The purpose of this study was to evaluate two pamphlets for assessing the accuracy of breast self-examination (BSE) in older women. The Learning Enhancement Pamphlet (LEP) was designed to be used by older women, and the Traditional Teaching Pamphlet (TTP) was developed by the Public Health Services, United States Department of Health and Human Services, and the National Institutes of Health.

Sixty-three women volunteers (Black = 22; White = 41), ages 65 to 94 years, from two independent care living facilities made up the study sample. A posttest only experimental design was used. Subjects were randomly assigned to one of two research assistants and randomly assigned to a treatment group. A one-on-one teaching approach was used while each participant used one pamphlet the first week and the other pamphlet the second week. An alternating procedure for pamphlet usage was utilized, and each subject served as her own control.

Accuracy for BSE performance using each pamphlet was measured. Data analysis demonstrated a 30% higher rate of mean scores on BSE accuracy of performance when using the LEP than when using the TTP. Whether the subjects preferred using one pamphlet over the other in relation to ease of reading, ease of handling, ease of opening, color best suited for reading, following directions, and overall pamphlet preference for teaching BSE was explored. The LEP was preferred over the TTP in regards to handling, reading, opening, color, directions, and pamphlet preference.

During a three month follow-up interview with each subject, a total of 35 (55.6%) of the 63 subjects reported performing the procedure monthly during the three months or more often than monthly. Twenty (31.8%) women reported having used the LEP during the three months while one (1.6%) used the TTP and one (1.6%) used both pamphlets. Forty-one (65.1%) women stated that they had used neither pamphlet because they knew the steps of BSE and felt confident in performing the procedure.

Future research is recommended using the LEP augmented with other teaching modalities such as films and breast models. Such research should address issues regarding an older client's attitudes, motivation, and skill in doing BSE.