Health 4 Her Trial

A brief intervention to improve awareness of the alcohol-breast cancer link and address harmful alcohol use among women attending breast screening services.

Overview

Breast cancer is the most common cancer in Australia, with 20,640 new cases estimated to be diagnosed in 2022. Alcohol is a major modifiable risk factor for breast cancer, even in low amounts. Yet, awareness of this risk remains low, and is not routinely addressed in healthcare settings.

While population alcohol consumption is declining, risky drinking is increasing among midlife and older-aged women, a demographic who are at highest lifetime risk for developing breast cancer. Population-based breast screening programs are uniquely positioned to provide women with health information about the risks of alcohol products.

Project Stages

Phase I: Need & Acceptability

Analysed data from 49,240 women breast screening service consumers who are part of the Peter MacCallum Cancer Centre’s Lifepool Project, and found that 1 in 5 women are drinking at a level exceeding national guidelines for weekly consumption (i.e. drinking more than 10 standard drinks per week).
Surveyed 391 women who attend breast screening, and found that just 20% of women were aware that alcohol products increase breast cancer risk. The vast majority (97%) supported adding 5 minutes to their screening appointment to receive breast cancer risk reduction information.
We worked with an additional 31 women who attend breast screening to collaboratively design a brief alcohol and lifestyle health promotion activity offered to women attending routine screening (which was called Health4Her), to increase awareness of the alcohol-breast cancer link, improve alcohol literacy more broadly, and reduce consumption.

Phase II: Effectiveness-implementation Trial

A total of 558 women attending routine screening at Maroondah BreastScreen participated in a double-blind, randomised controlled trial of the Health4Her intervention.
Of participants, 80% had recently consumed alcohol and just 20% were aware that alcohol consumption increases breast cancer risk.
Awareness of alcohol as a breast cancer risk factor, and alcohol literacy in general, improved to a greater extent among women who received the Health4Her intervention than among women who received general lifestyle advice only.
The Health4Her intervention was perceived by women to be highly acceptable and credible to deliver within the breast screening setting.
BreastScreen staff were also highly supportive of Health4Her as part of routine care, and were excited about playing a role in breast cancer prevention. However, they endorsed the need for an automated, self-completed version that requires minimal staff facilitation and minimal disruption to workflow.

Phase III: Health4Her-Automated

We are working with women who attend breast screening and Monash University’s Action Lab to collaboratively design the automated version of the Health4Her intervention.
In August 2023, we plan to test the effectiveness of the Health4Her-Automated intervention in reducing intentions to drink and alcohol consumption among women attending breast screening, alongside comprehensive program evaluation to understand the factors affecting implementation in practice.

Supporting Health4Her

Turning Point is seeking financial support to continue to expand the Health4Her project across Australia, empowering women to make informed decisions around alcohol consumption.

To help scale up the Health4Her intervention, you can donate to Turning Point.

Project team

Turning Point team

Dr Jasmin Grigg, Prof Victoria Manning, Ms Peta Stragalinos, Ms Isabelle Volpe, Ms Chloe Bernard, Dr Ali Cheetham, Dr Bosco Rowland, Prof Dan Lubman

Project partners

Dr Darren Lockie (Maroondah BreastScreen), Ms Michelle Giles (Maroondah BreastScreen), Prof Robin Bell (Monash University), Dr Christopher Greenwood (Deakin University), Dr Alex Waddell (Monash University), Dr Ling Wu (Monash University), Mr Joshua Seguin (Monash University), Dr Jue (Grace) Xie (Monash University), Prof Liam Smith, (BehaviourWorks), Prof Peter Bragge, (BehaviourWorks).

Our funders

VicHealth (Research Impact Grant)
Eastern Health Foundation (Research and Innovation Grant)
Shades of Pink

Publications

Grigg, J., Manning, V., Lockie, D., Giles, M., Bell, R.J., Stragalinos, P., Bernard, C., Greenwood, C.J., Volpe, I., Smith, L., Bragge, P. and Lubman, D.I. (2023), A brief intervention for improving alcohol literacy and reducing harmful alcohol use by women attending a breast screening service: a randomised controlled trial. Medical Journal of Australia. https://doi.org/10.5694/mja2.51991

Grigg, J., Manning, V., Cheetham, A., Greenwood, C. J., Youssef, G., Lockie, D., Bell, R., Stragalinos, P., Bernard, C., & Lubman, D. I. Risky alcohol consumption among women in Australia attending breast screening services: an exploratory cross-sectional study. Addiction, n/a(n/a). https://doi.org/https://doi.org/10.1111/add.16191

Grigg, J., Manning, V., Lockie, D., Giles, M., Bell, R., Stragalinos, P., Bernard, C., Volpe, I., Greenwood, C. J., Smith, L., Bragge, P., & Lubman, D. I. (2023). A Brief Intervention for Improving Alcohol Literacy and Addressing Harmful Alcohol Use Among Women Attending an Australian Breast Screening Service (Health4her): Protocol for a Hybrid Effectiveness-Implementation Trial [Protocol]. JMIR Res Protoc, 12, e44867. https://doi.org/10.2196/44867