title: Can a lifestyle intervention be offered through NHS breast cancer screening? Challenges and opportunities identified in a qualitative study of women attending screening.
abstract: Around one third of breast cancers in post-menopausal women could be prevented by decreasing body fatness and alcohol intake and increasing physical activity. This study aimed to explore views and attitudes on lifestyle intervention approaches in order to inform the proposed content of a lifestyle intervention programme amongst women attending breast cancer screening.
  
  
  
  Women attending breast cancer screening clinics in Dundee and Glasgow, were invited to participate in focus group discussions (FGD) by clinic staff. The groups were convened out with the clinic setting and moderated by an experienced researcher who attained brief details on socio-demographic background and audio-recorded the discussions. Data analysis was guided by the framework approach. The main topics of enquiry were: Understanding of risk of breast cancer and its prevention, views on engaging with a lifestyle intervention programme offered through breast cancer screening and programme design and content.
  
  
  
  Thirty one women attended 5 focus groups. Participant ages ranged from 51 to 78 years and 38 % lived in the two most deprived quintiles of residential areas. Women were generally positive about being offered a programme at breast cancer screening but sceptical about lifestyle associated risk, citing genetics, bad luck and knowing women with breast cancer who led healthy lifestyles as reasons to query the importance of lifestyle. Engagement via clinic staff and delivery of the programme by lifestyle coaches out with the screening setting was viewed favourably. The importance of body weight, physical activity and alcohol consumption with disease was widely known although most were surprised at the association with breast cancer. They were particularly surprised about the role of alcohol and resistant to thinking about themselves having a problem. They expressed frustration that lifestyle guidance was often conflicting and divergent over time. The concept of focussing on small lifestyle changes, which were personalised, supported socially and appropriate to age and ability were welcomed.
  
  
  
  Offering access to a lifestyle programme through breast screening appears acceptable. Explaining the relevance of the target behaviours for breast cancer health, endorsing and utilising consistent messages and identifying personalised, mutually agreed, behaviour change goals provides a framework for programme development.
authors: Institute of Health and Wellbeing, College of Social Science, University of Glasgow, 27 Bute Gardens, Glasgow, G12 8RS, UK.
authors: Ellie
authors: E
authors: Conway
authors: Institute of Health and Wellbeing, College of Social Science, University of Glasgow, 27 Bute Gardens, Glasgow, G12 8RS, UK.
authors: Sally
authors: S
authors: Wyke
authors: Centre for Public Health Nutrition Research, Ninewells Hospital & Medical School, University of Dundee, Level 7, Dundee, DD2 4BF, UK.
authors: Jacqui
authors: J
authors: Sugden
authors: Physical Activity for Health Research Centre, The University of Edinburgh, St Leonard's Land, Holyrood Road, Edinburgh, EH8 8AQ, UK.
authors: Nanette
authors: N
authors: Mutrie
authors: Centre for Public Health Nutrition Research, Ninewells Hospital & Medical School, University of Dundee, Level 7, Dundee, DD2 4BF, UK. a.s.anderson@dundee.ac.uk.|Centre for Research into Cancer Prevention and Screening, Ninewells Medical School, University of Dundee, Level 7, Mailbox 7, Dundee, DD1 9SY, UK. a.s.anderson@dundee.ac.uk.
authors: Annie S
authors: AS
authors: Anderson
mesh_terms: D000328:Adult; D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D001943:Breast Neoplasms / Q000517:prevention & control / Q000523:psychology*; D055088:Early Detection of Cancer / Q000379:methods / Q000523:psychology*; D015444:Exercise; D005240:Feasibility Studies; D005260:Female; D017144:Focus Groups; D006078:Government Programs / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D011314:Preventive Health Services / Q000379:methods*; D036301:Qualitative Research; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012606:Scotland; D013222:State Medicine
keywords: Alcohol; Body-weight; Breast cancer screening; Lifestyle; Physical activity