title: Promoting early presentation of breast cancer: development of a psycho-educational intervention.
abstract: OBJECTIVE
  Women who delay presenting with breast cancer have a reduced chance of survival. Older women, who are at greater risk of developing breast cancer, are more likely to delay presenting with the disease. The aim of this developmental work was to design a psycho-educational intervention to promote early help-seeking by older women with breast cancer symptoms. We also aimed to demonstrate the feasibility of implementing the intervention with women attending for their final invited mammogram in the National Health Service (NHS) Breast Screening Programme.
  
  
  METHODS
  The intervention was designed to address the factors associated with delayed presentation by women with breast cancer. These risk factors were placed in a theoretical framework to understand patient delay. The intervention incorporated behavioural change techniques that, according to previous research, have been demonstrated to be effective.
  
  
  RESULTS
  The intervention was developed in two formats to be delivered by diagnostic radiographers: a booklet alone and a brief interview plus the booklet. The intervention was acceptable to both older women and healthcare professionals in the NHS Breast Screening Programme.
  
  
  CONCLUSIONS
  The intervention will be tested ultimately in a multicentre randomized controlled trial to determine whether it can reduce the proportion of older women who delay their presentation and thereby save lives.
authors.affiliation: Cancer Research UK London Psychosocial Group, Institute of Psychiatry, Kings College London Adamson Centre, St Thomas' Hospital, London SE1 7EH, UK. caroline.burgess@kcl.ac.uk
authors.forename: C C
authors.initials: CC
authors.lastname: Burgess
authors.forename: A M
authors.initials: AM
authors.lastname: Bish
authors.forename: H S
authors.initials: HS
authors.lastname: Hunter
authors.forename: P
authors.initials: P
authors.lastname: Salkovskis
authors.forename: M
authors.initials: M
authors.lastname: Michell
authors.forename: P
authors.initials: P
authors.lastname: Whelehan
authors.forename: A J
authors.initials: AJ
authors.lastname: Ramirez
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D001943:Breast Neoplasms / Q000175:diagnosis / Q000523:psychology*; D042241:Early Diagnosis; D005260:Female; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008131:London; D010174:Pamphlets; D010342:Patient Acceptance of Health Care; D010865:Pilot Projects; D012307:Risk Factors