The Integrated Breast Cancer Educational Program in Indonesia: A Mixed-Methods Study Among Breast Cancer Patients and Survivors in Indonesia Breast Cancer Ed Indo
Abstract
Objective: This study aimed to develop an audience-tailored breast cancer educational program in Indonesia informed by factors associated with delayed breast cancer diagnosis.
Methods: This multiphase mixed-methods study followed a QUAL-QUAN-QUAL sequence. Eligible subjects were patients/survivors aged ≥18 years with confirmed breast cancer and no cognitive or communication impairment; caregivers were included in Phase 1. Phase 1 used purposive and snowball sampling with deductive matrix-based framework analysis. Phase 2 comprised an online cross-sectional survey and multivariable logistic regression. Phase 3 used multidisciplinary expert interviews integrate the preceding findings into an educational program.
Results: Twenty-five interview participants and 379 survey respondents were included. Qualitative findings identified knowledge, breast-health behaviors, diagnostic pathway, and social influencer as key domains related to diagnostic delay. Higher knowledge (aOR 0.87 per 10-point increase, 95% CI 0.77–0.98) and personal financing (aOR 0.61, 95% CI 0.37–1.00) were associated with lower odds of delay, while not performing regular breast self-examination was associated with higher odds (aOR 2.10, 95% CI 1.01–4.35). Integrated findings informed audience-specific educational program tailored for the general public, patients, caregivers, health workers, and health educators.
Conclusion: Delayed diagnosis in Indonesia was associated with knowledge gaps, breast-health behaviours, diagnostic and social factors. These findings informed an audience-tailored educational module to address key barriers to timely diagnosis and to effectively reach the primary target audiences.
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Copyright (c) 2026 Farida Briani Sobri, Adang Bachtiar, Sonar Soni Panigoro, Dumilah Ayuningtyas, Hardya Gustada Hikmahrachim, R Cita Resti Anantia Putri, Anggindita Diah Widihidayati
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