title: I Do Not Even Say "It" - a Mixed Methods Study on Breast Cancer Awareness of Omani Women.
abstract: BACKGROUND
  The incidence of breast cancer is rising in Oman, and the disease is diagnosed at late stages, when treatment success is limited. Omani women might benefit from better awareness, so that breast cancer can be detected early and treated. This study was conducted to assess Omani women's levels of breast cancer awareness and early detection practice, and explore factors which might influence these levels.
  
  
  METHODS
  A mixed methods study was conducted in 2014, including a quantitative survey of 1,372 and a qualitative assessment of 19 Omani women, aged ≥20 years from five Omani governorates using convenient sampling. Demographic information and scores for awareness levels were used in a multivariate regression model to investigate factors associated with awareness. Thematic analysis and interpretive description were used to analyse the qualitative data.
  
  
  RESULTS
  The overall means for early detection and general awareness scores were 0.58 (SD 0.24) and 0.46 (SD 0.21), respectively. General awareness was significantly associated with age, education, income and familiarity with cancer patients (<0.05), while early detection was significantly associated with age, marital status and education. A majority of women (59.5%) agreed with a belief in 'evil eye' or envy as a risk factor for breast cancer. Women discussed various factors which may empower or inhibit awareness, including the cultural-religion-fatalistic system, personal-familial-environmental system, and healthcare-political-social system.
  
  
  CONCLUSIONS
  The overall low scores for awareness and early detection, and the survey of local beliefs highlight a severe necessity for a contextually-tailored breast cancer awareness intervention programme in Oman.
authors.affiliation: College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman E-mail : esra@squ.edu.om.
authors.forename: Esra
authors.initials: E
authors.lastname: Alkhasawneh
authors.forename: Saad T
authors.initials: ST
authors.lastname: Siddiqui
authors.forename: Michael
authors.initials: M
authors.lastname: Leocadio
authors.forename: Vidya
authors.initials: V
authors.lastname: Seshan
authors.forename: Yahya
authors.initials: Y
authors.lastname: Al-Farsi
authors.forename: Mansour S
authors.initials: MS
authors.lastname: Al-Moundhri
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D055088:Early Detection of Cancer / Q000523:psychology / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D009850:Oman / Q000453:epidemiology; D010342:Patient Acceptance of Health Care; D011379:Prognosis; D012067:Religion; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult