The Integrated Breast Cancer Educational Program in Indonesia: A Mixed-Methods Study Among Breast Cancer Patients and Survivors in Indonesia: Breast Cancer Ed Indo

Objective: This study aimed to develop an audience-tailored breast cancer educational program in Indonesia informed by factors associated with delayed breast cancer diagnosis.Methods: This multiphase mixed-methods study followed a QUAL-QUAN-QUAL sequence. Eligible participants were patients and survivors aged ≥18 years with confirmed breast cancer and no cognitive or communication impairment; caregivers were included in phase 1. Phase 1 used purposive and snowball sampling with deductive matrix-based framework analysis. Phase 2 comprised an online cross-sectional survey and multivariable logistic regression. Phase 3 used multidisciplinary expert interviews to integrate the preceding findings into an educational program.Results: Twenty-five interview participants and 379 survey respondents were included. Qualitative findings identified knowledge, breast-health behaviors, diagnostic pathways, and social influences as key domains related to delayed diagnosis. Higher knowledge (aOR, 0.87 per 10-point increase; 95% CI, 0.77–0.98) and personal financing (aOR, 0.61; 95% CI, 0.37–0.99) were associated with lower odds of delay, while not performing regular breast self-examination was associated with higher odds (aOR, 2.10; 95% CI, 1.01–4.35). Integrated findings informed an audience-specific educational program tailored for the general public, patients, caregivers, health workers, and health educators.Conclusion: Delayed diagnosis in Indonesia was associated with knowledge gaps, breast-health behaviors, diagnostic factors, and social factors. These findings informed an audience-tailored educational module to address key barriers to timely diagnosis and to effectively reach the primary target audiences.