Program Evaluation: Application of Social Cognitive Theory

Running head: PROGRAM EVALUATION
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PROGRAM EVALUATION
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Program Evaluation
Student’s Name
Institution
Program Evaluation
Application of Social Cognitive Theory in Information Science
and Education
Social cognitive theory first started as a social learning theory
by Albert Bandura for application in psychology. Jenkins, Hall,
and Raeside (2018) asserted that, regarding the deployment of
social cognitive theory in understanding information seeking
behavior and use, the social cognitive theory had been used to
explore significant areas. Such areas like consumption of social
media content, information retrieval skills in the academic field,
information retrieval skills at the workplace, information
literacy in the educational field and day to day life information
seeking. For instance, Kim (2010) used the theory to explore
expectation differences in students of different genders when
using university library website resources. With regards to
knowledge sharing, Jenkins et al. (2018) found that social
cognitive theory has been used to explore various fields like
blogging and knowledge management systems.
In the field of education, Erlich and Russ-Eft (2011) reviewed
the application of social cognitive theory to academic advising

for assessment of student learning. Specifically, the researchers
applied the social cognitive theory concepts of self-regulated
learning as well as self-efficacy for the study. This medium is
because these concepts have been successfully applied to
education. The idea that learners should be able to recognize,
create as well as choose their career plans for successful
navigation through their college life contains the elements of
self-efficacy concept and self-regulated learning. For instance,
Erlich and Russ-Eft (2011) indicated that the confidence in
achieving academic plans at a given level could be an indication
of a student’s ability to perform academic planning activities at
a complex level, which is a demonstration of increased efficacy.
Learner’s self-regulated learning skills may help in
understanding the learning mechanisms by which a learner
acquired the strategies and tactics for performing academic
planning activities with independence and sophistication.
Program Timeline
Project Goal
Related Objective
Activity
Duration
To promote awareness about breast cancer prevention
By 2020, increase to 75% proportion of African American
women who understand the importance of annual clinical breast
exams
Identify the population who underutilize clinical breast exams
January 1, 2020-January 31, 2020
Develop a media campaign to educate African American women
about the benefits of early breast cancer detection
February 1,2020-March 30, 2020
Train faith-based organization members on how to educate their
congregations about the benefits of breast cancer screening

February 1,2020-March 30, 2020
To increase early detection of breast cancer through screening
By 2020, increase to 60% the proportion of Black American
women who have received a mammogram screening
Reduce depictions of breast cancer screening among African
women
February 1, 2020-April 30, 2020
Advocate for increased clinical breast cancer examination and
mammography among black American women
February 1, 2020-April 30, 2020
Devise targeted and effective mass media campaigns
April 1, 2020-May 30, 2020
To improve the quality of life of breast cancer survivors and
their loved ones
By 2020, decrease breast cancer-related deaths for Black
American women by 50%
Promote existing best practice programs
March 1, 2020-May 30, 2020
Develop guidelines for best practice programs that advocate for
and promote healthy living
February 1, 2020- April 30, 2020
Market existing programs for breast cancer survivors
March 1, 2020-May 30, 2020

The outcomes of this project will be examined using a formative
evaluation which is conducted during the actual operation of the
program and uses data gathered during the program cycle. It
also provides information during the implementation of the
program to help in determining the extent to which the program
is being implemented according to the program’s design. The
formative evaluation will also answer questions about the
program implementation as well as to focus on process
objectives and enable the manager to determine whether
modifications should be made to program operations even
before the program has completed its first year (Kettner,
Moroney & Martin, 2017).
There will be a need to identify the population who
underutilize clinical breast exams to achieve the program's first
goal of promoting awareness about breast cancer prevention
among African American women. This medium will develop a
media campaign that educates the target population about the
benefits of early breast cancer detection and train faith-based
organization members on how to educate their congregations
about the benefits of breast cancer screening. Various activities
like reducing depictions of breast cancer screening among the
target population, advocating for increased clinical breast
cancer examination and mammography and preparation of
targeted and effective mass media campaigns are essential in
attaining the program's second objective of increasing early
detection of breast cancer through screening. Finally, to
improve the quality of life of breast cancer survivors and their
loved ones, there will be a need to promote existing best
practice programs, develop guidelines for best practice
programs that advocate for and promote healthy living, and
market existing programs for breast cancer survivors.
References
Erlich, R. J., & Russ-Eft, D. (2011). Applying social cognitive
theory to academic advising to assess student learning

outcomes. NACADA Journal, 31(2), 5-15
Hall, H., & Jenkins, L. (2018). Applications and applicability of
social cognitive theory in information science research. Journal
of Librarianship and Information Science, 1-12. Retrieved from
https://journals.sagepub.com/doi/abs/10.1177/096100061876998
5
Kettner, P. M., Moroney, R. M., & Martin, L. L. (2017).
Designing and managing programs: Aneffectiveness-based
approach. (5th ed.). Thousand Oaks, CA: Sage.
Kim, Y. M (2010). Gender role and the use of university library
website resources: A social
cognitive theory perspective. Journal of Information Science
36(5), 603-617.
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2
Program Budgeting and Financial Analysis
Name
University
Evidence Based Practice I: Assessment and Design
January 20, 2019
Program Budgeting and Financial Analysis
Every initiative requires financial resources, and that is why it
is essential to prepare a budget for a program. A program
project, at its core, is developed for a specific activity. It

includes the revenue and the expenditure components for that
particular project. Many organizations use program budgets for
successful implementation of their initiatives. By listing all the
sources of revenues and expenditures, it is possible to control
all the financial activities in which a project takes part in (U.S.
Small Business Administration, n.d.). Another important aspect
in healthcare programs is financial analysis. Policymakers must
perform financial analysis for effective allocation of resources
and determination of economic benefits of a given initiative
(U.S. National Library of Medicine, 2008). This paper discusses
the budgetary requirements and cost-effectiveness of a breast
awareness campaign among African American women in
Baltimore County Maryland.
Program Budget
A functional budgeting system, which deals with the inputs and
outputs of a program or a project is adopted for this breast
cancer awareness program among African American women in
Baltimore County Maryland. According to Kettner, Moroney,
and Martin (2017) functional budgeting systems usually focus
on management and are mainly concerned with a program's
efficiency and productivity. Because of its principal purpose,
functional budgeting system is generally thought of as
efficiency budgeting. The primary goal of this breast cancer
awareness program is to increase awareness and enhance access
to breast cancer screening as well as diagnosis among African
American women. Like in any other budget, there are various
sources of revenues and expenditure items for this program’s
budget (see Table 1).
Table 1: Budget Line Items for Breast Cancer Awareness
Program
Revenues
Amount
Total
Membership contribution

$
100,000
Special Events
$150,000
Government contracts and grants
$250,000
Program income
$300,000
Endowment income
$50,000
Other income
$50,000
Third party payments
$100,000
Total Revenue
$1,000,000
Expenditures
Development and distribution of educational materials
$100,000
Breast cancer educational workshops
$230,000
One-on-one breast cancer health education
$70,000

Salaries and wages
$200,000
Rent
$30,000
Utilities
$20,000
Equipment
$50,000
Supplies
$50,000
Transport
$150,000
Telephone
$50,000
Other (miscellaneous)
$50,000
$1,000,000
A budget comprises of two principal sections: the
revenue part and the expenditure part (Hodges & Videto, 2011).
The total budget required for six months, from the start up to
the completion of this campaign, is 1 million United States
dollars. The program income membership contribution accounts
for 10% of the total revenue. By organizing special events such
as sporting activities, this campaign intends to raise 15,000
dollars, which is 15% of the total revenue. Program income
from various activities like sales of branded shirts is expected
to raise 30% of the total revenue. Government grants and
contributions will account for 25% of the total revenue. From,
third party payments such as nongovernmental agencies, this

awareness campaign will raise $100,000 in revenues.
Endowment income and other income will contribute 5% each to
the total amount of financial resources required for successful
implementation of this campaign.
These revenues will go toward development and distribution of
educational materials, which will account for $100,000 of the
entire budget. This medium is because there is a need to
develop and distribute materials that are culturally appropriate
to the African American population to realize the program's
goals and objectives. Also, it is important to organize
educational workshops for trainers from which they can learn
appropriate methods and techniques for spreading the program’s
purpose to the target population. Also, it is important to arrange
for educational workshops for community leaders and women
groups from where they can be sensitized about the importance
of breast cancer screening and diagnosis. This activity is
expected to cost 23% of the entire expenditure. Trainers must
also have one-on-one educational sessions with the most
affected group for successful sensitization, and this will account
for 7% of the total expenditure. Total salaries for the program's
director, two counselors, three training specialists, and four
support services staff is $200,000 for the six months. There is a
need to rent an office from where the administrative functions
can be carried out. Other utilities like electricity and waters,
transport and telephone are also important for successful
implementation of the program. Office supplies like pens and
books as well as equipment like personal computers and
projectors are other essential requirements.
Break-Even Analysis
Dirubbo (2006) defined break-even as a point at which revenue
is equal to expenditure. As such, the break-even point focuses
on the minimum expectation for a program's revenue. All
revenues earned after break-even analysis point represent
margin over profit. Conducting a break-even analysis is

necessary to determine the break-even point for this breast
cancer awareness program among black American women.
Mathematically;
Break-Even Point = Fixed cost/Contribution margin
Contribution margin = sales price per unit- variable cost per
unit.
For this campaign, 30,000 branded shirts will be sold at $10
each to raise revenue of $300,000
Out of the $1 million, variable cost is expected to account for
40% with the remaining 60% as fixed costs. The variable cost
will be incurred on 100,000 program participants. Therefore;
Fixed cost = $600,000
Variable cost per unit = $400,000/100,000
=$4
Selling price per unit =$10
The Break-Even Point = $600,000/($10-$4)
= $100,000
Budget Variance

Sometimes budgets have variance when revenues do not match
with the expenditures (Hodges & Videto, 2011). As for this
program, a budgetary variance may arise if the sale of branded
shirts does not meet the intended target of surpassing the
intended number of 30,000 branded shirts. Also, failure to
receive $250,000 in grants from the government may lead to a
variance in the budget. An increase in the cost of developing
and distributing educational materials may adversely affect the
budget. A favorable variance may also arise if the cost of
generating and distributing educational materials is lower than
the budgeted figure of $100,000. Changes in economic
performance may affect the prices of equipment such as
personal computers, which may affect the budget either
favorably or adversely. An increase in the cost of a personal
computer will cause an adverse variance while a decrease in the
price of a computer will lead to a favorable variance.
Financial Analysis
Program owners can use different methods of financial analysis,
whose suitability, according to the United States National
Library of Medicine (2008), depended on the purpose of an
assessment, availability of data plus other resources. Some of
the commonly used financial analyses are the cost of illness
analysis, cost-effectiveness analysis, cost consequence analysis,
and cost-benefit analysis. Others are cost-utility analysis, cost
minimization analysis, and budget impact analysis. Cost-
effectiveness analysis is the appropriate method for this
awareness campaign
Cost-Effectiveness Analysis
The cost-effective analysis is the comparison of costs measured
in monetary units against the non-monetary outcomes (U.S.
National Library of Medicine, 2008). In essence, it compares
the costs plus health effects of a program or an intervention to
assess the degree to which it can be considered as providing
value for money. This medium can enable decision-makers to

determine whether or not to allocate resources for a particular
program (Palumbo, Sikorski & Liberty, 2013). Mathematically;
Cost-effectiveness ratio = cost of intervention A ($)-cost of
intervention B ($)
effect of intervention A- effect of intervention B
We can assume that at the cost of $1million, the breast
awareness campaign would help educate 100,000 women of the
benefits of screening and mammography to compute the cost-
effectiveness ratio. Alternatively, a screening coordination
program may be used to help lessen the problem of breast
cancer among Black American women. This program is
anticipated to cost 2.5 million dollars and reach only 80,000
women.
Cost effectiveness analysis for cancer awareness
program=$1,000,000-2,500,000
100,000-80,000

= -70
The negative incremental cost of effectiveness ratio for cancer
awareness campaign implies that by adopting the program rather
than screening coordination initiative, there is an improvement
in the number of women reached out to and reduction in cost.
Conclusion
In conclusion, budget preparation is an important component of
a program. At least 1 million dollars will be required for the
successful implementation of this awareness program. More
than half of these resources will be allocated on some important
budgetary elements like preparation of educational materials,
organization of workshops and salaries. An analysis of break-
even point shows that revenue will equate expenditure at
$100,000 for this program. Most importantly, the cost-
effectiveness analysis proves that a breast awareness campaign
is more effective than screening coordination.
References
Dirubbo, N. E. (2006). Break-even analysis--can I afford to do
this? The Nurse Practitioner, 31(7), 11. Retrieved from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohos
t.com/login.aspx?direct=true&db=mnh&AN=16862051&site=eh
ost-live&scope=site.
Hodges, B. C., & Videto, D. M. (2011). Assessment and
planning in health programs (2nd ed.). Sudbury, MA: Jones &
Bartlett Learning.
Designing and managing programs: An effectiveness-based
approach (5th ed.). Thousand Oaks, CA: Sage.
Palumbo, M. V., Sikorski, E. A., & Liberty, B. C. (2013).
Exploring the cost-effectiveness of unit-based health promotion

activities for nurses. Workplace health & safety, 61(12), 514-
520. Doi: https://doi.org/10.1177/216507991306101203.
Hiatt, J. (2006). ADKAR: a model for change in business,
government, and our community. Prosci.
U.S. Small Business Administration. (n.d.). Writing a business
plan. Retrieved January 17, 2019 from
http://www.sba.gov/category/navigation-structure/starting-
managing-business/starting-business/writing-business-plan.
U.S. National Library of Medicine. (2008). HTA 101: IV. Cost
analysis methods. Retrieved January 17, 2019 from
http://www.nlm.nih.gov/nichsr/hta101/ta10106.html.
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Program Design Elements
Name
University
January 6, 2019
A program is only successful when it does not only achieve its
objectives but also meets or exceeds stakeholders' expectations.
It is the stakeholders who take responsibility of ensuring that a
project reaches its goals. They remain accountable and sacrifice
their time and resources for the good of the project. The success

of a project depends on the involvement of all key stakeholders.
Some of the familiar stakeholders include the community, the
government, organizations, project managers and project
sponsors (Kettner, Moroney & Martin, 2017). This paper
discusses the importance of involving community members and
organizations in the process of developing goals and objectives
for a breast cancer awareness program among African American
women.
Stakeholder Involvement
Importance of Involving Representatives in Goal Development
Involvement of representatives in goal development is a vital
process that ensures the needs and expectations of the target
population are catered for in the project (Hodges & Videto,
2011). There are various benefits associated with the
involvement of representatives in the process of developing
goals and objectives for the breast cancer awareness program
for the selected population. It is undeniable that engaging the
representatives can lead to the accommodation of local agendas
within the local and national programs that aim at reducing
breast cancer among African American women.
Consideration of the stakeholders’ needs and interests
throughout the evaluation process is critical to productive
development of interventions. Representatives can play a major
role in the process of goal development of programs targeted at
African American women who have breast cancer. Given that
many campaigns and communication efforts are complex and
sophisticated, stakeholders normally help in identifying the
right objectives and ensuring that the outcomes are utilized to
make a difference (Hodges & Videto, 2011). Stakeholders are
much more likely to not only support the program assessment
but also act on the program’s outcomes. Their involvement
ensures that the suggestions and areas of differences are solved
throughout the development process which in turn has the
benefits of preventing conflicts or sabotage of the entire
project.
Stakeholders Involved in the Program Planning Process

The community is one of the relevant stakeholders who will be
involved in the program planning process. Soong et al. (2015)
asserted that community members have the responsibility of
identifying and evaluating problems that are healthcare oriented
and solve them amicably. The efforts directed at solving such
problems must also accommodate the possible barriers to the
solutions. Breslau et al. (2015), in their support, indicated that
the community solution to health problems start from the
activities of the community members which implies that
African-American women community can solve the problem if
they are involved right from the initiation phase of the project
to its implementation phase.
Other than the community, organizations will also be involved
in the program planning process because organizations can
provide technical, financial and mobilization assistance as well
as media sponsorship for successful implementation of the
breast cancer awareness program among African American
women. Kettner, Moroney, and Martin (2017) asserted that
organizations could financially sponsor the logistics and
planning activities of a health awareness program. Media
organizations can enhance program implementation by
advertising the program, broadcasting radio and television
jingles as well as granting interviews. Government agencies and
local partners can provide technical and mobilization support.
These initiatives can play significant roles in influencing
African American women's perception of breast cancer
awareness and prevention.
How Representatives can be Involved
Various strategies can be used to undertake stakeholder
engagement for breast cancer programs among African
American women. Some methods, according to O’Haire et al.
(2012) include partnership, participation, consultation, and push
communications as well as pull recommendations. Partnership
programs entail establishing shared accountability and
responsibility with stakeholders. Fawcett and Ellenbecker
(2015) indicated that partnership involves close cooperation and

information sharing. It should also require an engagement
method in which part of the team is included in the delivery of
tasks or with the responsibility for a specific area. This method
is characterized by the establishment of limited ways of sharing
responsibilities. In conference strategy, stakeholders
participate, but team members are not accountable and cannot
influence anything outside of consultation boundaries.
Push communication strategy is a one-way stakeholder
engagement mechanism. When using push communications,
organizations can spread a message across all stakeholder
groups. This medium can alternatively be directed specific
individuals with the utilization of communication channels like
social media, emails, podcasts and broadcast media (O'Haire et
al., 2012). Furthermore, they can use the nominal group
technique. Stakeholders ideas and views can be obtained
through a nominal approach that is free of interference and
threats (O’Haire et al., 2012). The method enhances creativity
and open sharing of information.
Every individual in the group has the freedom to share and learn
new ideas. Stakeholders can choose the proposed ideas. This
approach aims at promoting open communication of views and a
listing of predetermined needs from stakeholders in non-
hierarchical discussion forums (O’Haire et al., 2012). This form
of engagement aims at structuring discussions when groups are
having problems in reaching universal agreement on complex
issues.
Program Mission, Goals, Objectives and Activities
Mission: To eliminate breast cancer as a significant health
problem among African American women by preventing breast
cancer and diminishing suffering from breast cancer through
education and advocacy
Goals
Objectives
Activities
To promote awareness about breast cancer prevention

By 2020, increase to 75% proportion of African American
women who understand the importance of annual clinical breast
exams
Identifythe population who underutilize clinical breast exams
To increase early detection of breast cancer through screening
By 2020, increase to 60% the proportion of Black American
women who have received a mammogram screening
women
To improve the quality of life of breast cancer survivors and
their loved ones
By 2020, decrease breast cancer-related deaths for Black
American women by 50%

Program Gantt Chart
Activities
Month and Year of Plan
01/2019
02/2020
03/2020
04/2020
05/2020
Identifythe population who underutilize clinical breast exams
American women

References
Breslau, E. S., Weiss, E. S., Williams, A., Burness, A., &
Kepka, D. (2015). The implementation road: Engaging
community partnerships in evidence-based cancer control
interventions. Health Promotion Practice, 16(1), 46-54.
https://doi-
org.ezp.waldenulibrary.org/10.1177/1524839914528705
Fawcett, Jacqueline, and Carol Hall Ellenbecker. "A proposed
conceptual model of nursing and population health." Nursing
outlook 63, no. 3 (2015): 288-298.
https://doi.org/10.1016/j.outlook.2015.01.009.
planning in health programs (2nd ed.).
Sudbury, MA: Jones & Bartlett.
Designing and managing programs: Aneffectiveness-based
approach. (5th ed.). Thousand Oaks, CA: Sage
O’Haire, C., McPheeters, M., Nakamoto, E., LaBrant, L., Most,
C., Lee, K., ... & Guise, J. M. (2011). Engaging stakeholders to
identify and prioritize future research needs. Methods Future
Research Needs Reports, No.4. Retrieved from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohos
t.com/login.aspx?direct=true&db=mnh&AN=21977526&site=eh
ost-live&scope=site
Soong, C. S., Wang, M. P., Mui, M., Viswanath, K., Lam, T. H.,
& Chan, S. S. (2015). A “community fit” community-based
participatory research program for family health, happiness, and
harmony: Design and implementation. JMIR Research
Protocols, 4(4). https://doi-
org.ezp.waldenulibrary.org/10.2196/resprot.4369.

1
7
Initial Analysis for Program Planning
Name
University
December 23, 2018
Initial Analysis for Program Planning
Breast cancer is a common type of cancer affecting women in
the whole world, and in the United States, it is one of the most
leading causes of cancer death (The American Cancer Society,
2012). Irrespective of the significant improvements made in
breast cancer detection, diagnosis as well as prevention, the
American Cancer Society (2012) indicated that black American
women are still unequally affected by breast cancer. White
women have a 90 percent five-year survival white African
Americans have a five-year survival rate of 78 percent, which is
lower than that of other races as well as ethnic groups in
America (The American Cancer Society, 2012). Therefore, there
is a need for a new plan of action and methods to advocate for
the prevention of breast cancer, decrease its mortality, as well
as enhance survival rate among Black American women. The
purpose of this paper is to establish an initial analysis for
program planning and needs assessment of the issue of the
breast cancer in black American women in the United States of
America
Problem Identification and Target Population
Compared with Caucasian female, black American women have
increased mortality rates and are more likely to be diagnosed
with the disease prior the age of 40 years. Breast cancer
incidence and mortality rates trends demonstrate varying

patterns among different races. Whereas African American
females have a lesser lifetime risk of suffering from cancer of
the breast, they have an increased mortality rate than white
American women (Allicock, Graves, Gray & Troester, 2013).
Greater breast cancer-related deaths are occurring among black
American women with nearly 33 percent higher risk of loss of
loss due to breast cancer than white American females. A recent
report showed that black American females with cancer of the
breast have a poorer prognosis when compared to white women
that were diagnosed at the same age and stage (Yedjou et al.,
2017).
Social Cognitive Theory for African Women with Breast Cancer
The social cognitive theory utilizes several concepts associated
with behavioral change. First, there is self-efficacy concept
which is a belief that people have the ultimate control over their
health and can do whatever they want. Second, there is the
expectation concept which focuses on the behavioral change
outcome (Hodges & Videto, 2011). For instance, a patient must
go for regular checkups to keep her health in check and at the
required standard. Self-control is another important concept of
the social cognitive theory. This provides patients the autonomy
as well as total control over their behavior change. Most
importantly, African American can, through observational
learning, observe whatever white women are doing to increase
their survival rates. Finally, it is possible to reinforce the theory
using incentives like free checkups as well as rewards for every
patient who regularly visits the hospital for checkups (Hodges
& Videto, 2011).
Social cognitive theory is appropriate for assessing the problem
of breast cancer among Black American women. This is because
the theory focuses on the effect of individual experiences, other
peoples' activities and actions as well as environmental aspects
on the behavior and health status of the affected population.
This is made under the consideration that breast cancer is

treatable but can also be fatal if advanced. Also, the social
cognitive theory offers support in a social context by installing
self-efficacy expectations and utilizing observational, and other
reinforcements to achieve the desired behavioral change and
perception (Hodges & Videto, 2011).
Literature Review
The phenomenon of higher cancer of the breast mortality among
black American females in the America involves various
factors. Black American females are more prone to suffer from
the cancer of breast at an early age, to get the diagnosis at a
later disease stage as well as to die from breast cancer than
other women of other racial groups (Karcher et al., 2014). For
more than four decades, the United States has witnessed an
expansion in the five-year relative survival rate for breast
cancer for both white and black American females. In any case,
there is as yet a significant racial distinction with new data
revealing that the 5-year survival rate for black American and
Caucasians women is standing at 79 percent and 92 percent,
respectively (Coughlin, 2015).
The contrast in survival rate is because of the diagnosis at a
later stage as well as poorer stage-specific survival rates amid
black American females (Coughlin, 2015). It is believed that
various factors, both biological and non-biological, contribute
to the higher mortality rate among African American women.
Some of the biological factors include more treatment-resistant
tumors as well as more aggressive histology. The common non-
biological factors are access to care and attitudes about seeking
care (Daniel et al., 2018). Given that the non-biological factors
are more mutable compared to biological factors, there is a need
to develop proactive measures to address the increasing
mortality rates among African American women (Daniel et al.,
2018).
Efforts to prevent breast cancer-related deaths have focused on

various risk factors like the promotion of physical activity,
reduced alcohol consumption, taking of balanced diet as well as
early detection through regular mammography (Albuquerque,
Baltar & Marchioni, 2014). In as much as, recent data from a
national survey in the United States show that black American
females are as unlikely as white females to have had
mammograms in the recent past, some patient locations and
geographical localities still have some black-white disparities in
mammogram rates as well as referrals for breast cancer
evaluation and detection. These are caused by socioeconomic
factors like family income as well as educational attainment
(Coughlin, 2015).
Cancer of the breast screening rates are low amid low-income,
uninsured as well as underinsured households which lead to
higher mortality rates due to breast cancer among these
populations (Coughlin, 2015). Another issue is of some Black
American females having misconceptions about breast cancer
etiology, about their risk factors of breast cancer as well as
barriers to receiving timely screening and treatment (Yedjou et
al., 2017). Black American women who are at risk are unlikely
than their white counterparts to be aware of the present
guidelines as well as recommendations related to preventive
measures (Coughlin, 2015).
Needs Assessment
Needs Assessment Approach
Monsen et al.'s Problem-Analysis Framework will be used to
identify the needs of black American females in reducing
mortality rates due to breast cancer. According to Annan et al.
(2013), Monsen et al.’s problem analysis framework of 2008
focuses on clear conceptualization and clarity of facts to
provide focused interventions. The framework is divided into
five major phases, with phase 1 requiring therapist and

researchers to focus on the background information, role as well
as expectations. In phase 2, there is a need to prepare the initial
guiding hypothesis for the problem under study. Phase 3 is
about identifying the problem dimensions, and phase 4 is about
the preparation of an integrated conceptualization. In phase 5, a
researcher or a therapist must prepare an intervention plan and
implementation strategy. Finally, phase 6 is about monitoring as
well as the evaluation of actions and outcomes.
Method of Data Collection
The data collection methods that will be used for the study
include questionnaires and interviews. The questionnaires will
be in print and electronic form depending on the convenience of
the respondents. The importance of allowing for flexibility so to
allow the respondents to choose the type channel through which
they can respond to the questions is that the respondents may be
busy in income-generating or any other activities and as such,
may have limited time to answer the questionnaires (Derguy et
al., 2015). Thus, electronic questionnaires will allow for
convenience since busy respondents can answer the questions at
their free time in their mobile phones, tablets, or PCs. The
questionnaires will contain semi-structured-open-ended
questions to allow for flexibility and respondents' free
expression. Apart from the questionnaires, face-to-face and
telephone interviews will also be conducted depending on the
respondent's convenience. Respondents who will have enough
time at their disposal: those who are confident will take face-to-
face interviews whereas those who are busy, shy, or value their
privacy will take telephone interviews.
Potential Challenges and Possible

Solution
s
The possible challenges that will be encountered during the
data-gathering process are poor cooperation by the respondents.
This is because the study deals with breast cancer, which is a
sensitive subject among women. Besides, there may be fears of
ethical and privacy issues by the respondents in which they may
believe that their health information and identities can be
exposed in the study, which can significantly reduce the turnout
and cooperation of disclosure of accurate information by the
respondents. Different distant data-collection options will be
provided such as online questionnaires and telephone interviews
to increase the likelihood of cooperation. Ethical and privacy
issues will be solved by involving community stakeholders and
assuring the respondents of maximum privacy since their real
names will not be used.
References
Albuquerque, R. C., Baltar, V. T., & Marchioni, D. M. (2014).
Breast cancer and dietary patterns: a systematic

review. Nutrition reviews, 72(1), 1-17.
https://doi.org/10.1111/nure.12083.
Allicock, M., Graves, N., Gray, K., & Troester, M. (2013).
African American women's perspectives on breast cancer:
Implications for communicating the risk of basal-like breast
cancer. Journal of Health Care for the Poor and Underserved,
24(2), 753–767. Doi: 10.1353/hpu.2013.0082.
American Cancer Society. (2012).Cancer facts and figures for
African Americans 2011–2012. Atlanta, GA: American Cancer
Society. Retrieved from:
https://www.cancer.org/research/cancer-facts-statistics/cancer-
facts-figures-for-african-americans.html
Annan, M., Chua, J., Cole, R., Kennedy, E., James, R.,
Markúsdóttir, I., ... & Shah, S. (2013). Further iterations on
using the Problem-analysis Framework. Educational Psychology
in Practice, 29(1), 79-95. DOI: 10.1080/02667363.2012.755951
Coughlin, S. S. (2015). Intervention approaches for addressing
breast cancer disparities among African American women.
Annals of Translational Medicine & Epidemiology, 1(1), 1-12.
Retrieved from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4283773/
Daniel, J. B., Gaddis, C. L., Legros, J. R., Bennett, M. D., &
Turner, N. C. (2018). Breast Cancer Knowledge, Beliefs and
Screening Practices among African American Women in a Rural

Setting: A Pilot Study. International Journal of Health
Sciences, 6(1), 29-38. DOI: 10.15640/ijhs.v6n1a3
planning in health programs. (2nd ed.). Sudbury, MA: Jones &
Bartlett Learning.
Karcher, R., Fitzpatrick, D. C., Leonard, D. J., & Weber, S.
(2014). A community-based collaborative approach to improve
breast cancer screening in underserved African American
women. Journal of Cancer Education, 29(3), 482–487. Doi:
10.1007/s13187-014-0608-z.
Yedjou, C. G., Tchounwou, P. B., Payton, M., Miele, L.,
Fonseca, D. D., Lowe, L., & Alo, R. A. (2017). Assessing the
racial and ethnic disparities in breast cancer mortality in the
United States. International Journal of Environmental Research
and Public Health, 14(486), 1-14. Retrieved from:
https://doi.org/10.3390/ijerph14050486

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