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      Training Primary Health Professionals in Breast Cancer Prevention: Evidence and Experience from Mexico

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          Abstract

          To analyze the key successful factors of a national educational strategy for early breast cancer detection developed in Mexico for primary health care personnel from 2008 to 2014, an educational strategy to train physicians, nurses, health promoters, and medical students from local ministries of health with a competency-based approach was developed and implemented using diverse educational modalities, face-to-face, blended, and a massive open online course (MOOC). Formative and summative evaluations were used during the implementation of the course. A total of 19,563 health professionals were trained from 2008 to 2014. The graduation rate, an average of all educational modalities, was 91 %, much higher than those previously reported in the literature. The factors that might have influenced this success were (1) the training strategy, which was designed according to the characteristics and specific needs of the target groups; (2) the political will and commitment of the country’s health authorities; (3) the technological and educational models used; and (4) the punctual follow-up of participants. This study shows that carefully designed educational interventions can improve service professionals’ competencies and that regardless of the modality, face-to-face, blended learning, or MOOC, high graduation rates can be achieved. Further evaluation is required to demonstrate that the competencies remained in all target groups after 6 months of the intervention and that the women served by the trained personnel were provided accurate information and timely diagnoses of breast cancer.

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          The online version of this article (doi:10.1007/s13187-016-1065-7) contains supplementary material, which is available to authorized users.

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          Breast cancer in Mexico: a pressing priority.

          Breast cancer is a serious threat to the health of women globally, and an unrecognised priority in middle-income countries. This paper presents data from Mexico. It shows that breast cancer accounts for more deaths than cervical cancer since 2006. It is the second cause of death for women aged 30-54 and affects all socio-economic groups. Data on detection, although under-reported, show 6,000 new cases in 1990, and a projected increase to over 16,500 per year by 2020. Further, the majority of cases are self-detected and only 10% of all cases are detected in stage one. Mexico's social security systems cover approximately 40-45% of the population, and include breast cancer treatment. As of 2007, the rest of the population has the right to breast cancer treatment through the Popular Health Insurance. Despite these entitlements, services are lacking and interventions for early detection, particularly mammography, are very limited. As of 2006 only 22% of women aged 40-69 reported having a mammogram in the past year. Barriers exist on both the demand and supply sides. Lobbying, education, awareness-building and an articulated policy response will be important to ensure expanded coverage, access to and take-up of both treatment and early detection.
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            Cooperative Learning for Academic and Social Gains: valued pedagogy, problematic practice

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              Recursos disponibles para el tratamiento del cáncer de mama en México

              OBJETIVO: Describir los recursos existentes para el tratamiento del cáncer de mama en México. MATERIAL Y MÉTODOS: Se recolectó información de 23 Centros Estatales de Cáncer (CEC), dos hospitales federales y el Instituto Nacional de Cancerología. Este estudio se realizo en México, DF, en agosto y septiembre del año 2008. RESULTADOS: Los 23 CEC ofrecen atención médica para el cáncer de mama, incluidos cirugía, quimioterapia y radioterapia, todos ellos acreditados por el Seguro Popular. Las cuotas de recuperación se definieron por etapa clínica, desde 27 500 pesos para la etapa clínica cero hasta 480 000 pesos en pacientes con enfermedad avanzada. Se ha atendido a 2 689 pacientes con cáncer de mama; sólo 1% se presentó con carcinoma in situ CONCLUSIONES: Se tiene la infraestructura y los recursos médicos para el óptimo tratamiento, pero los costos son altos debido al diagnóstico tardío. La detección oportuna del cáncer de mama es una prioridad para el óptimo control de esta enfermedad en México.
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                Author and article information

                Contributors
                +52-777-311-22-18 , cecilia.gonzalez@insp.mx
                http://tomateloapecho.org.mx
                http://tomateloapecho.org.mx
                Journal
                J Cancer Educ
                J Cancer Educ
                Journal of Cancer Education
                Springer US (New York )
                0885-8195
                1543-0154
                30 June 2016
                30 June 2016
                2018
                : 33
                : 1
                : 160-166
                Affiliations
                [1 ]ISNI 0000 0004 1773 4764, GRID grid.415771.1, Secretaría Académica, , Instituto Nacional de Salud Pública, México, ; Universidad 655, Col. Santa María Ahuacatitlán, C.P. 62100 Cuernavaca, Morelos Mexico
                [2 ]ISNI 0000 0004 1773 4764, GRID grid.415771.1, Centro de Investigación en Sistemas de Salud, , Instituto Nacional de Salud Pública, México, ; Avenida Universidad 655, Col. Santa María Ahuacatitlán, C.P. 62100 Cuernavaca, Morelos Mexico
                [3 ]Competitividad y Universalidad en Salud, Fundación Mexicana para la Salud, A.C., Periférico Sur 4809, El Arenal Tepepan, Tlalpan, 14610 México, DF Mexico
                [4 ]Tómatelo a Pecho, A.C. Periférico Sur 4809, El Arenal Tepepan, Tlalpan, 14610 México, DF Mexico
                [5 ]ISNI 0000 0004 1936 8606, GRID grid.26790.3a, Miller School of Medicine, , University of Miami, ; 1601 NW 12th Ave, Miami, FL 33136 USA
                Article
                1065
                10.1007/s13187-016-1065-7
                5762772
                27357140
                39aaf37e-ae35-496c-91a5-477f803e4bec
                © The Author(s) 2016

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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                © American Association for Cancer Education 2018

                Oncology & Radiotherapy
                face-to-face learning,blended learning,mooc,breast cancer,mexico,training courses,virtual education and multidisciplinary training,health promoters

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