Effects of cervical cancer prevention education in middle-school girls in Korea: A mixed-method study

Associations between socio-demographics, sexual knowledge and behaviour and sexually transmitted infections among reproductive-age women in Southeast Asia: Demographic Health Survey results

Sexually Transmitted Infections (STIs) seriously affect population morbidity, mortality, and are a major public health problem worldwide. A cross-sectional study was conducted using the latest Demographic and Health Survey (DHS) data published between 2005 and 2022 for five Southeast Asian countries. The study's focus was on STI risk factors in the DHS of Timor-Leste, Philippines, Indonesia, Myanmar, and Cambodia. The study included 139,062 women of reproductive age, aged 15 to 49 years, who reported whether they had experienced an STI or its symptoms and had comprehensive information on the variables of interest, including socio-demographics, sexual behaviour and knowledge. The report shows that the prevalence of STIs or symptoms of STIs in 5 Southeast Asian (SEA) countries included in the study is 11.6%, with the highest prevalence found in Cambodia, and the lowest in Philippines. Women aged 15-24 years in Indonesia (17.08%) and Philippines (9.81%), had a higher risk of STIs than those aged 25-49 years. In most studied countries of SEA (Cambodia, Indonesia and Myanmar), poorer women had higher risk of STIs. Also, in most SEA countries (Cambodia, Indonesia, and the Philippines), knowledge of STIs was significantly associated with having an STI in women aged 15-49 years. Sexual behaviour factors showed that acceptance of beating a wife for refusing to have sex with her husband was associated with STIs in all countries except Myanmar. The association between women's characteristics in reproductive age including socio-demography, sexual knowledge and behaviour, and STIs or symptoms of STIs is varied in countries of SEA. STIs interventions can be tailored to the specific characteristics of women in each of the 5 countries of SEA.

Determining the relationship between gynecologic cancer awareness and health literacy among women of reproductive age: a descriptive study

PURPOSE

To determine the relationship between gynecologic cancer awareness and health literacy among women of reproductive age.

METHODS

This study was conducted in a descriptive design and involved 510 women. Data collection utilized the "Personal Information Form", "Gynecologic Cancer Awareness Scale (GCAS)" and "Health Literacy Scale (HLS)", gathered. Pearson correlation and linear regression analyses, independent samples t-test, one-way analysis of variance and post hoc analyses were employed for data analysis. Effect sizes were calculated using eta-squared (η2) coefficients.

RESULTS

The mean total score of women on the GCAS was 154.42 ± 18.27, while the mean total score on the HLS was 57.07 ± 7.86. Significant differences were observed in women's GCAS total scores concerning age, perceived income status, and history of gynecological examination, whereas significant differences were noted in HLS total scores concerning age, educational status, marital status, and perceived income status. A weak positive correlation was detected betwixt women's GCAS and HLS total scores. It was determined that 20.8% of the total variation in gynecologic cancer awareness level was explained by health literacy.

CONCLUSION

Women exhibit an above-average level of awareness regarding gynecologic cancers. Health literacy level contributes to an increase in gynecologic cancer awareness.

Assessing the impact of cervical cancer education in two high schools in Ghana

BACKGROUND

Cervical cancer is one of the commonest female cancers in Ghana. However, it is preventable. Prevention through Human Papilloma Virus immunization and early detection by screening have their foundation in awareness and a good knowledge about the disease. Acquiring the right knowledge about cervical cancer should be earlier rather than later while mindsets are still being formed to translate into the right attitudes and behaviours later in life.

METHODOLOGY

An unpaired pre- and post-test quasi experimental study was conducted at two Ghanaian senior high schools. An educational intervention was carried out comprising a drama, PowerPoint lecture, question and answer session and cervical cancer information leaflet distribution. A self-administered questionnaire was given as a pre-test and repeated as a post-test after 3 months. The total score for each domain of knowledge tested was categorized into adequate knowledge (≥ 50%) and inadequate knowledge (< 50%).

RESULTS

The number of participants in the pre- and post-test were 1,107 and 1,276 girls respectively, with average age of 16 years. General knowledge on cervical cancer improved to 94.4% from 73% following the intervention, but only 46.2% said cervical cancer was curable following the education. Knowledge on symptoms improved from 78 to 87.1% and risk factor knowledge improved from 81.8 to 89.3%. After the intervention, 37% from an initial 42% still thought that having sex at a young age (adolescence) was not a risk factor. Screening and prevention knowledge improved from 82.9 to 91% but only 37.2% knew the recommended age to begin screening with pap smears, even after the education. Overall knowledge on cervical cancer after the education significantly improved from 79.1 to 92.3%.

CONCLUSION

Knowledge of cervical cancer among young girls in two High Schools, improved with the educational intervention. Areas of education to be emphasized are: cervical cancer is curable if diagnosed early, increased risk with early onset of sexual activity, and recommended age to start screening. Educating young girls on cervical cancer increases their awareness and gives them adequate knowledge which should influence their attitudes and behaviour towards cervical cancer in the future. It should be considered for adoption into high school curricula.

Effectiveness of an educational intervention on knowledge and practice of young midwifery college students about IUD and Pap smear, Babol, Iran

OBJECTIVES

The high status of midwifery within the Millennium Development Goals (MDGs) is closely tied to enhancing clinical education. The purpose of this study was to review the effect of education on the knowledge and practice of midwifery students about Intrauterine Device (IUD) and Pap smears.

METHODS

This quasi-experimental study was conducted over the course of four semesters, involving 128 bachelor of midwifery students. The sampling method was non-random, utilizing convenience sampling. Four consecutive 45 min weekly sessions were held, which included three theory sessions and one practical training session. Education was conducted in face-to-face training sessions using different methods such as lectures, question and answer, slide shows, educational films and brochures, and training participants with moulage. The data were gathered using a questionnaire covering demographic characteristics, various aspects of IUD and Pap smear knowledge, along with checklists for IUD insertion and Pap smear. Paired-samples T-test and multiple regression test were used to analyze the data. A significance level of p<0.05 was set for the analysis.

RESULTS

The results of this study showed that there was a significant difference in the average knowledge across various aspects of IUD and Pap smear before and after the intervention (p<0.001). On multiple regression analysis, residence and income significantly influenced knowledge (β=0.313, p=0.001 and β=-0.384, p=0.001, respectively). Also, multiple regression analysis indicated that the use of IUD among family or friends and age significantly impacted practice (β=-0.450, p=0.005 and β=-0.206, p=0.030, respectively).

CONCLUSIONS

The educational intervention yielded a noticeable enhancement in the knowledge and practical skills of midwifery students. These students tend to achieve higher levels of success and deliver superior services to both patients and clients.

Details of Cancer Education Programs for Adolescents and Young Adults and Their Effectiveness: A Scoping Review

The purpose of this review was to establish what cancer education programs have been carried out aimed at adolescents and young adults (AYAs) and what outcomes they achieved. The databases used were MEDLINE, CINAHL, and Web of Science, and the search period was set as 2011-2020. The extracted literature was evaluated for quality using the Joanna Briggs Institute's critical appraisal tools. The subjects of the analysis were 29 studies: 10 randomized controlled trials and 19 quasi-experimental designs. Regarding the varieties of cancers found in the data, in descending order, 10 documents looked at cervical cancer, 9 looked at cancer in general, and 4 looked at breast cancer. Most studies focused on AYAs exclusively, with just three studies involving their parents simultaneously. Many studies used lecture-based intervention, with information technology-based interventions using websites and cell phones. Topics included in the program were cancer epidemiology, cancer risk factors, cancer warning signs and symptoms, prevention methods, and screening methods. After the intervention, all studies showed statistically significant improvements in at least one outcome measure, which included knowledge and awareness of cancer, health beliefs, and intent to take preventive action, demonstrating a basis for educational intervention. Educating AYAs about cancer at a time when their ways of life are becoming more concrete can be expected to have a positive impact on cancer preventing behaviors in adulthood, increase their parents' awareness of cancer, and have a positive impact on behavior around screening.

Assessing the impact of a health education outreach project on cervical cancer awareness among Vietnamese-American women in San Diego

The objective of this study was to assess the rate of effectiveness of cervical cancer awareness outreach among Vietnamese women in San Diego, USA. In collaboration with different community partners, educational seminars were hosted by student pharmacists in the Vietnamese community. We hypothesized that the seminars would increase cervical cancer awareness and encourage a positive outlook on obtaining annual Pap smears and HPV vaccines. The study design included pre- and post-intervention assessment surveys in either Vietnamese or English language. The surveys were administered to Vietnamese women who participated in the seminars. Eight seminars were hosted at local health fairs in San Diego. A total of 120 Vietnamese women participated in the seminars. Our study showed that educational seminars significantly improved the knowledge about cervical cancer, Pap smears and HPV vaccines. By comparing the pre- and post-intervention surveys, we observed an improvement in knowledge about cervical cancer (61% vs 93%, p < 0.001) and a positive change in the attitude towards obtaining a Pap smear within a year following the educational intervention (57% vs. 78%, p < 0.002). Therefore, we concluded that the educational health outreach seminars presented by student pharmacists are an effective educational model to help improve knowledge about cervical cancer and prevention among Vietnamese women.

Awareness about Gynecologic Cancers and Related Factors among Healthy Women: A Cross-Sectional Study

The risk of cancer-related mortality and morbidity decreases when women are aware of the risk factors for gynecologic cancers and implement strategies such as attending relevant early screening programs. This cross-sectional study conducted between August 2017 and August 2018 at a public hospital in Turkey aimed to determine the awareness about gynecologic cancers among healthy women by utilized the Krieger's ecosocial theory as a framework for the study. The study included 554 Turkish women aged 18-65 years. Data were collected using the Gynecological Cancer Awareness Scale (GCAS) and a questionnaire designed in this study. Significant differences were noted between the average GCAS score and variables such as the amount of menstrual bleeding, entering menopause, a history of reproductive system disease, regular gynecological examination (including Pap test), regular vaginal self-examination, sexually transmitted infections (STIs), genital hygiene behavior, the fear of having cancer, having knowledge about cancer, and requiring information about cancer (p < .05). Despite the high level of awareness about gynecologic cancer among these women, the lack of proper knowledge and preventive measures was high. Having knowledge about gynecologic cancers results in increased awareness; however, the level of knowledge is not sufficient to prevent gynecologic cancers, which shows the need for sufficient and effective cancer screening and education programs.

The Impact of Video-Based Educational Interventions on Cervical Cancer, Pap Smear and HPV Vaccines

Background: Video-based interventions have the potential to contribute to long-lasting improvements in health-seeking behaviours. Ghana's upsurge rate of information and communication technology usage presents an opportunity to improve the awareness of HPV vaccination and screening rates of cervical cancer among women in Ghana. This research aimed to assess the impact of video-based educational intervention centred on the Health Belief and Transtheoretical Models of behavioural changes in promoting HPV vaccination, cervical carcinoma awareness and willingness to have Pap smear test (PST) among women in Ghana. Methods: To achieve the intended sample size, convenient, purposive and stratified random sampling techniques were used. SPSS v. 23.0 was used in the data analysis. Percentages and frequencies were used to represent participants' demographic characteristics, knowledge of (1) cervical carcinoma, (2) human papillomavirus vaccine, and (3) Pap smear test. The chi-square test by McNemar was employed to evaluate variations in the post- and pre-intervention responses. A p-value < 0.05 was considered statistically significant. The level of significance was adjusted owing to multiple comparisons by using the Bonferroni's correction. Results: Before the intervention, 84.2% of the participant had some knowledge or information about cervical cancer, but after the intervention, 100% of the participant became aware of cervical cancer which represents 15.8% increment at a P < .001. The willingness to have a pap smear test increased from 35.8% to 94.2% (df = 58.4%, P < .001) after the educational intervention. The willingness to be vaccinated increased from 47.5% to 81.7% (df = 34.2%, P < .001) after the educational intervention. Six months after the intervention, participants were followed-up. 253 (42.2%) participants had gone for cervical cancer screening (Pap smear test) while 347 (57.8%) participants had not been screened. In terms of HPV vaccination, 192 participants (32.0%) had begun their HPV vaccination cycle. Conclusion: The study results show that health education, using videos, may be influential in perception changing, self-efficacy improvement and the understanding of cervical carcinoma screening and HPV vaccination.

The Effectiveness of Interventional Cancer Education Programs for School Students Aged 8-19 Years: a Systematic Review

The implementation of effective interventional cancer education programs in schools could help to reduce delays in diagnosis and improve cancer survival by increasing awareness of risk factors and symptoms among students. The aim of this review was to determine the effectiveness of interventional cancer education programs delivered to school students aged 8-19 years. Various databases were searched to identify controlled and uncontrolled studies published in English language articles between January 2000 and January 2020. Selected publications were then critically appraised using the Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews. A total of 12 studies meeting these criteria were identified. Of these, eight were randomized, and five included control groups. All of the studies conducted the intervention over the course of 1, 3, or 4 days, and there was no follow-up phase in seven studies. Various modes and materials were used in the delivery of the interventions, including children's books and booklets, expert talks or presentations, videos, discussions, role-playing exercises, hands-on activities, group work, quizzes, and homework. There was some evidence to indicate that the interventions enhanced short-term knowledge, attitudes, self-efficacy, and behavioral intentions; however, there was less evidence regarding their long-term effectiveness, particularly in terms of help-seeking barriers. Interventional education programs are important to increase knowledge of cancer among school students aged 8-19 years. Decision-makers should consider including relevant topics within the educational curricula. Both healthcare providers and non-educational organizations should work together to support effective cancer interventional education programs for school students as part of their long-term cancer prevention efforts.

Human Papillomavirus (HPV) Health Savings as an Alternative Solution: HPV Vaccination Behavior in Adolescents

OBJECTIVE

This study aimed to measure the effects of reproductive health savings (tabungan kesehatan reproduksi, Takespro) on human papillomavirus (HPV) vaccine initiation program and the quality of the decision making to get vaccinated, as measured by knowledge, attitudes, beliefs, and self-efficacy toward HPV vaccination.

METHODS

This quasi-experimental study was conducted on 128 students randomly allocated to intervention and control groups. This research was conducted in junior high schools. The intervention group received the health education "Takespro HPV" intervention through videos and booklets for 6 months at school. Participants in the control group received usual care from the school. Data were collected using a questionnaire of knowledge, attitudes, beliefs, and self-efficacy about HPV vaccination modified by researchers based on previous research and tested for validity and reliability. Data were analyzed using Mann-Whitney test and independent t-test.

RESULTS

A total of 40 participants were actively enrolled in the intervention group, and 88 were passively enrolled in the control group. The health education that was part of the Takespro HPV intervention improved the knowledge (p < 0.05) and self-efficacy (p < 0.05) of the intervention group compared with the control group. The attitude and belief variables showed no significant difference (p > 0.05). Forty students exhibited the health reproduction savings behavior at schools. However, the savings amount was insufficient to get HPV vaccination at the initiation phase.

CONCLUSION

"Takespro" HPV intervention can be considered an alternative to increasing the coverage of HPV vaccination in adolescents in Yogyakarta.
.

Incidence and mortality of cervical cancer in Vietnam and Korea (1999-2017)

OBJECTIVES

Cervical cancer is a major disease burden in Vietnam. This study aimed to estimate the incidence and mortality rates of cervical cancer in Vietnam (1999-2017) in comparison to those in Korea, where a population-based cancer registry and national cervical cancer screening program have been implemented.

METHODS

The estimated incidence and mortality of cervical cancer in Vietnam and Korea (1999-2017) were collected from Global Burden of Disease 2017 study. Estimated age-standardized rates (ASRs) in both countries were calculated utilizing the 1999-2017 population of each country and the World Health Organization standard population. The reported ASRs in Korea were also computed using data on incidence and mortality (1999-2017) and the Korean population from the Korea Statistical Information Service.

RESULTS

In Vietnam, the estimated incidence and mortality of cervical cancer decreased annually by 0.84% and 1.01%. In Korea, the trend of reported incidence showed a dramatic drop (1999-2007 annual percent change [APC], -4.53%) before stably declining (2007-2017 APC, -2.71%). Reported mortality also significantly decreased (2003-2008 APC, -6.63%), and then maintained a stable decline (2008-2017 APC, -3.78%). The incidence and mortality rates were higher in Vietnam than in Korea. The declining trend of incidence and mortality in Vietnam was slower than the corresponding trends in Korea.

CONCLUSIONS

A national screening program should be implemented for Vietnamese women aged over 30 to maintain, or even hasten, the decline in cervical cancer incidence and mortality. A population-based cancer registry may help monitor the effectiveness of a cervical cancer screening program.