Abstract

This study examines how teachers, who are at an elevated risk for breast cancer, understand and use scientific information about the causes of breast cancer in making health behavior decisions, and how they attribute its cause.

Issue

Teachers are under an elevated risk for breast cancer. This study examines how teachers understand and utilize information designed to reduce worry, concern and to increase teacher understanding of scientific information related to behavior, causes and prevention measures.

Response

The first year of this project used focus groups and interviews with open-ended, pre-tested questions on teachers' experiences with breast cancer at work and elsewhere, their trust of information about cancer already received, responsibility for reducing risk, and the willingness to take part in changes to reduce risk. Educators in the study expressed frustration with a lack of coherent scientific and medical messages about breast cancer risk factors, and some distrust of science and medicine, both set against a backdrop of their contextual experiences of critical cancer and environmental incidents. In contrast, many participants expressed positive views of their regional cancer centers and some of their own doctors. Participants' ideas about individual or collective behaviors to address risk were framed by dissonant impressions of where control or responsibility lay for risk reduction. Although participants did not express awareness of increased risk among teachers specifically, they were keenly aware of the number of breast (and/or other) cancer cases in their schools and social networks. These educators felt they had both unique risks and unique responsibilities in addressing breast cancer risk. Unique risks they described included negative views on teachers' personal health habits, emphasis on care of others over themselves, the constant exposure to illness, and school-based chemical exposures. They felt their unique responsibilities stemmed from connectedness to the larger community.

Impact

These findings suggest that the range of teachers' and education support professionals' perceptions of cancer and environmental risk is similar to that of other groups of women, including a tendency to emphasize personal responsibility. The elevated risks, unique exposures, close social environment at work, and the special community roles perceived by these educators present important distinctions. Study participants' perceptions were expressed against a backdrop of related critical incidents such as perceived cancer clusters, "sick building" episodes, and historic environmental contamination events that had made a large impression. There was a tendency for melding general of other environmental health hazards or events into any discussion of breast cancer risk with the responsibility for these hazards or events remaining unclear.

These perceptions and tendencies, when studied in further detail, carry several implications for public health practice. These include using a range of strategies to address risk, building capacity for collective action by teachers, and putting environmental health hazards in perspective. The second year will include a larger scale survey to test the frequency and distribution of these findings and trends.

Funding Sources

• Federal Formula Funds - Research (e.g., Hatch, McIntire-Stennis, Animal Health)

Collaborators

• Rodney Page, Director, Sprecher Institute for Comparative Cancer, College of Veterinary Medicine Research, Cornell University, advisor
• Jerald Newberry, Executive Director, National Education Association Health Information Network, stakeholder/research collaborator
• Suzanne Snedeker, Associate Director for Translational Research, Cornell Program on Breast Cancer and Environmental Risk Factors (BCERF), advisor
• Nellie Brown, Senior Extension Associate, NYS School of Industrial and Labor Relations, consultant
• Peggy Reynolds, Chief, Environmental Epidemiology and Geographic Information Section, California Department of Health Services and Principle Investigator, California Teachers Study, advisor

Key Personnel

• Bruce V. Lewenstein, Associate Professor of Science Communication, Department of Communication, Cornell University
• Clifford Scherer, Associate Professor, Department of Communication, Cornell University
• Carol M. Devine, Associate Professor and Extension Leader, Division of Nutritional Sciences, Cornell University
• Carmi Orenstein, Extension Associate, Cornell Program on Breast Cancer and Environmental Risk Factors, Sprecher Institute for Comparative Cancer Research, College of Veterinary Medicine, Cornell University