Assigment .Apa seven . All instructions attached.

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Health Promotion Proposal, Part 1

Writing Assignment Week 4

Sluvia Algarin

Florida National University

Health Promotion & Role Development in Adv. Nursing Practice-DBX-DL01

Dr Nora Hernandez-Pupo

May 24, 2024

Breast Cancer

Breast cancer is still one of the most trumpeted health concerns facing women the world over. It is the most prevailing cancer in women, accounting for about 30% of all female cancer incidence. The magnitude that this illness carries with it is worrying; the American Cancer Society projects that it is estimated that about one in every eight United States women will develop invasive breast cancer over the years of her lifetime. Breast cancer, despite advances in medical technology and better treatments, continues to claim so many lives. Risk factors go along with genetic predisposition, lifestyle, environmental exposures, and vulnerability of some populations due to restrictions in access to healthcare, socioeconomic challenges, and educational disparities (Zafar et al., 2022). Such a health disparity creates a need for targeted health promotion for better early diagnosis rates, improved information about the disease, and a supportive environment for patient care.

Effective health promotion includes early diagnosis improved outcomes of treatments, and thus eventually reducing deaths arising from breast cancer. Such an urgent health problem is to be tackled through the all-inclusive approach that includes education, ss to screening programs and support systems, and the emotional and physical burdens disease entails. In low- and middle-income nations, the health promotion program should raise breast cancer awareness and aid early diagnosis. Community-based education campaigns, training for community health workers to provide support and navigation services, and affordable and accessible screening facilities will improve breast cancer screening knowledge. The program will aim to raise breast cancer screenings by 20% and early-stage breast cancer diagnoses by 15% in the first year. Local health records and program participation data will track these outcomes.

Vulnerable Population

Women at Risk for Breast Cancer

The susceptible groups who are highly affected by breast cancer are women from low economic status, ethnic minorities, and those who reside in rural settings. These groups tend to be associated with considerable barriers to the use of healthcare services due to inadequate insurance, poor availability of medical facilities, and cultural or language differences (Chazarri et al., 2023). Besides this, women with low education have less knowledge regarding what risks are associated with the disease of cancer and the significance of receiving regular screening services for breast cancer. Due to poor awareness and access to preventive care, the incidence of late-stage diagnoses on the rise is related to poorer outcomes and higher mortality rates. The most vital risk factor for breast cancer is the socioeconomic status in such populations. Women from economically disadvantaged families are unlikely to have insurance coverage, which consequently reduces their access to routine medical services such as mammograms and clinical breast exams. Ko et al. (2020) add that the uninsured women are diagnosed with breast cancer disease during the late stage of the disease, which is hard to cure. Furthermore, the Centers for Disease Control and Prevention continue reporting that late-stage diagnoses are more common in rural areas because women within the population usually have low income, and there are no health care services centers.

Many vulnerable breast cancer groups are ethnic and racial minorities. African American women are more likely than whites to get triple-negative breast cancer, which is more aggressive but less curable. These differences are caused by genetics, tumor biology, and detection and treatment delays. Research shows that African American women are unable to acquire prompt follow-up care after an abnormal mammography and proper treatment for their stage of cancer, which may worsen their outcome. Additionally, Hispanic and Latina women have distinct problems. They are less likely to participate in breast cancer screening programs because of cultural beliefs, linguistic barriers, and fear of diagnosis. A recent Journal of Cancer Education study found that Hispanic women often rely on family and community support for health information, which may delay medical treatment (Polek et al., 2020). Socioeconomic factors, such as lack of insurance and low income, limit their access to necessary medical services. The other significant etiological factor is the genetic factor, especially if the patient is female with a family history of breast cancer. The mutations of the BRCA1 and BRCF2 genes predispose a person to have a very high chance of developing breast cancer. However, genetic testing can be pretty helpful in the identification of high-risk individuals; accessibility in terms of affordability and availability is typically low for at-risk women in vulnerable populations. The report in the Journal of Clinical Oncology also demonstrated that minority women were less likely to be referred for genetic counseling testing.

Review of Literature on Evidence-Based Interventions for Breast Cancer

According to an evidence-based study, early detection, rapid diagnosis, and complete treatment improve breast cancer survival rates, especially in low—and middle-income countries. Wilkinson and Gathani (2021) note that community-based education and awareness programs reduce cancer stigma and promote early symptom detection. These therapies can considerably downstage breast cancer upon diagnosis, improving treatment results and reducing death. The WHO's Global Breast Cancer Initiative (GBCI) standardizes care through health promotion, timely detection, and complete treatment, which are crucial in resource-constrained areas.

Despite their benefits, these approaches need to be revised. Regional healthcare infrastructure variability is a drawback. Community health workers and education initiatives are crucial, but many LMICs need more basic diagnostic and treatment facilities. Wilkinson and Gathani note that insufficient diagnostic services can lead to over- or under-treatment. In addition, financial constraints and the high expense of comprehensive cancer care worsen breast cancer outcomes. Universal health coverage (UHC) is offered to decrease financial problems; however, implementing it is challenging. Digital innovations and artificial intelligence may reduce workforce shortages and improve diagnosis accuracy, but their efficacy and deployment in low-resource settings must be proven and studied. Therefore, while the evidence-based interventions recommended are intense, their effectiveness depends on addressing these systemic deficiencies and providing equal healthcare access.

A contrasting study by Smolarz et al. (2022) presents a detailed review emphasizing that effective interventions are multidisciplinary. Some of the key strategies include hormone therapy, chemotherapy, and emerging treatments like immunotherapy, essential for triple-negative breast cancer, which is quite challenging due to its aggressive nature, and no targeted therapies are available at this time. The strengths of the review concern detail in the source about several treatment modalities that, in the process, pinpoint their specific applications depending on the molecular subtype of breast cancer. The paper stresses individualized treatment plans, so how new treatments could affect outcomes is very apparent. However, significant weaknesses are the limited focus on preventative measures and the socioeconomic barriers inherent in advanced treatments, especially in the developing world.

Health Promotion Model: Pender's Health Promotion Model

Breast cancer early detection and prevention among low—and middle-income countries can be effectively implemented with the help of Pender's Health Promotion Model. Nola Pender developed her HPM based on individual behaviors and their determinants; hence, it applies broadly to those activities where health promotion is expected to encourage early screening for breast cancer and timely consultation with the doctor. In this model, the perception of the personal factors, perceived benefits, and barriers to action toward identified challenges in breast cancer care is critical.

Critical constructs in the model are individual characteristics and experiences, behavior-specific cognitions and affect, and behavioral outcomes. Individual characteristics such as age, educational level, and even cultural beliefs, and experience can guide health behaviors in breast cancer prevention. For example, awareness campaigns could be specifically targeted to particular demographic groups that are experiencing barriers towards screening, such as misconceptions of cancer or fear of diagnosis. The theory of HPM proposed that systematic and practical health promotion intervention design can be realized by paying particular attention to such perceived benefits as the potential for enhancement in survival rates due to early detection and reducing perceived barriers related to cost and accessibility in diagnostic services (Turner & Reed, 2023).

References

Chazarri, L. P. -, Ponce-Blandón, J. A., Immordino, P., Giordano, A., & Morales, F. (2023). Barriers to Breast Cancer-Screening Adherence in Vulnerable Populations. Cancers, 15(3), 604. https://doi.org/10.3390/cancers15030604

Ko, N. Y., Hong, S., Winn, R. A., & Calip, G. S. (2020). Association of Insurance Status and Racial Disparities With the Detection of Early-Stage Breast Cancer. JAMA Oncology. https://doi.org/10.1001/jamaoncol.2019.5672

Polek, C., Hardie, T., & Deatrick, J. A. (2020). Breast Cancer Survivorship Experiences of Urban Hispanic Women. Journal of Cancer Education, 35(5), 923–929. https://doi.org/10.1007/s13187-019-01543-0

Smolarz, B., Nowak, A. Z., & Romanowicz, H. (2022). Breast Cancer—Epidemiology, Classification, Pathogenesis and Treatment (Review of Literature). Cancers, 14(10), 2569. https://doi.org/10.3390/cancers14102569

Turner, A. R., & Reed, S. M. (2023). Theory Analysis: The Health Promotion Model and Motivation in Physical Activity. Research and Theory for Nursing Practice, 37(2), RTNP–2022-0085.R1. https://doi.org/10.1891/RTNP-2022-0085

Wilkinson, L., & Gathani, T. (2021). Understanding breast cancer as a global health concern. The British Journal of Radiology, 95(1130). https://doi.org/10.1259/bjr.20211033

Zafar, T., Naik, A. Q., Kumar, M., & Shrivastava, V. K. (2022). Epidemiology and Risk Factors of Breast Cancer. Breast Cancer: From Bench to Personalized Medicine, 3–29. https://doi.org/10.1007/978-981-19-0197-3_1