Thoughts of a Key Stakeholder

“As a young women breast cancer is an all too real threat, but unfortunately I
can say that I have not been educated enough about the illness. I know when
breast cancer awareness month is, and I know the home screening tips but my
knowledge really ends there. Senate Bill 994 is a great idea and would be
advantageous to all young women such as myself. 'Think Pink Early' opened my
eyes to this bill and to issues associated with it. I think the female
population needs to take a proactive step in increasing awareness to every
generation about breast cancer, the earlier the better.”

- Caity Flint, Virginia Tech freshman.

Action Plan Feedback

As of November 5, 2009 we have not received any feedback from legislators in response to writing letters and sending e-mails. Today an e-mail was sent to the Young Survivor Coalition and the American Nurses Association political action committee asking for support.

Positive feedback and support was received from peers and local constituents via internet networks such as Gmail postings, Facebook, and blog comments. One peer commented, “Every women needs to know the facts about Breast Cancer and understand the impact it has on individuals, family members, and friends.”

Connections are being made with other organizations such as the Zeta Tao Alpha sorority at Radford University and James Madison University to increase our numbers in support for the EARLY Act. The ZTA philanthropy is Breast Cancer Awareness- they provide support for early breast cancer detection year-round. The Susan G. Komen site has been utilized as a reference for our information to each of our contacts in following out our action plan.

Reaching out to Legislators

Senator Amy Klobuchar- is the sponsor of senate bill 994 and has worked closely with Representative Debbie Wasserman Shultz to promote the bill through the legislative process. Senator Klobuchar and Representative Wasserman Shultz were the first to propose this legislation at a press conference in the capitol building. In support of the bill in March 2009, Senator Klobuchar stated,

"Breast cancer is a leading cause of death for women. We need to make sure that women, especially young women, have access to the best information and the best support possible to protect themselves against this killer”

Senator Klobuchar is actively involved in this legislation as she is the sponsor of senate bill 994. It is vital to gain her support and recognition of our efforts to support this bill in our political action process.

Congressman Bob Goodlatte- Because Rep. Debbie Wasserman-Shultz’s jurisdiction is in Florida, we decided to contact Bob Goodlatte, congressman of the 6th congressional district of VA ( covering Harrisonburg) We contacted Congressman Goodlatte because he has already worked to pass the National Breast and Cervical Cancer Early Detection Program Reauthorization Act, which was signed by the President in 2007. In a 2007 newsletter, Congressman Goodlatte stated,

“I encourage folks to mark Breast Cancer Awareness month by remembering and honoring friends and family who are living with breast cancer and those who have lost their lives to this dreadful disease. The courage and determination of these brave women, like Congresswoman Jo Ann Davis, are an inspiration to us all. We must seize this opportunity to renew our commitment to fighting this disease, raising awareness, and supporting those affected by breast cancer.”

Senator Barbara Mikulski- is important to contact because she has control over key issues in the state of Maryland. Not only is she the Maryland's state Senator, she is the Dean of Women- serving as a mentor to other women Senators when they first take office. Being a woman with social work and activist experience make her a prime candidate to influence the passing of the EARLY Act. Senator Mikulski believes that her constituents have a right to know, a right to be heard, and a right to be respected.

Senator Jack Reed- is a critical Senator to contact. His track record on his issues in health care is great for supporting this bill. He is a strong supporter of appropriating funds for healthcare workforce education. He believes that public education and awareness has helped prevent and treat many diseases as well as lessened the stress on families involved. Contacting him will be beneficial to gain support of this bill.

Senator Kay Hagan- It is important that we contact Senator Kay Hagan because she supports the passage of this bill and the need to identify problems early on through education of warning signs and risk factors. As a mother of two daughters, she understands how crucial it is that these issues to be addressed in young women. Senator Hagan states,

"Women need to be aware of techniques to identify problems early on," said Hagan, a member of the Senate Health, Education, Labor and Pensions (HELP) Committee. "As a mother of two daughters, I think it is crucial that young women know how best to recognize early warning signs and reduce risk factors. I applaud Representative Wasserman Shultz for bringing attention to her experience with breast cancer to raise awareness for women. Passage of the EARLY Act will help build on her efforts, and will provide a support structure for those diagnosed with breast cancer."

Senate Bill 994: What is our stand? Who are the stakeholders? What legislators are key in passage?

We are in support of S.B. 994. In the U.S. over 250,000 women under the age of 40 have been diagnosed with breast cancer, and it is projected that 10,000 more women under the age of 40 will be diagnosed in the next year (YSC, 2009). As nursing students, we see the benefits of preventive healthcare, such as education programs and early screening. Education can help a young female become more aware of her risk factors such as ethnicity, family history, and lifestyle factors. Early screening, such as mammograms and genetic testing, promote early diagnosis and proper treatment. Unfortunately, the educational tools available to young women at risk for breast cancer are limited. If the bill is passed, there will be more funding available for education and media coverage.

Political Action Plan:

- Send letters to extend invitations to our blog to key legislators mentioned below

- Contact the ANA-Political Action Committee to lobby for passage of our bill

- Contact the Young Survival Coalition

- Utilize the Susan G. Komen Foundation as a resource

- Connect and communicate with other organizations that support breast cancer education, prevention and awareness

Key Stakeholders:

- Young women (age 15-40)

- Families of young women diagnosed

- Health care providers

- Media

- Professors at universities

- State agencies that put on educational programs at secondary school and universities such as the Department of Health

- Center of Disease Control and Prevention (CDC)

Key Legislators:

- Senator Amy Klobuchar

- Representative Debbie Wasserman-Schultz

- Senator Barbara Mikulski of Maryland who is a strong promoter of women’s health and is an advocate for cancer screening in women as well as funding for more education and research in women’s health.

- Senator Jack Reed of Rhode Island

- Senator Kay Hagan of North Carolina who believes in preventing illnesses rather than waiting for a disease process to begin in order to start treatments

Senate Bill 994: Objectives, Influences, and Impact

Governmental Objectives of Senate Bill 994

1. Increase public awareness regarding the threats posed by breast cancer in young women, including increased risks based on race, ethnicity, age, and heredity. Achieve early detection though community-centered informational forums, public service advertisements and media campaigns.

2. Directs Secretary to award grants to establish national multimedia campaigns that encourage awareness of personal risks, early detection, genetic counseling, life style changes

3. Requires the Secretary to: (1) establish an advisory committee to assist in creating and conducting the public education campaign; (2) conduct an education campaign to increase awareness among health care professionals; and (3) conduct prevention research.

4. The EARLY Act will also provide grants to organizations that support young women diagnosed with breast cancer in order to receive the assistance they need—including social and psychological support, fertility preservation counseling, and recurrence prevention training

What are Senate Bill 994’s important political influences?

The Director of the Center for Disease Control and Prevention, Thomas R. Frieden has a strong political influence on this policy. The bill calls for the CDC to conduct a national evidence-based education campaign, which will provide valid indication for the need of early breast cancer awareness. The media also is a key political influence favoring the implementation of this bill. Grants will be awarded to the establishments of national multimedia campaigns oriented toward young women in order to support the education campaign carried out by the CDC. The bill calls for an advisory committee within the CDC to be established in order to effectively conduct the national education campaign for young women who may be at risk for breast cancer. The CDC and the Administrator of the Health Resources and Services Administration, Mary Wakefield, are called to work together to conduct an education campaign to increase awareness among physicians and other health care providers. Both education campaigns are meant to evaluate the current knowledge of young women and health care providers and their awareness of breast cancer risks, prevention, and available treatment options.

What is the potential impact of the policy change on nursing, clients, and the health care system?

S. 994 will have an impact in nursing and other health care providers due to the increase of education that will be required by the bill. Most young women see their gynecologist once a year for an annual exam. At these appointments, women are typically asked, among other questions, if they perform self-breast exams. That is the extent of early detection and prevention that most young women are aware of. What many women do not know are the cultural, ethnic, and lifestyle factors that play into the development of breast cancer. Nurses and health care providers will need to expand upon this information, which will mean more time spent on preventive education in the health care setting. Education will include handouts, videos, and web-based information developed by the director of Center for Disease Control and Prevention. Workers in the health care setting, especially nurses will need to be aware of these educational resources in order to facilitate the appropriate education to young women. Furthermore, nurses need to be able to direct young women to the community-centered informational forums on recognizing breast cancer early that will be widespread if the bill passes.
The young women are the clients who will be impacted by the bill. Although sometimes breast cancer can be a touchy subject and uncomfortable to talk about, the overall impact of the bill in young women should be favorable. Early detection through education on cultural, racial, and lifestyle risk factors can help young women to have a better understanding as well as possible better coping with the diagnosis of the disease. In an article found in the Australian Journal of Advanced Nursing it was found that younger women who are diagnosed with breast cancer have treatment concerns that are qualitatively different from those of older women. Younger women also feel as though they are too young to take on the “sick role”, and it was shown that the support systems for younger women are usually not as prepared to deal with such a crisis as those for younger women (Coyne, 2009). S. 994 is designed to develop educational material for emotional, social, lifestyle, and caregiver support for these young women who are diagnosed. The overall impact of the bill on clients is that they will have a wider base of knowledge concerning risk factors, early detection, and support outlets if diagnosed.

Related Videos and Links:

Rep. Debbie Wasserman Schultz’ blog about The EARLY Act

Sign the Petition and send a letter to your Senator asking them to co-sponsor the EARLY Act of 2009!


Rep. Debbie Wasserman Schultz addresses the issue of breast cancer in young women

Think Pink Early: The need for change

It has come to the public's attention that women under 40 are at an increased risk for breast cancer. It is essential that women under the age of 40 recognize modifiable risk factors through early education and prevention. This bill would promote awareness and support to those women at risk or recently diagnosed with breast cancer.