Education programs have been developed to promote adherence to recommended breast cancer screening guidelines. Few studies have assessed the degree to which ethnic subgroups are perceiving and acting on the proffered information. Such assessment is vital to the creation of efficient public health interventions. This paper describes the reported breast cancer knowledge, attitudes, and screening behaviors of 194 American Asian Indian women. While monthly breast self exam adherence was low, only 40.7%, 61.3% of women 40 and older, and 70% of women 50 and older, reported having had a mammogram within the past 12 months. These rates for annual mammography screening are high relative to many other ethnic groups. While the results are encouraging, the respondents may not be representative of all Asian Indian women. The majority of these women reported that their breast cancer knowledge is inadequate. They were willing to be called upon to share with others any knowledge they gained. There is a clear opportunity for public health nurses to provide Asian Indian women with a more comprehensive understanding of breast health and disease. Those women can then share their health knowledge with other women within their ethnic group.

Background:There are multiple risk factors during adolescence, which become precursors of various diseases and injuries inflicting high morbidity, mortality, and disability. There are several gaps in adolescent health research in India; one among them is that programs targeting adolescent health are constrained by the absence of rigorous interventional research informing interventions for improving adolescent health. This study aims to document the effectiveness of intervention on adolescent health and knowledge change on the risk factors among adolescents in one of the selected districts in Gujarat, India.Methods:This was an interventional study with quasi-experimental design executed in one of the blocks of Gujarat. Baseline was conducted in 2013–2014 followed by intervention and the end line during 2016–2017. A structured validated questionnaire after pilot testing was executed to collect information on sociodemographic profile, nutrition status, menstrual hygiene practices, reproductive and sexual health, substance abuse, program awareness and utilization, and empowerment through life skills of adolescents in baseline and end line survey. Data analysis was carried out using IBM SPSS Statistics for Windows, Version 20.0. (Armonk, NY: IBM Corp).Results:This study documented increased awareness regarding anemia, knowledge about STD and HIV/AIDS, reduced addiction to tobacco, improved practices during menstrual hygiene and engagement with adolescent services/schemes in the intervention site.Conclusion:This study concludes that evidence-based interventions lead to increase in knowledge and practices; however, some improvements have also been documented in the nonintervention site. Therefore, changes due to interventions could not be attributed completely for improving adolescent health. Further long term interventional studies are required to develop a robust evidence on improving health of adolescents in India.

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This study has benefited immeasurably from the inputs of many. We are extremely grateful to the John D. and Catherine T. MacArthur Foundation and the Human Dignity Foundation for their financial support which made this study possible. We could not have successfully completed this study without the support of the Education Department, Government of Gujarat. We would like to acknowledge with gratitude the support that we received from Shri. J. G. Pandya, District Education Officer, and Shri. P. S. Parghi, District Primary Education Officer, Surendranagr district, Gujarat. We would also like to acknowledge the contribution of various officials of the Education Department at the block level in Surendranagar District, principals and other teachers of the primary and secondary schools in the villages in which the survey was conducted. We are grateful to Dr. Leela Visaria, Honorary Professor, Gujarat Institute of Development Research, Ahmedabad for reviewing the earlier draft of this report and providing insightful comments and suggestions. At the Population Council, several colleagues have supported us in both the technical and administrative aspects of this study. We are grateful to Barbara Mensch and Cynthia B Lloyd for reviewing the study protocol as well as the earlier draft of this report, and for giving valuable comments and suggestions. We would also like to thank M.A. Jose for ably managing the administrative aspects of the project, Shilpi Rampal for her support with data management and Komal Saxena for ably coordinating the printing of the report. We would like to thank Jyoti Moodbidri and Komal Saxena for their editorial contributions. We also appreciate the efforts of our investigators who painstakingly collected the data. At CHETNA too, several colleagues have supported the study; we are grateful to Pallavi Patel for her support for the study. Finally, and most importantly, we would like to thank the adolescent girls who generously gave us their time and shared their views and experiences with us.