NUR121 Health, Culture and Society Task

Name the health issue:

1. Why is the issue a priority for the Australian healthcare industry? (100 words)

Breast screen is national health program of Australia, the program comprise free mammogram in every two years for women aged 50-74. The breast cancer is one of the serious health burden in Australia, mortality rate is significantly high and to reduce this burden breast screening has been conducted to avoid diagnose the disease early and avoid mortality due to this issue (Nickson et al. 2018).   Mammography screening detects cancer at early stage so that early treatment can be provided and death due to this issue can be avoided.  Populace based approach support in target audience asymptomatic women to have regular mammogram. 


Nickson, C, Procopio, P, Devereux, L, Carr, S, Mann, G, Arzhaeva, Y, Velentzis, L, James, P & Campbell, I, 2018, Prospective Validation of the NCI Breast Cancer Risk Assessment Tool and the Autodensity Mammographic Density Tool on 40,000 Australian Screening Program Participants.


2. Describe the health promotion program and discuss the key features that are used to address the health issue? (400 words).

As breast cancer is one of the biggest health issue in Australia and due this death rates are considerably high, to reduce these rates the breast screen program is launched by government to provide free mammogram to women aged 50-74 (Lew et al. 2019). It is population based approach that encourages target audience to have regular mammogram so early diagnoses and treatment of the disease to ensure safety of the target audience.   Early detection is the biggest achievement of BreastScreen program of Australia as it maximize the benefits of early detection and reduce the consequences of disease to women.  Breast cancer symptoms in women indicates high risk and might need effective person-centered care and services that are different from screening program, the aim of the program are to reduce the annual rate of mortality and morbidity, ensure that women have screening in every two year to ensure the safety and wellbeing, the program ensure that high quality service provided that are appropriate to meet the need of the target audience.   As part of BreastScreen Australia program offer screening services in qualified Screening and Assessment Services and arrange for program management, service delivery, monitoring, and assessment of high standard.  The program is designed to ensure continuous improvement in management of the disease in the country and to ensure that women receive quality, effective and safe care. BreastScreen accreditation system is independent service review and state coordination unit that offer method of informing and assessing the good improvement program the process of accreditation comprise four year assessment and provide women confidence that the care provided is of high quality and standard.  Continuous performance review survey against the standard are need throughout four yearly interval. The National Quality Management Committee is accountable for appraising applications for authorization and annual data reports from BreastScreen Services and making a final decision about whether a Service and/or SCU is qualified and it is  also liable for enabling quality development within BreastScreen Australia (Cristaudo & Zhu 2017).  Women who are eligible in terms of their age is invited for screening (women aged fifty to seventy four), the interval of screening is two years,   screening is conducted at minimal cost where no cost is taken from the women.  Precipitants of the screening decided on basis of the socioeconomic, ethnic, and cultural factors of targeted audience.



Cristaudo, A.T & Zhu, K.J, 2017, A case report of small bowel obstruction from previously undiagnosed lobular breast carcinoma: First in Australian literature. International journal of surgery case reports, 30, pp.152-154.

Lew, J.B, Feletto, E, Wade, S, Caruana, M, Kang, Y.J, Nickson, C, Simms, K.T, Procopio, P, Taylor, N, Worthington, J & Smith, D, 2019, Benefits, harms and cost-effectiveness of cancer screening in Australia: an overview of modelling estimates. Public health research & practice, 29(2).


3. How does the program demonstrate the principles of primary healthcare? (400 words)


As we know that principles of primary healthcare comprise service that is of high standard, accessible, culturally appropriate, effective and ensure safety of target audience, the primary principle of healthcare also include person-centered approach and empowerment individual and community to avoid risk behaviors and improve self-management and awareness about safety and wellbeing. Strategies to discourse the health necessities of persons and communities by educating health literacy and to ensure informed evidence based services and program delivered by qualified practitioners. In consideration to primary healthcare principle BreastScreen demonstrate the principles as standard 1 of the program (Access and participation standard) provide appropriate level of access and participation to screening in the target audience. The standard 1 ensure that target audience on basis of their age are eligible for screening or rescreening, the service monitor the report of the participants in two years interval (Armes et al. 2017).   BreastScreen services are available to the target and eligible audience, specifically women from Indigenous, remote/rural areas, culturally and linguistically diverse culture, lower socioeconomic backgrounds and women with a disability. The service ensure that suitable policies and procedure are implemented to invite women for screening and rescreening and follow-up women who did not respond to the screening invitation and deliver service to women in the target audience. The polices for invitation comprise understanding the benefits of the screening and exposure to communication with the BreastScreen program, also comprise direct promotion of the service, referral from health professionals, promotion and encouragement from family and friends,  referral from indigenous health worker. The program use wide range of approach and strategies to encourage women in target audience to participate in the BreastScreen program. Standard 2 of the program comprise the monitoring of the screening. Overall the BreastScreen Australia program ensure that they documents strategy to encourage participation, communicate benefits and risk to wider audience, analyze the data of the participation. Effective communication strategies used to ensure women attend the service. Women from indigenous community can be invited through collaborating with local and relevant organization and culturally appropriate information included, service ensured that care delivered is suitable and accessible for the women in the community and is of high standard (Van et al. 2017). Similarly women speaking different language or women with disability will be provided care considering person-centered approach to provide quality care.  It is vital that appropriate consent s obtained before screening and person confidentiality is maintained and information can be only used after taking person consent or for best interest of the person. To facilitate continuous improvement and outcome of the program feedback and survey are conducted to ensure the quality service are delivered to wide range of targeted audience.



Armes, J.E, Galbraith, C, Gray, J & Taylor, K, 2017, The outcome of papillary lesions of the breast diagnosed by standard core needle biopsy within a BreastScreen Australia service. Pathology, 49(3), pp.267-270.

Van Gaans, D, Coffee, N, Daniel, M & Roder, D, 2018, Breast Screen Service Characteristics as a Measure of Accessibility. Research in Health Science, 3(4), pp.103-114.


4. What health promotion strategies are used by the program and how are the principles of health promotion applied in their strategies? (400 words)

The Breastscreen Australia program use wide range of data in their promotional strategies as in order to reach wider target audience breastscreen program Australia use local organization, independent social worker in the community, general practitioner and other health professional referral to aware women about the benefits of the program ad inviting them for screening.  As Breastscreen  Australia program face significant difficulty in reaching audience in isolated community such as indigenous community, there are many difficulty face by the program in the community whether it is related to language barriers or cultural belief, most of the indigenous population didn’t like to communicate with people outside their community, their inattentiveness about the issue is also one of the reason of increase rate of case in indigenous community,  the program use remote tele radiology to deliver quality service nation including isolated population. The NQMC (national quality management community) think it’s vital the new procedure such as remote tele radiology is evidence based and follow national law to ensure safety of patient and quality service (Ingman et al. 2020). For non-speaking English audience, the program ensure that workforce is diverse and has essential skills to connect and reach wider audience.  There are almost 50% of immigrant audience in Australia and 58% non-English speaking audience (Nickson et al. 2019), to reach this audience to attend the screening or rescreening different health promotion program under this program has been initiated to reach specific target audience, for instance, to reach Chinese women program living is been initiated guided by Chinese philosophies , using evidence based material for promotion, social media marketing has been used to for better promotion of the campaign. The Breast screen program ensure that the service empower the women, the campaign provide knowledge about disease to women and benefit of the screening, this strategies work in compliance to traditional health promotion policy that comprise importance of empowerment to enable people to make effective decision and action that can affect their health, also the campaign ensure that women from different community take active participation in the screening and for this BreastScreen Australia program use doctor referral, local organization support to reach wider target audience and thus, program is intersectoral that is another health promotion strategy. The program is fair to all and sustainable, the program work in compliance to national policy and procedure to ensure safe environment, to ensure effective service delivery program ensure that personal development is use in the program by worker, such as self-esteem, communication, motivation, etc. thus BreastScreen program utilize health promotion principle in their strategies.




Ingman, W.V, Richards, B, Street, J.M, Carter, D, Rickard, M, Stone, J & Dasari, P, 2020, Breast Density Notification: An Australian Perspective. Journal of Clinical Medicine, 9(3), p.681.

Nickson, C, Velentzis, L, Brennan, P, Mann, G.B. & Houssami, N, 2019, Improving breast cancer screening in Australia: a public health perspective. Public health research & practice, 29(2).



5. How can the program be improved to better meet the needs of their target group? (200 words). Provide one recommendation and support it with a reference. 

The program main goal is to reach wider audience to ensure safety and wellbeing of the women, in order to ensure this the BreastScreen Australia program ensure best practice for quality improvement, one way the program can be improved is by setting qualification and skills requirement work key role in the program. As we know that program face significant difficulty in reaching isolated or culturally diverse audience despite utilizing the accredited services, as we know that indigenous people did not like to communicate with people outside their community due to language barrier thus, having worker in program that speak or have knowledge about the language will reduce this issue, also to ensure quality service and facilitates continuous improvement setting qualification and skills requirement will be beneficial for the program. For key service roles setting qualification and skills requirement is vital, in present, NAS commentary didn’t nor have specific skills and qualification requirement especially for nonclinical service manager (Worthington et al. 2020). Setting skills and qualification requirements for key service roles. There is a number of key service roles for which the NAS Commentary does not define skills and qualification requirements, or where the specification is not mandatory (Pilkington et al. 2017).   As we know that major role in the program require leadership, management and effective governance that can significantly influence performance of service, in present the qualification standard for data management is highly required as data is vital in evaluating the performance/outcome of the program and strengthening the quality of service.  



Pilkington, L., Haigh, M.M, Durey, A, Katzenellenbogen, J.M & Thompson, S.C, 2017, Perspectives of Aboriginal women on participation in mammographic screening: a step towards improving services. BMC public health, 17(1), p.697.


Worthington, J, Lew, J.B, Feletto, E., Holden, C.A, Worthley, D.L, Miller, C & Canfell, K., 2020, Improving Australian National Bowel Cancer Screening Program outcomes through increased participation and cost-effective investment. PloS one, 15(2), p.e0227899.


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