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Be a Bosom Buddy Salon Project:
Empowering hairdressers to promote
screening mammograms Gillian MacSmith1,2, Emma Webster3 & Catherine Hawke3
1BreastScreen NSW, 2Western NSW Local Health District, 3School of Rural Health, Sydney Medical School
14th National Rural Health Conference
Cairns, April 2017
BreastScreen NSW
Overview
• Overview of the intervention
• Engaging with hairdressers
• Appropriateness and acceptability of
the intervention
• Preliminary results
2
BreastScreen NSW
Project Rationale
• Breastscreen NSW offers FREE screening mammograms every
2 years for women aged 50 – 74.
• Screening mammograms are the most effective
way of detecting breast cancer early, yet only around
1 in 2 women have regular mammograms.
We needed a new and innovative approach to promotion!
3
BreastScreen NSW
The Bosom Buddy Salon Project
• Founded on ‘settings’ based approach to
health promotion2
• Built on the unique relationship shared
between a woman and her hairdresser
• Adapted from the Central West Ontario
‘Be a Breast Friend Salon Project’
conducted by the Canadian Breast Cancer
Foundation1
Bathurst Bosom Buddy Salons
BreastScreen NSW
Supporting evidence
Why hairdressers?
• Considered to be an appropriate, non-clinical setting for a personalised
message5,6,7,8
• Women-focused, with regular attendees who spend a significant amount of
time there were a range of topics are discussed between client and hairdresser6
• Successful in disseminating health information and improving client
knowledge3,4,5
• Successful in reaching a subset of the target population who have otherwise
been unreachable by conventional methods3,4,5
BreastScreen NSW
Aim
To increase awareness of the importance of screening
mammograms by empowering hairdressers to act as
peer health educators by engaging in discussion with
their clients about 4 key breast health messages
METHOD
BreastScreen NSW
Invitation All salons in Orange, Dubbo &
Bathurst were invited to participate (n = 89)
Information Pack
Follow-up phone call or visit
Launch Event
Follow-up phone call or visit
+/- phone call or visit
BreastScreen NSW
Initial Education Session & Start Up Pack
Overview of BreastScreen NSW
Education on 4 key messages
Education on target audience (50-74 years)
Education on how to use promotional material
Sessions were conducted face-to-face in each Salon (n = 24)
BreastScreen NSW
Support visits and Quarterly Forums
Phone call or visit
Fortnightly for first month
Monthly for remainder of Project
Informal discussion (5-10 minutes)
Held in each town
Content shaped by hairdressers
Provide information/share stories
45 – 60 minutes
Ongoing support was provided throughout the Project
Group forums were run every 3 months in each site
BreastScreen NSW
Promotional Material
1500- 2000 copies
Information on BSNSW
Screening locations/times
Local women’s stories
Myth busting & FAQs
Articles: family history, implants, assessment clinics
Bosom Buddy Magazine (5 issues x 2000 copies)
BreastScreen NSW
Promotional Material
Cherry & Pea key ring (x2500)
BreastScreen fridge magnet (x1500)
Branded pens (x5000)
Branded emery boards (x15,000)
Provided throughout the Project
BreastScreen NSW
Evaluation
Pre-Project & Post Project
Telephone Survey
Survey of Women
Reason for Referral Report
• Demographics • Knowledge of 4 messages
• No. of conversations each week • What is/isn’t working
• Content of Quarterly Forum(s)
• Reach of the target audience • If women are comfortable
• If women are encouraged to screen
• Impact on number of screens
Project period: January 2016 – June 2017
RESULTS
BreastScreen NSW
Preliminary results Participating Hairdressers (Pre-Project Survey)
• Recruitment of 24 salons out of 89 (= 27%)
• 64% of hairdressers reported >10 years of experience
• Of the 56% of hairdressers who were eligible for a mammogram,
70% reported having had a mammogram
• 47% of hairdressers reported that >¾ of their clients are women aged
50-74
• 33% reported >½ but <¾ of their clients are women aged 50-74
BreastScreen NSW
Preliminary results
Participating Hairdressers (Telephone Survey)
• Report 9-10 conversations on average per week
• The promotional items are very popular and helpful in
promoting conversation (for women and hairdressers)
• Report that clients are eager to let them know that they
have been for a screening mammogram
‘I got a text message from one of my clients to tell me she had
gone for her first mammogram’
‘One of my clients, who is in her mid 50’s went for her first
mammogram….she is now telling all her friends’
BreastScreen NSW
Survey of women (n = 206)
• 69% reported they had spoken with their hairdresser about
mammograms
• 36% reported that their conversation had encouraged them
to make a booking
• 65% of women reported that they had been going to their
hairdresser for more than 5 years
Preliminary results
BreastScreen NSW
Preliminary results
89%
0% 11%
Do hairdressers believe they are an appropriate person to discuss
mammograms (n=36)?
Yes
No
Unsure
Are hairdressers the appropriate person to talk about mammograms and are women comfortable with this discussion?
How comfortable are women (n=206)?
74%
22%
3% 1% 0%
Very comfortable
Okay
Neutral
Slightlyuncomfortable
Very uncomfortable
BreastScreen NSW
Challenges/Successes Challenges
• Attendance at an event (e.g. Launch event and Quarterly Forums)
• Hairdressers’ primary focus is their clients
• Hairdressers began to feel they were ‘annoying’ regular clients after
6-8 months
Successes
• One-on-one meetings instead of groups sessions
• Pre-arranged times for phone calls and support visits
• The giveaways were popular and useful in prompting conversation
• The magazine was successful with particular interest in local content
BreastScreen NSW
Conclusion The Project has been effective as a ‘setting’ based approach to health
promotion as it has:
• Been successful in starting conversations within the salon
context about screening mammograms;
• Shown that the Salon setting is a comfortable environment for
these conversations; and
• Shown the intervention is suitable for a rural setting where
salons are small and have a client base of regular, long-term
clients who have a unique relationship with their hairdresser.
BreastScreen NSW
Recommendations
• Recruitment should be approached with prearranged,
one-on-one meetings for optimal engagement with
potential participants
• A shorter project period (e.g. 4-6 months) would be
more effective to allow hairdressers to intently focus on
the project for a specific time period without ‘annoying’
regular clients
BreastScreen NSW
Acknowledgement
22
• The project is funded by the Cancer Institute NSW’s
Evidence to Practice Grant (FY 2015/2017)
• Adapted from the Central West Ontario
‘Be a Breast Friend Salon Project’
conducted by the Canadian Breast Cancer
Foundation – Ontario Region1
BreastScreen NSW
References • 1Canadian Breast Cancer Foundation (CA). Be a Breast Friend [internet]. Canada: Canadian Breast Cancer Foundation
(CA); 2017 [cited 2017 April 3]. Available from http://www.beabreastfriend.ca/resources.php
• 2World Health Organisation (WHO). Ottawa Charter for Health Promotion [internet]. Ottawa: World Health Organisation; 1986 [cited 2017 April 3]. Available from http://www.who.int/healthpromotion/conferences/previous/ottawa/en/
• 3Forte D. Community-based Breast Cancer Intervention Program for Older African American Women in Beauty Salons. Public Health Reports. 1995;110(2):179-183.
• 4Hess P, Reingold J, Jones J, Fellman M, Knowles P, Ravenell J et al. Barbershops as Hypertension Detection, Referral, and Follow-Up Centers for Black Men. Hypertension. 2007;49(5):1040-1046.
• 5Turrisi, R., Gunn, MD., Hultgren, BA., Warner, N. & Mallett, KA. The Style Project: Feasibility of Collaborating with Salons for Prevention and Early Detection of Skin Cancer. American Medical Association. 2012; 148 (10).
• 6Solomon, FM., Linnan, LA., Wasilewski, Y., Le, AM., Katz, ML. & Yang, J. Observational study in ten beauty salons: results informing development for the North Carlonia BEAUTY and Health Project. Health Educ Behav. 2004; 31(6): 790-807.
• 7Roosta, N., Wong, MK. & Woodley, MD. Utilising hairdressers for early detection of head and neck melanoma: An untapped resource. J Am Acad Dermatol. 2012; 66; 687-688.
• 8Sadler, GR., Ko, CM., Wu, P., Alisangco, J., Castaneda, SF. & Kelly, C. A Cluster Randomized Controlled Trial to Increase Breast Cancer Screening Among African American Women: The Black Cosmetologists Promoting Health Program. J Natl Med Assoc. 2011; 102 (8): 735-745.
• 9Whitelaw, S. et al. ‘Settings’ based health promotion: a review. Health Promotion International. 2001; 16(4); 339-353.
BreastScreen NSW
Questions?
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December 2014