title: Identifying important breast cancer control strategies in Asia, Latin America and the Middle East/North Africa.
abstract: BACKGROUND
  Breast cancer is the most frequent cause of cancer death in women worldwide, but global disparities in breast cancer control persist, due to a lack of a comprehensive breast cancer control strategy in many countries.
  
  
  OBJECTIVE
  To identify and compare the need for breast cancer control strategies in Asia, Latin America and the Middle East/North Africa and to develop a common framework to guide the development of national breast cancer control strategies.
  
  
  METHODS
  Data were derived from open-ended, semi-structured interviews conducted in 2007 with 221 clinicians, policy makers, and patient advocates; stratified across Asia (n = 97), Latin America (n = 46), the Middle East/North Africa (ME/NA) (n = 39) and Australia and Canada (n = 39). Respondents were identified using purposive and snowballing sampling. Interpretation of the data utilized interpretive phenomenological analysis where transcripts and field notes were coded and analyzed and common themes were identified. Analysis of regional variation was conducted based on the frequency of discussion and the writing of the manuscript followed the RATS guidelines.
  
  
  RESULTS
  Analysis revealed four major themes that form the foundation for developing national breast cancer control strategies: 1) building capacity; 2) developing evidence; 3) removing barriers; and 4) promoting advocacy - each specified across five sub-ordinate dimensions. The propensity to discuss most dimensions was similar across regions, but managing advocacy was discussed more frequently (p = 0.004) and organized advocacy was discussed less frequently (p < 0.001) in Australia and Canada.
  
  
  CONCLUSIONS
  This unique research identified common themes for the development of breast cancer control strategies, grounded in the experience of local practitioners, policy makers and advocacy leaders across diverse regions. Future research should be aimed at gathering a wider array of experiences, including those of patients.
authors.affiliation: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N, Broadway, Baltimore, MD 21205, USA. jbridges@jhsph.edu
authors.forename: John F P
authors.initials: JF
authors.lastname: Bridges
authors.forename: Benjamin O
authors.initials: BO
authors.lastname: Anderson
authors.forename: Antonio C
authors.initials: AC
authors.lastname: Buzaid
authors.forename: Abdul R
authors.initials: AR
authors.lastname: Jazieh
authors.forename: Louis W
authors.initials: LW
authors.lastname: Niessen
authors.forename: Barri M
authors.initials: BM
authors.lastname: Blauvelt
authors.forename: David R
authors.initials: DR
authors.lastname: Buchanan
mesh_terms: D000328:Adult; D000352:Africa, Northern; D000368:Aged; D000369:Aged, 80 and over; D001208:Asia; D001943:Breast Neoplasms / Q000517:prevention & control*; D019049:Developed Countries; D003906:Developing Countries; D005260:Female; D014943:Global Health; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000458:organization & administration*; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D007843:Latin America; D008875:Middle Aged; D008877:Middle East; D020380:Needs Assessment; D011322:Primary Prevention / Q000458:organization & administration*; D018570:Risk Assessment