Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N, Broadway, Baltimore, MD 21205, USA.
BMC Health Serv Res. 2011 Sep 20;11:227. doi: 10.1186/1472-6963-11-227.
Breast cancer is the most frequent cause of cancer death in women worldwide, but global disparities in breast cancer control persist, due to a lack of a comprehensive breast cancer control strategy in many countries.
To identify and compare the need for breast cancer control strategies in Asia, Latin America and the Middle East/North Africa and to develop a common framework to guide the development of national breast cancer control strategies.
Data were derived from open-ended, semi-structured interviews conducted in 2007 with 221 clinicians, policy makers, and patient advocates; stratified across Asia (n = 97), Latin America (n = 46), the Middle East/North Africa (ME/NA) (n = 39) and Australia and Canada (n = 39). Respondents were identified using purposive and snowballing sampling. Interpretation of the data utilized interpretive phenomenological analysis where transcripts and field notes were coded and analyzed and common themes were identified. Analysis of regional variation was conducted based on the frequency of discussion and the writing of the manuscript followed the RATS guidelines.
Analysis revealed four major themes that form the foundation for developing national breast cancer control strategies: 1) building capacity; 2) developing evidence; 3) removing barriers; and 4) promoting advocacy - each specified across five sub-ordinate dimensions. The propensity to discuss most dimensions was similar across regions, but managing advocacy was discussed more frequently (p = 0.004) and organized advocacy was discussed less frequently (p < 0.001) in Australia and Canada.
This unique research identified common themes for the development of breast cancer control strategies, grounded in the experience of local practitioners, policy makers and advocacy leaders across diverse regions. Future research should be aimed at gathering a wider array of experiences, including those of patients.
乳腺癌是全世界女性癌症死亡的最常见原因，但由于许多国家缺乏全面的乳腺癌控制策略，全球乳腺癌控制方面仍存在差距。
确定并比较亚洲、拉丁美洲和中东/北非地区乳腺癌控制策略的需求，并制定一个共同的框架来指导国家乳腺癌控制策略的制定。
数据来源于 2007 年对 221 名临床医生、政策制定者和患者权益倡导者进行的开放式、半结构式访谈；参与者按亚洲（n = 97）、拉丁美洲（n = 46）、中东/北非（ME/NA）（n = 39）和澳大利亚和加拿大（n = 39）进行分层。通过目的性和滚雪球抽样确定受访者。对数据的解释采用了解释现象学分析，对转录本和现场记录进行编码和分析，并确定了共同的主题。根据讨论的频率和手稿的撰写情况对区域差异进行分析，遵循 RATS 指南。
分析显示，制定国家乳腺癌控制策略的基础是四个主要主题：1） 建立能力；2） 发展证据；3） 消除障碍；4） 促进宣传——每个主题都包含五个下属维度。各地区讨论大多数维度的倾向相似，但在澳大利亚和加拿大，讨论管理宣传的频率更高（p = 0.004），讨论有组织宣传的频率更低（p < 0.001）。
这项独特的研究确定了制定乳腺癌控制策略的共同主题，这些主题基于不同地区的当地从业者、政策制定者和宣传领导人的经验。未来的研究应旨在收集更广泛的经验，包括患者的经验。
