EFFECTIVENESS OF BREAST SELF-EXAMINATION PROMPTS ON ORAL-CONTRACEPTIVE PACKAGING

Background. The purpose of this study was to determine if a breast sel f-examination (BSE) ''prompt'' on oral contraceptive pill (OCP) packag es would improve the frequency and timing of BSE among women who use O CPs. Methods. Women between 13 and 40 pears of age who were initiating , restarting, or continuing use of OCPs completed a baseline survey th at assessed health behavior and practices. All received BSE education and then were randomized to take either OCPs with a BSE prompt or regu larly packaged OCPs (without BSE prompt) for three cycles. Three month s later, subjects completed a follow-up survey that assessed BSE frequ ency and timing. A telephone survey of randomly selected subjects cond ucted 6 months after the baseline survey assessed BSE compliance after discontinuation of the prompt. Results. Of the 907 subjects at baseli ne, 49.3% performed BSE monthly but only 24.5% performed BSE during th e correct time of the menstrual cycle. Among subjects who never perfor med BSE prior to the study, 40.3% of prompt subjects and 36.4% of the education-only subjects began BSE by the 3-month survey. Among subject s who performed BSE less than once per month at baseline, 50.9% of pro mpt subjects and 45.5% of education-only subjects increased the freque ncy of BSEs to a monthly basis by the 3-month survey. More women perfo rmed BSE during the correct time of the menstrual cycle at the 3 month follow-up survey (68.1% prompt, 62.2% education only) and 6-month sur vey (57.4% prompt, 48.9% education only) when compared with the baseli ne survey (24.7% prompt, 24.1% education only). Ninety-one percent of women in this study expressed a preference for a BSE prompt on OCP pac kaging. Conclusions. An increased frequency of BSE was observed when w omen were exposed to an OCP package prompt, particularly for women who at baseline were already partially compliant with performing monthly BSE. A small but significant improvement was observed for correct BSE timing and this effect continued after the prompt was removed, althoug h at a reduced level. The innovative BSE prompt was overwhelmingly wel l received by women in this study.