A model for community participation in breast cancer prevention in Iran.
BACKGROUND
Genuine community participation does not denote taking part in an action planned by health care professionals in a medical or top-down approach. Further, community participation and health education on breast cancer prevention are not similar to other activities incorporated in primary health care services in Iran.


OBJECTIVE
To propose a model that provides a methodological tool to increase women's participation in the decision making process towards breast cancer prevention. To address this, an evaluation framework was developed that includes a typology of community participation approaches (models) in health, as well as five levels of participation in health programs proposed by Rifkin (1985 and 1991).


METHODS
This model explains the community participation approaches in breast cancer prevention in Iran. In a 'medical approach', participation occurs in the form of women's adherence to mammography recommendations. As a 'health services approach', women get the benefits of a health project or participate in the available program activities related to breast cancer prevention. The model provides the five levels of participation in health programs along with the 'health services approach' and explains how to implement those levels for women's participation in available breast cancer prevention programs at the local level.


CONCLUSIONS
It is hoped that a focus on the 'medical approach' (top-down) and the 'health services approach' (top-down) will bring sustainable changes in breast cancer prevention and will consequently produce the 'community development approach' (bottom-up). This could be achieved using a comprehensive approach to breast cancer prevention by combining the individual and community strategies in designing an intervention program for breast cancer prevention.
Department of Social and Development Sciences, Faculty of Human Ecology, Universiti Putra Malaysia, UPM Serdang, Selangor, Malaysia. marydian50@yahoo.com
Maryam
M
Ahmadian
Asnarulkhadi Abu
AA
Samah
D001943:Breast Neoplasms / Q000517:prevention & control* / Q000523:psychology*; D003153:Community Health Services / Q000458:organization & administration*; D003256:Community Participation / Q000523:psychology*; D005260:Female; D006266:Health Education; D006801:Humans; D007492:Iran; D008962:Models, Theoretical; D011379:Prognosis