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Health Outcomes | Breast Cancer Evaluation Measures

Health outcomes measures for breast cancer screening1-11

The effectiveness of breast cancer screening programs depends on the intensity of program effort and the use of multiple interventions. A rule of thumb is that the more programs implemented together as a package or campaign, the more successful the interventions will be.

Baseline

  • Determine levels of employee breast cancer screening rates from employee health survey or health risk appraisal. Examples include:
    • What percentage of employees have been screened
    • Measures of the percent of employees who currently achieve breast cancer screening guidelines by employee health survey
  • Determine baseline percentage of employees with health behaviors or conditions where individuals have a higher risk associated with breast cancer such as family history, overweight/obese (increases risk for breast cancer after menopause), drinking alcohol (more than one drink a day), using birth control pills (oral contraceptives), or being physically inactive
  • Determine levels of diagnostic and treatment procedures from health care and pharmaceutical claims data
    • Of those employee who were screened, what percentage of mammograms reported abnormal results
    • What percent of women with abnormal screening mammograms were referred to and completed diagnostic testing to confirm the absence or presence of breast cancer
    • How many cases of breast cancer were identified
    • What percent of breast cancers were identified at stage 0, stage I, stage II, stage III, or stage IV
  • Determine employee knowledge, attitudes, and beliefs about breast cancer screening ◦Evaluate employees’ current knowledge of the health benefits of breast cancer screening
    • Measure employee’s knowledge of their risks for breast cancer
    • Measure employee’s knowledge of current breast cancer screening guidelines
    • Assess employee awareness of existing workplace breast cancer screening programs, policies, and benefits
    • Assess employee awareness of behaviors that may reduce breast cancer risk, such as reducing obesity or overweight (increases risk for breast cancer after menopause), drinking alcohol (more than one drink a day), or being physically inactive

Process

  • Periodic repeats of baseline measures

Outcome

  • Assess changes in levels of employee breast cancer screening rates such as: ◦Increases in the number of employees screened
    • Changes in the percentage of employees reaching breast cancer screening guidelines
  • Assess changes in the percentage of employees with health behaviors or conditions where individuals have a higher risk associated with breast cancer such as being overweight/obese (increases risk for breast cancer after menopause); drinking alcohol (more than one drink a day); using birth control pills (oral contraceptives), or being physically inactive5-10
  • Determine changes in the levels of diagnostic and treatment procedures from health and pharmaceutical claims data
  • Assess changes in employee knowledge, attitudes, and beliefs about breast cancer prevention and screening
    • Evaluate changes in employee knowledge of current breast cancer screening health benefits and guidelines
    • Measure changes in employee’s knowledge of their risks for breast cancer
    • Assess changes in employee awareness of existing workplace breast cancer screening programs, policies, and benefits
    • Assess changes in employee awareness of behaviors that may reduce breast cancer risk

References

1.  Centers for Disease Control and Prevention with the Prudential Center for Health Care Research. The manual of intervention strategies to increase mammography rates. 1997. Available from: https://www.cdc.gov/cancer/nbccedp/pdf/prumanual.pdf [PDF – 4.4MB]

2.  Campbell KP, Lanza A, Dixon R, Chattopadhyay S, Molinari N, Finch RA, editors. A Purchaser’s Guide to Clinical Preventive Services: Moving Science into Coverage. Washington, DC: National Business Group on Health; 2006.

3.  Centers for Disease Control and Prevention. Framework for program evaluation in public health. Morbidity and Mortality Weekly Report 1999;48(No. RR-11): 1-40.

4.  Goetzel RZ, Ozminkowski RJ. Program evaluation. In: O’Donnell MP, editor. Health promotion in the workplace, 3rd edition. Albany, NY: Delmar Thomson Learning; 2002. p 116-165.

5.  Matson Koffman DM, Lanza A, Campbell KP. A Purchaser’s Guide to Clinical Preventive Services: A tool to improve health care coverage for prevention. Preventing Chronic Disease, April 2008; 5(2).

6.  Stewart BW & Kleihues P, editors. World Cancer Report. France: IARC Press: 2003.

7.  Institute of Medicine. National Research Council. Lifestyle Behaviors Contributing to the Burden of Cancer. In: Curry S, Byers T, & Hewitt M, editors. Fulfilling the Potential of Cancer Prevention and Early Detection. Washington, DC: The National Academies Press: 2003. p. 41–86.

8.  National Cancer Institute. Bethesda, MD: National Institutes of Health. Breast Cancer PDQ: Prevention — Health Professional. Available from: http://www.nci.nih.gov/cancertopics/pdq/prevention/breast/healthprofessional.

9.  National Cancer Institute. Bethesda, MD: National Institutes of Health. Breast Cancer PDQ: Prevention — Patient. Available from: http://www.cancer.gov/

10.  National Cancer Institute. Bethesda, MD: National Institutes of Health. Breast Cancer PDQ: Treatment — Patient. Available from: http://www.cancer.gov/

11.  International Agency for Research on Cancer. Evaluation. In: Vainio H & Bianchini F, editors. IARC Handbooks of Cancer Prevention: Weight Control & Physical Activity. France: IARC Press: 2002. p. 249–250.

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