This research developed a BSE Web site, called
“Purelady” (see Figure 1). We developed the Web site based on results of a community health assessment, social learning theory, construction theory, and literature review about factors influencing BSE behavior. The development process of the “Purelady” Web site was based on System Development Life Cycle (SDLC) model, which includes feasibility analysis, system analysis, system design, implementation, test, and maintenance (See Figure 2).
Based on student’s characteristic of using network and health promotion idea, we designed the Web site by considering the features of the characters in animations, the helpfulness of automatic e-mail sending functionality, and the need for visually pleasing and user friendly interface design. After developing the Web site, we invited specialists in breast cancer, nursing informatics, community health, information management, and nursing administration to review the content validity. We then modified the Web site based on their comments and suggestions. After testing all the server-side programs, we come out with a complete BSE Web site, called “Purelady”.
Our Web site consists of the following components: member registration, latest news, BSE education (text, animation and online video versions), for members only, personalized self-examination records, making appoints with the school nurse, frequently asked questions (FAQs), related sites, the bulletin board, discussion groups, and the chat room (see Figure 3). A major feature of our Web site is the BSE reminder program that automatically sends e-mails to members two days earlier before their menstruation. The Web site also provides interfaces for the school nurse (system manager) to publish information and manage the Web site.
All the backend programs were developed using PHP (Hypertext Preprocessor), a server-side
scripting language. Member information, bulletin board contents and other data are stored in the Microsoft’s SQL Server database. All the animations of BSE education were created using Flash.
4. Conclusion
Our Web site has the following features: (1) the menstruation monitor program automatically sends e-mails to members to remind them to perform BSE based on their menstruation cycles;
(2) its backend system provides anonymous health counsel and allows members to make appointments with the school nurse to practice BSE by using breast models; (3) it follows the HON Code of Conduct for medical and health Web sites and clearly specifies Web site design principles; (4) our BSE education materials utilize Flash animations, audio, text, graphics, and online video; (5) it uses computer media as the intervention strategy, and utilizes social learning theory and construction theory as the foundation for educational intervention; (6) it provide each member with her own BSE procedures and records of examination results to satisfy the needs for personalization.
In a school, the nurse is usually the only person that has a professional training for health care. School nurses should take advantages of the explosive growth of information technology to provide Web-based health education. In Taiwan, most of the BSE intervention educators adopt traditional in-class education. None of them use Internet and WWW as the platforms to conduct researches of health intervention education for schools and communities. That constitutes much of the motivation for our research. Our overall research goal is to develop an interactive Web-based for BSE intervention education to increase female college students’
BSE knowledge, attitude and behavior.
Our future research is to conduct an experiment to examine the knowledge, attitude and behavior differences among female college students without intervention, with traditional
in-class education intervention, and with Web-based education intervention, and verify the feasibility of using the Web as the medium for health education.
5. References
[1] Gross, R. E.（2000）. Breast cancer：risk factors, screening, and prevention. Seminars in Oncology Nursing, 16(3), 176-184.
[2] George, S. A.（2001）. Barriers to breast cancer screening: an integrative review.
Health Care for Women , International, 21
（1）, 53-65.
[3] Leaffer. T., & Gonda. B. （ 2000 ） . The Internet: An Underutilized Tool in Patient Education. Computer in Nursing, 18(1), 47-52.
[4] Cheng, S. H., Tsou, M. H., Liu, M. C., Jian, J. J., Cheng, C. H., Leu, S. Y., Hsiech, C. Y.,
& Huang, A. T.（2000）.Unique features of breast cancer in Taiwan. Breast Cancer Research and Treatment, 63,213-223.
[5] Vicki, V., Poskitt, S., Slaninka, S. C.,
（ 1997 ） . Enhancing Breast Cancer Screening in the University setting. Cancer Science Nursing,20 （5）,323-329.
[6] Lu, Z. J.（2001）. Effectiveness of breast self-examination nursing interventions for Taiwanese community target groups.
Journal of Advanced Nursing, 34(2), 163-170.
[7] Kim, H. S., Kim, E., & Kim, J. W.（2001）.
Development of Breast Self-Examination Program for the Internet. Cancer Nursing, 24(2), 156-161.
[8] Rhodes, F., Fishbein, M., & Rein, J. (1997).
Using Behavior theory in computer-based health promotion and appraisal. Health education & behavior, 24(1), 20-34.
[9] James, C., James, N., Davies, D, Harvey, P.,
& Tweddle, S. (1999). Preference for different sources of information about cancer. Patient Education and Counseling, 37, 273-282.
184
Figure 1. The Purelady Web site and its tools.
Interactive Functions Browsing Procedures
Moral Principles System Interface Development Tools
Web Pages Teaching Objectives
Resources and Limitations Web Site Contents
Technology User’s Needs
Software &
Hardware Bandwidth
(Network) User
Figure 2. The Procedures for Developing the Purelady Web Site.
Experts’
Review
Semantic Clearness Content Appropriateness System Stability
Implementation Testing Development
Design Analysis Web Site Team
186
E Ed ti
Web Site Announcement
Homepage Guided Tours for New
Members Latest News
Latest News
Borrowing BSE Models Member Login
(ID & Password)
Self-xamination
Text Version
BSE videotape from S.Y.
Dao Memorial Fund Animation Version
(Flash)
BSE videotape from Catholic Sanipax Socio-Medical Service &
Education Foundation Forgotten
Password Online Video
Version My Calendar Homepages for
Members
Query for Self-Examination Records Sign In
(As a Member)
Self-Examination
Records Correct
Self-Examination Procedures Management
Interface for the Nurse Sign In
(As a Nurse) Answering BSE
Questions (With Award)
Filling out Self-Examination Records Related Web
Sites Making an
Appointment
Making an Appointment with a Nurse FAQs
Department of Health Common Wealth Magazine King Net Web hospital I Care Asia
Catholic Sanipax Socio-Medical Service &
Education Foundation S.Y. Dao Memorial Fund
Der-Tao Cancer Education Foundation Formosa Cancer Foundation
Guided Tours for New Members
Related Web Sites Bulletin Board
System Chat Room
For Breast Cancer Prevention & Treatment Discussion
Groups Topics for Voting
For Healthy Life BSE Reminder