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Breast cancer as a scourge has become a global issue and its threat has led to a growing consciousness among women who are potential victims. This is why Pink Pearl Foundation (PPF) Breast Cancer Campaigns is undertaking an awareness and attitude change campaign to influence positive behaviour towards its prevention among women. Hence, this study evaluates the effectiveness of Pink Pearl Foundation (PPF) Breast Cancer Campaigns among women in south-south Nigeria. Using the survey and content analysis methods of research, responses were generated from randomly selected respondents, while data were drawn from manifest content of communication of the newspapers as well as responses from women using questionnaire. A sample size of 300 was used for this study. The findings reveal among other things, that there is lack of depth in knowledge about PPF breast cancer campaign and also lack of prominence in newspaper coverage of the phenomenon. Hence, the researcher recommends that journalists should go beyond the normal straight news reporting to giving background and interpretation to health issues of this nature to improve knowledge and engender positive behaviour from readers.
1.1 Background of the Study
The prevalence of Breast Cancer among Nigerian women has been the subject of discourse in recent time. Each diagnosis of cancer usually comes with fear, confusion as well as the uncertainty of survival, which can be alleviated by timely information that can produce behavioural change.
Over the years, information has increasingly been considered important in helping people cope with cancer (Meredith & Symonds, 1996). Numerous studies have shown the continuing dissatisfaction with current information provisions in terms of content and delivery mechanisms. Lack of timely and accurate information has been responsible for not meeting the needs of women with breast cancer, given that information can play an important role in patient’s empowerment and satisfaction. (Jenkins & Fallowfield, 2001; Bray, McCarron & Parken, 2005; Dumitrescu & Crotaria, 2004)
Breast cancer has touched the lives of countless people, yet many women have misconceptions about the disease. One of the most common sources for breast cancer information used by Non-governmental Organizations in their campaigns is the newspaper.
Every day, women read facts about breast cancer awareness followed by messages telling them to get mammogram, perform breast self-examinations, exercise regularly and maintain a healthy diet to reduce their risk of developing breast cancer. Information about breast cancer during these campaigns such as risk factors, preventive measures and findings of recent studies about the disease frequently appear in the media. The mass media, especially the newspaper, play a vital role in public understanding of many health issues and the information relayed to the public through this medium often influences health behaviour (Kreps, 2003).
Health care consumers play a more active role in their health than ever before and they show increased interest in health information published in popular newspapers (Moyer, 1995).
The public views the media as an important source of information on science, health and wellness issues (Andsager & Powess, 1999). Breast cancer is the most common cancer in women worldwide; it is a major cause of death among women aged 30 and above. It is the most common form of cancer among women in both high and low resource setting countries (Bray, McCarron & Parken, 2005; Dumitrescu & Crotaria, 2004; WHO Global Burden of Disease, 2004).
Presently, breast cancer constitutes a major public health issue globally, with over one million new cases diagnosed annually, resulting in over 400,000 annual deaths and about 4.4 million women living with the disease. It also affects one in every eight women during their lifetime (Dumitrescu & Crotaria, 2004; Bray, McCarron & Parkin, 2005; Okobia, Bunker, Okonofua & Usifo, 2006).
But the recent report from the World Health Organization (WHO) calls for urgent action against the cancer scourge (Chukwuma & Wole, 2012). According to their report, by the year 2020, cancer could kill up to 10 million people yearly with the number of cancer cases increasing from 11 million in 2002 to 15.7 million in 2020 worldwide. Following this report, WHO estimates that cancer could kill some 84 million people by 2020 if preventive measures are not taken (Onyebuchi, 2012).
Breast cancer is cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk (Ademola, Adenike, Adebo & Abraham, 2007). Cancers originating from ducts are known as ductal carcinomas, while those originating from lobules are known as lobular carcinomas. It is the commonest cause of death in women worldwide.
In view of this scourge, so many campaigns have been carried out and are still ongoing by different bodies (NGOs) under the umbrella of Pink Breast Cancer Campaigns (PBCC). Some of these organizations are African Health Project, African Association of Health Disease, Breast Cancer Association of Nigeria (BRECAN), Global Health Foundation, Pink Dove Charitable Initiative, Pink Pearl Foundation, Breast without Spot Initiative, Genevieve Pink Ball, etc. These preventive measures represent efforts of the organization and other global initiatives to achieve interventions using newspaper campaigns.
Given the disturbing data on the widespread problem of breast cancer in Nigeria, there is an urgent need to create large scale media campaigns by using newspapers that raise awareness and increase prevention of breast cancer. In 2007, Pink Pearl Foundation was launched as an initiative to combat the scourge in Nigeria – specifically with the production and implementation of multi-media, multi-platform awareness and prevention campaigns focusing on women.
The control and prevention of Breast Cancer has become a centre piece of activities of so many Non-governmental and Federal Ministry of Health with the target of reducing the death rate caused by this malignant. Meeting the objectives of these organizations and the broader aims of the campaigns would transform the lives of millions of people especially women who will be spared from cancer burden and premature death. Prevention becomes the best protection for cancer. It includes: awareness, breast self-examination and mammogram.
In an effort to promote breast cancer early detection, health communicators turn to the media for three primary purposes: (1) as part of a campaign for prompt screening and promote screening behaviour (2) add the campaign of breast cancer screening to the public agenda and (3) working for policy changes that lead to increased rates of screening (Freimuth, 1995)
The health of women is of great importance because of several negative lifestyle behaviours including higher intake of animal and hydrogenated fats and lower intake of fibre (Popkin, 2006). These negative lifestyle behaviours are placing women at an increased risk of lifestyle influence which causes death. The Centre for Disease Control and Prevention (2007) identifies ten leading causes of death among women. They are:
· Cancer (27.2%)
· Heart Disease (22%)
· Stroke (7.5%)
· Chronic Liver (3.9%)
· Respiratory Disease (5.2%)
· Aizheimers Disease (3.9%)
· Unintentional Injuries (3.3%)
· Diabetes (3.1%)
· Influenza and Pneumonia (2.7%)
· Kidney Disease (1.8%) and Septicema (1.5%)
The top four categories – disease of the heart, all forms of cancer, stroke and respiratory diseases – are considered to be chronic lifestyle influenced diseases.
Numerous health agencies and researchers agree that the major causes of death among women have shifted away from diseases such as tuberculosis, malaria and cholera, to more chronic lifestyle – related diseases such as heart diseases, cancer and stroke (Kennedy, 2006; National Center for Health Statistics, 2006). This dramatic shift has largely been choices that are non-conducive to health (Belaal, 2006).
Communication campaigns remain one of the most popular tools in promoting health and social change issues. (Salmon & Atkin, 2003) and they aim to produce specific goals, outcomes and impacts by targeting a sizeable number of people within a particular time frame through a series of activities through communication and media channels (Rogers & Storey, 1987). Campaigns are designed to increase public knowledge, change behaviour and attitudes on issues such as HIV / AIDS, drug abuse, drunk-driving, Breast cancer and environment and protection.
1.1.2 About ‘Pink pearl foundation’ breast Cancer campaigns in Nigeria
October each year is breast cancer awareness month. Aside creating more awareness about this killer disease which is stealing women away from their loved ones irrespective of their race, class or status. It also means hundreds of Pink fund raising events and a heightened focus on the impact of this disease in the world.
Anywhere you see the Pink Ribbon; it is a wake-up call to the realities of breast cancer. The Pink ribbon represents fear of breast cancer, hope for the future, and the charitable goodness of people and businesses that publicly support the breast cancer movement. It is intended to evoke solidarity with women who currently have breast cancer (Vanguard newspaper, Oct.26, 2012).
Breast cancer organisations use the Pink ribbon to associate them with breast cancer, promote breast cancer awareness, and to support fund raising, while others use it as their primary symbol. While specifically representing breast cancer awareness, the Pink Ribbon is also a symbol of goodwill towards women in general.
In Nigeria, each October hundreds, if not thousands of products are emblazoned with pink ribbons, coloured pink, sold with a promise of a small portion of the total cost of being donated to support breast cancer awareness and help victims get adequate treatment. Aside the Pink as solidarity with breast cancer victims and help the silent sufferers speak out.
However, the pink pearl foundation is a public service charity organisation designed for empowering women. At the forefront of their agenda is the firm establishment in the minds of Nigerian women, the need to undergo annual cancer screening, combined with an outreach to the community hospitals and the cancer awareness centres to provide services as a matter of a routine practice.
Breast cancer takes more lives every year in our society. The most significant progress made to reduce death rate from cancer is through early detection and this is what the foundation preach through increased public awareness, prevention through lifestyle, early detection initiatives, education, and entertainment. Improved treatment modalities and sponsorship research, the Pink pearl foundation is to contribute to the reduction of suffering, permanent physical scars and death caused by breast and cervical cancer.
Pink pearl foundation was founded in October 2007 by Orode Ryan Okpu(Uduaghan). It is an awareness organization in association with iCARE foundation, with the goal of fighting breast and cervical cancer and also to empower women across Nigeria. At Pink Pearl, a forum has been created where women are educated about breast cancer, free checkups, treatment and learn healthy tips in order to avoid having these diseases. Women are very important members of the society, and if you can save a woman, you have saved a generation.
Mission and Vision
The Pink pearl foundation is dedicated to improving access to high quality breast cancer screening and diagnostic services for women who are underserved, and to increasing public awareness through education about prevention, disease processes and the importance of regular examinations for early detection. And their vision is to reduce the spread of breast cancer in Nigeria by creating awareness for it in educative and entertaining ways.
1.2 Statement of Problem
Across the globe and particularly in resource – limited societies like Nigeria, breast cancer and its treatment constitute a great physical, psychological and economic challenge. The hallmarks of the disease are patients presenting themselves at an advanced stage for treatment in hospitals.
Awareness and knowledge of breast cancer vary among communities and population groups worldwide. While studies conducted to assess the knowledge of breast cancer among women have revealed satisfactory levels in some places (Grefield, Ramiez, Hunter & Richard, 2001), other reports, especially from developing countries such as Nigeria, have revealed inadequate knowledge and awareness of the disease (Adebanjo & Ajayi, 2000).
Research evidence has since demonstrated that the mass media have long been used in the promotion of good health practices and the prevention of various social and health problems. In all its diversity, the mass media have been identified as constituting a primary source of information through which people learn about the world around them.
As Agudosi (2007) maintains, one major way of promoting health care is by engaging in mass media campaign which it is believed, will reach the target audience. He further highlights that these mass media campaigns are capable of generating cognitive, attitudinal, behavioural or psychological effects on the audience.
For some time now, the media is replete with statistics of cases of breast cancer. There are a lot of quantitative studies on the issue of breast cancer with little or no qualitative study. There are also a lot of campaigns by different bodies on breast cancer, yet the death rate accruing from the scourge remains alarming. In view of this disturbing trend, this study seeks to evaluate the performance of the media (especially newspapers) in promoting positive attitude towards reducing cases of breast cancer. Given persistent widespread nature of the epidemic (breast cancer), it stands to ascertain how effective these media campaigns have been in creating attitudinal change. It is observable that simultaneity of media campaigns in different media has been known to enhance better understanding and subsequent implementation of the message advocated (Uzochukwu & Dunu, 2010). Yet, the consistent media efforts seem to be yielding little positive result compared to the expectations of all concerned bodies and in the continued prevalence of breast cancer.
Previous researches conducted in Nigeria have focused on knowledge, awareness, perception, behaviour and behaviour of breast self-examination (Irurhe, Raji, Olowoyeye, Adeyomoye, Arogundade, Soyebi, Ibitoye, Abony & Eniyandunni, 2012). Little is known about the coverage of campaigns carried out by different non- governmental organisations.
It is on this premise that this study became imperative to determine the extent of newspaper coverage of Pink Pearl Foundation (PPf) breast cancer campaigns in south-south Nigeria. This is important because only news that promotes development objectives in the society that should be played up.
1.3 Objectives of the Study
This study undertakes an evaluation of Nigeria newspaper coverage of Pink Breast Cancer Campaigns (PPF) in South-South Nigeria.
In specific terms the study objectives are stated as follows:
1. To determine the extent to which newspaper coverage of Pink Pearl Foundation (PPF) breast cancer campaigns have increased awareness and knowledge among South-South women in Nigeria.
2. To find out the areas of breast cancer awareness where enlightenment has been made so far through PPF breast cancer campaigns in South-South Nigeria.
3. To evaluate the effectiveness of PPF breast cancer campaigns on the behaviours of women towards breast cancer prevention in South-South Nigeria.
4. To ascertain the level of prominence given to the PPF breast cancer campaigns by the Nigeria newspapers.
5. To find out the challenges facing the PPF breast cancer campaigns in South-South Nigeria.
1.4 Research Questions
The meet the above objectives, the researcher formulated the following research questions:
1. To what extent has newspaper coverage of PPF breast cancer campaigns increased awareness and knowledge of breast cancer among women in South-South Nigeria?
2. What are the areas of breast cancer awareness that enlightenment has been made so far through PPF breast cancer campaigns in South-South Nigeria?
3. How have PPF breast cancer campaigns in newspapers influenced positive behaviours towards preventing breast cancer among women in South-South Nigeria?
4. What is the level of prominence given to the PPF breast cancer campaigns in the Nigeria newspapers?
5. What are the challenges facing PPF breast cancer campaigns in South-South Nigeria?
1.5 Significance of the Study
As the region moves from an emergency response to long term sustainable responses, rigorous impact evaluation studies are critical to provide strong evidence on the causal links and effectiveness of ongoing interventions to achieve positive health and socio-economic outcomes.
This study is relevant at a time like this when efforts are ongoing to ensure that maternal mortality rates are reduced. Hence, findings from this study will help policy makers and program managers in the health sector to understand the best approach to increasing the awareness and knowledge level of women in Nigeria.
Non-governmental organizations and other agencies who have initiated campaigns on breast cancer will find the results of the research useful in assessing the effectiveness of their campaigns and also come up with new techniques to tackle the scourge.
This study will also benefit women generally in increasing their knowledge on what constitutes breast cancer and how to guide against it. Professionals in the health sector will find the results of this study useful in carrying out periodic evaluation of breast cancer campaigns, checking trends and coming up with possible adjustment mechanism to suit the prevailing characteristics of the emergence of the scourge.
Lastly, the academia will benefit from the findings of this study as it will pave way for new areas of research to complement efforts made in previous studies in addressing the scourge.
1.6 Scope of Study
The research is on the evaluation of Nigeria newspaper coverage of Pink Pearl Foundation Breast Cancer Campaigns in South-South Nigeria. For a proper delineation of the study, it will focus on newspaper coverage of PPF campaigns within a two year period (from January 2011 – December 2012). The evaluation will be done on coverage made by four national dailies in Nigeria.
Similarly, for the survey, women from selected states in the south-south geo-political zone will be the focus where the questionnaire will be administered. These selected states are: Delta State, Edo State and Rivers State.
1.7 Definition of Terms
For a proper understanding of the concepts in this study, the following key terms will be operationalized: Coverage, Campaign, Awareness, Newspaper, Cancer, Breast Cancer.
This refers to the presentation of stories on breast cancer by the media, with particular reference to newspapers in Nigeria.
A campaign is a series of planned activities or an effort made to prevent something, get rid of or stop that which affects the people’s health.
This is the making of the existence of and importance of something (breast cancer) known to people.
Newspaper refers to all national newspapers published in Nigeria and circulated within at least twelve states of the country.
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