Dg. Ferris et al., EFFECTIVENESS OF BREAST SELF-EXAMINATION PROMPTS ON ORAL-CONTRACEPTIVE PACKAGING, Journal of family practice, 42(1), 1996, pp. 43-48
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.