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Breast Cancer: Socio-Ecological Model

Subject: Medicine
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Abstract

The modern society is faced with numerous public health issues across diverse populations on a global scale. Assessment of public health issues using the Socio-ecological Model would significantly contribute to the formulation of an effective solution to the public health problem based on the identified indicators and determinants. This paper is focused on evaluating breast cancer as a pertinent public health issue facing the African-American female population. A succinct analysis of the background information pertaining to breast cancer will provide information regarding the impacts of the health issue to individuals and the society at large. Various risk behaviors of breast cancer will be discussed based on the applicable socio-ecological theory. This will be applied in the proposition of multi-level interventions resulting in positive health outcomes for the populations. Finally, this paper will evaluate the success likelihood of the proposed intervention and how it addresses at least two of the public health services across all levels of the Socio-ecological Model.

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Breast Cancer: Background Information

Breast cancer has become a common public health issue in the society today. Most people have had an encounter with breast cancer either at a personal level, through relatives or in the neighborhood. Basically, breast cancer is a medical problem that results from the excessive growth of breast cells (CDC, 2016). According to the Center for Disease Control (2016), breast cancer appears in different forms depending on the type of cells that grow out of control to become cancerous and the part in which they grow. A human breast has three main parts which include the connective tissues, lobules, and ducts. Notably, most cases of breast cancer result from the excessive growth of cells around the ducts or lobules (Center for Disease Control, 2016). The cancerous cells then spread to other body parts through lymph and blood vessels.

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The process through which cancerous cells spread to other body parts is called the metastasization. Ductal carcinoma and invasive lobular carcinoma are the most prevalent types of breast cancer affecting the African-American women today. Uncontrolled growth of cells from the cell ducts to the rest of the breast tissue results in invasive ductal carcinoma cancer while the spread of the cancerous cells from the lobules to other breast tissues results in the invasive lobular carcinoma type of breast cancer (Center for Disease Control, 2016). Breast cancer is associated with various signs and symptoms including the emergence of new lumps in the breast, swollen breast tissues, irritation of the skin around the breast, breast skin redness, nipple discharge, and the change in the breast shape or size. Breast cancer can be detected through physical breast examination or screening (Breast Cancer Facts & Figures, 2015). Mammograms reveal benign breast lumps which are neither cancerous nor do they grow excessively within the breast tissues.

Prevalence of Breast Cancer among African American Women

Breast cancer incidence rate is relatively low among African American Women while the mortality rate is relatively higher in comparison to Caucasian women. This implies that African American women have reduced chances of developing breast cancer but higher chances of dying from the disease once contracted (Wertich, 2017). Statistics reveal that death rate from breast cancer is currently at 41% among the African American women. This rate is higher than any other ethnic group on a global scale. Moreover, the African American women have fewer chances of surviving for more than five years after getting diagnosed with breast cancer due to its aggressive form is known as the triple-negative breast cancer(Hughes et al., 2014). Comparatively, the African American women have three times higher chances of developing breast cancer compared to the Caucasian women.

Breast Cancer: Social Determinants

The social determinants of health refer to the factors that influence the environments where people exclusively live and grow despite the risks associated with access to basic utilities For instance, lack of social support is a primary social determinant of breast cancer among African American women. Basically, social support enables women to understand various self-care interventions as well as providing them with the much-needed counseling and moral support. Offering social support to women suffering from breast cancer helps them to access proper medical care by helping them to understand the need to take medication and embrace proper nutrition to improve their chances of survival. Moreover, social support involves emotional counseling by close friends and family significantly reduces the stress levels as well as the reactivity of the hypothalamus-pituitary-adrenal axis. This is important in boosting the body immunosurveillance from cancer reoccurrence (Hughes et al., 2014). Lack of these essential provisions of social support on women suffering from breast cancer may result in negative consequences that result in deterioration. Isolation of women suffering from breast cancer significantly elevates their mortality risk due to lack of access to home-based care interventions and counseling services.

The Socio-Ecological Model

Public health policies significantly contribute to the development and implementation of strategic and actionable interventions to multi-dimensionally improve the quality of life for the breast cancer survivors. The socio-ecological model is used as the basis for research, design, and implementation of the multi-dimensional interventions to evaluate various methods through which the internal and external factors affecting women suffering from breast cancer at personal, interpersonal, and community levels. This affects the community at large, the healthcare service providers, and the caregivers as they coordinate to identify the major issues of concern, develop the action plans, and implement the program to improve the quality of life for breast cancer survivors. According to the National Action Plan for Cancer Survivorship (NAPCS), various factors and strategies within the public health domain should be used as the basis of collaboration between various components of the socio-ecological model for improvement of breast cancer survivorship outcomes. The socio-ecological model outlines various factors affecting the patient behavior at different levels based on the personal attributes such as attitude, demographic data, health literacy, behavior, interpersonal relations, and developmental history. The level of interpersonal relations is addressed based on the available support systems by the professional health workers and the relatives of the breast cancer patient. The organizational level is made up of the available social systems upon which various policies and regulations are formulated. The community level is concerned with the existing relationships between various organizations and related information networks whose boundaries are clearly defined (Hughes et al., 2014). Finally, the policy levels are defined by the local, state, federal, and international policies and regulations.

Community-Based Participatory Research as an Intervention

The Community-based Participatory Research focuses on collaborating with the affected communities to develop alternative research techniques based on the assumption that the characteristic phenomenon can be treated independently of its context for research purposes (Holkulp et al., 2009). These techniques that develop from a positive philosophical framework have been widely used as the basis for differentiating research with practice. However, the CBPR is cognizant of the benefits of involving members of the population under study as the key participants in every stage of research as long as the study aims at implementing change. The existing health disparities at the community level can be significantly reduced by proper implementation of the Community-based Participatory research programs. Moreover, community involvement is critical for the proposed intervention to reduce the mortality rate due to breast cancer among the African American women. Therefore, this approach will ensure that stakeholders at all levels will cooperate to implement the desired change.

Based on the fact that breast cancer is quite prevalent among the African American women, the chances of successful implementation of the proposed interventions is high. This is because each intervention that has been proposed focuses on the primary ways in which breast cancer affects African American women. The approaches to each intervention are practically realistic as long as there are sufficient volunteers to implement. Recruiting volunteers for this cause is not a hard task since most African American communities have numerous social support groups that take pride in serving the community. After ensuring that the volunteers are recruited and prepared for the work, they should be then assigned to specific roles to ensure that each team is working to fulfill certain objectives based on the larger goal of reducing breast cancer among the African American women. Collaboration between different stakeholders significantly increases the success rate.

he public healthcare system is founded on a framework of various services that serve to monitor, identify, and resolve issues within the community healthcare system. The core functions of the public health system in a community setting includes;

  • Diagnose and resolve health issues
  • Educate and empower the masses about public health
  • Mobilize resources for partnership with various organizations to facilitate the interventions
  • Develop regulations to support healthcare improvement efforts
  • Implement the laws and regulations that ensure community health and safety
  • Provide the community with access to sufficient healthcare services.
  • Promote competency in the healthcare system
  • Evaluate the efficiency of healthcare systems
  • Ensure access to affordable care
  • Promote quality in the individual and community-based healthcare services
  • Promote research into diverse solutions to healthcare issues.

The proposed healthcare intervention for the African American women having breast cancer has sufficiently addressed the issue of information as the primary intervention as it empowers the people with crucial information regarding breast cancer. The information is passed through awareness campaigns, mainstream media, and print media to inform the community about various cancer screening options. The second intervention focuses on ensuring the efficiency of the healthcare service providers in facilitating the screening process through volunteers to ensure that the affected women are able to access proper care.

Conclusion

The issue of breast cancer among the African American women has resulted in many deaths compared to the Caucasian women. However, the African American women have reduced chances of developing breast cancer compared to the European women. As a result, various interventions should be designed and implemented to facilitate early detection and medication as a way of reducing the mortality rate. Early detection paves a way for early treatment thus reducing the severity of the disease. Additionally, it creates a room for proper healthcare to ensure that the women have access to consistent medication to improve their quality of life even after diagnosis. Additionally, social support systems play an important role in helping the affected women to cope with the disease. Through social support, the women get the much needed moral guidance and even financial support since the treatment is quite expensive. Therefore, it’s important that proper screening mechanisms and equipment are set in place to ensure early detection and the consequent treatment. Creating awareness is also a critical factor in saving lives.

1. Holkup, Patricia A., Tripp-Reimer, Toni., Salois, Emily Matt., and Weinert, Clarann. (2009 Nov 6). Community-based Participatory Research.

2. Hughes, S., Jaremka, L. M., Alfano, C. M., Glaser, R., Povoski, S. P., Lipari, A. M., … & Malarkey, W. B. (2014). Social support predicts inflammation, pain, and depressive symptoms: longitudinal relationships among breast cancer survivors. Psychoneuroendocrinology, 42, 38-44.

3. Leung, J., Pachana, N. A., & McLaughlin, D. (2014). Social support and health‐related quality of life in women with breast cancer: a longitudinal study. Psycho‐Oncology, 23(9), 1014-1020.

4. Pierce, J. P., & Kealey, S. (2015). Socio-ecological Model and Health Promotion in the Healthy People Initiative.

5. Miller, A. M., Ashing, K. T., Modeste, N. N., Herring, R. P., & Sealy, D. A. T. (2015). Contextual factors influencing health-related quality of life in African American and Latina breast cancer survivors. Journal of Cancer Survivorship, 9(3), 441-449.

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