Discussion
cancer, breast cancer symptoms, breast cancer
DISEASE PROGRESSION, BREAST CANCER, CANCER, DISEASE, MINOR, BREAST CANCER DIAGNOSIS
The results of our study confirm that a web-app-based educational intervention can improve the level of adherence to dietary and physical activity, in 8 of 12 recommendations, as well as the level of knowledge, improved from pre-intervention to post-intervention for 6 risk factors and 6 symptoms, among women without a breast cancer diagnosis aged 25–50.There are two relevant aspects to consider in the design of the intervention. On the one hand, the active role granted to the participants. Various researchers suggest that breast cancer prevention policies should include strategies involving women in developing healthy lifestyles [The content of the web-app was similar to the one employed in previous interventions using webpages [Satisfactory outcomes have also been observed among women participating in interventions facilitating knowledge acquisition, as well as in previous studies using a web-app as a medium to disseminate information about cancer prevention [After the intervention, women in the IG identified a higher number of risk factors than before the intervention than women in the CG. Awareness of risk factors is essential to enable women to take an active role in eliminating them [Similarly, women in the IG significantly improved their knowledge of breast cancer symptoms. Knowledge of these symptoms encourages early identification, allowing for immediate effective diagnostic tests and early treatment if needed, which is related to improved disease progression [An improvement in the behavior of both groups was observed, although it was only significant in the IG. Physical activity and a healthy diet have a positive and clearly established impact on breast cancer. The risk of developing breast cancer decreases in women who engage in regular physical activity [Therefore, an intervention based on the use of a web-app such as the one described in this study can achieve an increase in knowledge of the disease as well as behavioral changes. In view of the results obtained using the web-app the next step could be to regularly offer this intervention as a supplementary resource for all women to address some of the clinical challenges faced by health services in preventing breast cancer [The strengths of this study include the alignment of its objectives with one of the priorities identified by the European Commission [The limitations of this study include those inherent to any study of this kind. Although the results point to an estimate of a real-life implementation, it is still necessary to conduct randomized experimental studies with a larger population to compare the results. The online format of the intervention and the self-reporting of information by participants may have introduced obsequiousness bias in relation to behavioral variables, including the impossibility of verifying that it was indeed the participant who was completing the questionnaires. However, considering the nature of the questions and the relevance of breast cancer as a health problem affecting many women, we believe that these limitations may not be significant. This study had a 30% drop out rate, what could be considered as bias. Nonetheless, even the causes were not assessed, is important to highlight that the intervention was carried out during initial phase of COVID pandemic, and we hypothesize that it could explain both why the post-test intervention was minor than the pre- intervention participation (before COVID).