweens. New York:
Three Rivers Press.
Acknowledge BBHI adolescent breast health
program
Biden Breast Health Initiative (BBHI)
P.O. Box 4616
Wilmington, DE 19807
302-658-1545
[email protected]