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Khoshnazar MS, Tarrahi MJ, Shahnazi H. Impact of virtual education based on health belief model on cervical cancer screening behavior in middle-aged women: A quasi-experimental study. Cancer Rep (Hoboken) 2024; 7:e2058. [PMID: 38600048 PMCID: PMC11006602 DOI: 10.1002/cnr2.2058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 02/29/2024] [Accepted: 03/23/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Cervical cancer is one of the most common cancers in women worldwide and a cause of high mortality among people. Pap smear screening is an appropriate method to prevent cervical cancer and reduce its mortality. AIM This study aimed to determine the effect of web-based education based on the Health Belief Model (HBM) on cervical cancer screening behavior in middle-aged women. METHODS AND RESULTS This study is a quasi-experimental interventional research that was conducted on 240 middle-aged women aged 40-59 years in Isfahan, Iran, in 2022. An online educational intervention based on the constructs of the Health Belief Model was conducted for the intervention group using the Triple-B platform. The information on the intervention and control groups was collected before, immediately after the intervention, and 2 months later using a valid questionnaire. The gathered Data was analyzed using ANOVA and LSD post-hoc, independent samples t test, chi-square, and MANCOVA statistical tests in SPSS 26 software. After the intervention, the mean scores of knowledge, perceived susceptibility, perceived severity, perceived benefits, self-efficacy, and internal cues to action in the intervention group increased and the mean score of perceived barriers decreased (p < .001). The mean score of the external cues to action did not show a significant difference between the intervention and control groups before, immediately, and 2 months after the intervention. Two months after the intervention, 32 women (26.2%) in the intervention group and two women (1.7%) in the control group performed the Pap smear test. CONCLUSION Web-based educational intervention based on HBM using different strategies such as question and answer, presentation of infographics, lectures, brainstorming, showing videos and numerous educational images can be an effective way for increasing knowledge and cognitive variables of women and doing Pap smear test.
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Affiliation(s)
| | - Mohammad Javad Tarrahi
- Department of Epidemiology and Biostatistics, School of HealthIsfahan University of Medical SciencesIsfahanIran
| | - Hossein Shahnazi
- Department of Health Education and Health Promotion, School of HealthIsfahan University of Medical SciencesIsfahanIran
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Mariño JM, Nunes LMP, Ali YCMM, Tonhi LDC, Salvetti MDG. Educational interventions for cervical cancer prevention: a scoping review. Rev Bras Enferm 2023; 76:e20230018. [PMID: 38018622 PMCID: PMC10680385 DOI: 10.1590/0034-7167-2023-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/12/2023] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVES to identify, map and describe characteristics of educational interventions for cervical cancer prevention in adult women. METHODS a scoping review conducted on eleven databases and the gray literature, including studies that described educational interventions aimed at preventing cervical cancer in adult women. RESULTS thirty-three articles with 151,457 participants were analyzed. The most used educational strategies were participatory discussions and educational leaflets. Most of the interventions took place in a single session, ranging from 40 to 60 minutes. The most used theoretical model in interventions to improve women's compliance with Pap smear was the Health Belief Model. CONCLUSIONS group discussions, lectures and educational brochures can increase knowledge and reduce barriers to cervical cancer prevention. Theory-based and culturally sensitive interventions can have a positive impact on women's health.
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Affiliation(s)
- Josiane Montanho Mariño
- Universidade de São Paulo. São Paulo, São Paulo, Brazil
- Universidade Federal do Amazonas. Coari, Amazonas, Brazil
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Pirani N, Jafari M, Motlagh AG, Pourasghari H. Policy analysis of cervical cancer prevention in Iran based on the policy triangle model. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:381. [PMID: 38333179 PMCID: PMC10852161 DOI: 10.4103/jehp.jehp_1411_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 10/26/2022] [Indexed: 02/10/2024]
Abstract
BACKGROUND Widespread use of screening in high-income countries has led to a significant reduction in cervical cancer mortality. Most low- and middle-income countries still have poorly organized screening programs. This study aimed at policy analysis of prevention and early detection of cervical cancer in Iran, a middle-income country. MATERIALS AND METHOD This qualitative retrospective study, extended by the health policy triangle model, was conducted from July 2020 to September 2021. A sample of this study consisted of 43 participants, including 16 key policy experts; nine 11 senior health system managers, 13 executives, and 3 clients selected purposefully. Data were collected through semi-structured interviews using the interview guide and analyzed using a framework analysis method based on the policy triangle model in MAXQDA2020. RESULTS Nine themes, 15 subthemes, and 36 codes were extracted based on the 4 dimensions of the model; stakeholder analysis challenges, including conflict of interest and decision-making challenges. Moreover, the most important policy process challenges indicated the weakness of monitoring and evaluation systems and weakness of using scientific principles in policy making. Weakness of organizational and intersectoral structure and weakness of executive management were obtained among the challenges in the context analysis. Finally, the most important challenges related to content analysis are weaknesses in applying scientific principles in policy making, including weaknesses in standard operating procedures, and low use of HTA capacity in developed guidelines. CONCLUSION A wide range of economic, social, and cultural problems can affect cervical cancer prevention policies. Several strategies are suggested to overcome these challenges, including allocating separate funds to cancer prevention programs, using structures to sustain prevention programs, designing, and using them to improve public awareness.
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Affiliation(s)
- Narges Pirani
- PhD. in Health Policy, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Jafari
- Professor of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Ali G. Motlagh
- Associate Professor of Clinical Oncology, Department of Radiotherapy, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Pourasghari
- Assistant Professor of Health Policy, Hospital Management Research Center, Iran University of Medical Science, Tehran, Iran
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Pirani N, Jafari M, Bagherzadeh R, Keikhosravi M, Pirani H. Cervical Cancer Prevention, Its Challenges and Solutions in Iran and Worldwide: A Systematic Review. IRANIAN JOURNAL OF PUBLIC HEALTH 2023; 52:2313-2324. [PMID: 38106838 PMCID: PMC10719694 DOI: 10.18502/ijph.v52i11.14031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/14/2023] [Indexed: 12/19/2023]
Abstract
Background Widespread use of screening in high-income countries has led to significant reductions in mortality from cervical cancer. However, in Iran, the main reason for the late diagnosis of cervical cancer was the failure to perform a Pap smear (Papanicolaou). We aimed to investigate the status of cervical cancer prevention and its challenges and solutions in Iran. Method We conducted a systematic review of literature published from 1974 to 2021 in the electronic databases, including PubMed, Web of Science, Embase, Scopus, and Google Scholar, and retrieved all English-language articles. Following the application of the inclusion and exclusion criteria, full-text articles were identified and evaluated for eligibility. Finally, these publications were analyzed as part of the synthesis. Results Lower social-economic level, inadequate knowledge of screening tests and health centers for Pap test performance leading to worse outcomes such as lower screening participation or coverage. Conclusion By addressing these challenges through increasing education, increasing service accessibility, expanding screening programs, improving public awareness, improving insurance coverage, and establishing a control protocol for follow-up, it is possible to reduce cervical cancer incidence and mortality.
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Affiliation(s)
- Narges Pirani
- Health Policy, Ministry of Health and Medical Education, Tehran, Iran
- Health Promotion Research Center, Health School, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Jafari
- Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Rafat Bagherzadeh
- English Department, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Hadis Pirani
- Public Administration, Payam Noor University, Khuzestan, Iran
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Bahri N, Mardani F, Sharifi N, Dashti S. Predicting factors for breast cancer screening in Middle Eastern women based on health belief model: a systematic review. J Egypt Natl Canc Inst 2022; 34:50. [DOI: 10.1186/s43046-022-00150-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 09/14/2022] [Indexed: 12/05/2022] Open
Abstract
Abstract
Background
Breast cancer screening can reduce mortality and improve the quality of life in affected women. The present study aimed to determine the predictive factors of breast cancer screening in Iranian women based on the health belief model (HBM).
Methods
This review was conducted by searching electronic databases of Google Scholar; electronic databases, including Scopus, PubMed/MEDLINE, Cochrane Library, Web of Science, ProQuest, Embase, and Google scholar Magiran; and SID with the English keywords of “breast cancer,” “mammography,” “health belief model,” and “breast self-exam” and the equivalent Persian keywords. The results were evaluated based on the health belief model (HBM) constructs. Articles were evaluated for quality and the findings were extracted and reviewed.
Results
A total of 8 relevant articles were selected for review. Women’s awareness of breast cancer screening methods was moderate in two studies and poor in two other studies. Among the constructs of HBM, knowledge, perceived susceptibility, perceived severity, perceived benefits, and action plan were poor in the majority of the studies, while perceived barriers, cues to action, and self-efficacy were mainly good.
Conclusion
Considering the observed weakness of many HBM constructs, it is recommended that special attention be given to all HBM constructs in implementing HBM-based education programs.
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Barrera Ferro D, Bayer S, Brailsford S, Smith H. Improving intervention design to promote cervical cancer screening among hard-to-reach women: assessing beliefs and predicting individual attendance probabilities in Bogotá, Colombia. BMC Womens Health 2022; 22:212. [PMID: 35672816 PMCID: PMC9172610 DOI: 10.1186/s12905-022-01800-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 05/05/2022] [Indexed: 11/30/2022] Open
Abstract
Background Despite being a preventable disease, cervical cancer continues to be a public health concern, affecting mainly lower and middle-income countries. Therefore, in Bogotá a home-visit based program was instituted to increase screening uptake. However, around 40% of the visited women fail to attend their Pap smear test appointments. Using this program as a case study, this paper presents a methodology that combines machine learning methods, using routinely collected administrative data, with Champion’s Health Belief Model to assess women’s beliefs about cervical cancer screening. The aim is to improve the cost-effectiveness of behavioural interventions aiming to increase attendance for screening. The results presented here relate specifically to the case study, but the methodology is generic and can be applied in all low-income settings.
Methods This is a cross-sectional study using two different datasets from the same population and a sequential modelling approach. To assess beliefs, we used a 37-item questionnaire to measure the constructs of the CHBM towards cervical cancer screening. Data were collected through a face-to-face survey (N = 1699). We examined instrument reliability using Cronbach’s coefficient and performed a principal component analysis to assess construct validity. Then, Kruskal–Wallis and Dunn tests were conducted to analyse differences on the HBM scores, among patients with different poverty levels. Next, we used data retrieved from administrative health records (N = 23,370) to fit a LASSO regression model to predict individual no-show probabilities. Finally, we used the results of the CHBM in the LASSO model to improve its accuracy. Results Nine components were identified accounting for 57.7% of the variability of our data. Lower income patients were found to have a lower Health motivation score (p-value < 0.001), a higher Severity score (p-value < 0.001) and a higher Barriers score (p-value < 0.001). Additionally, patients between 25 and 30 years old and with higher poverty levels are less likely to attend their appointments (O.R 0.93 (CI: 0.83–0.98) and 0.74 (CI: 0.66–0.85), respectively). We also found a relationship between the CHBM scores and the patient attendance probability. Average AUROC score for our prediction model is 0.9.
Conclusion In the case of Bogotá, our results highlight the need to develop education campaigns to address misconceptions about the disease mortality and treatment (aiming at decreasing perceived severity), particularly among younger patients living in extreme poverty. Additionally, it is important to conduct an economic evaluation of screening options to strengthen the cervical cancer screening program (to reduce perceived barriers). More widely, our prediction approach has the potential to improve the cost-effectiveness of behavioural interventions to increase attendance for screening in developing countries where funding is limited.
Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01800-3.
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Affiliation(s)
- David Barrera Ferro
- Southampton Business School, University of Southampton, Southampton, UK. .,Departamento de Ingeniería Industrial, Pontificia Universidad Javeriana, Bogotá, Colombia.
| | - Steffen Bayer
- Southampton Business School, University of Southampton, Southampton, UK
| | - Sally Brailsford
- Southampton Business School, University of Southampton, Southampton, UK
| | - Honora Smith
- Mathematical Sciences, University of Southampton, Southampton, UK
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Liu C, Chen X, Huang M, Xie Q, Lin Q, Chen S, Shi D. Effect of Health Belief Model Education on Increasing Cognition and Self-Care Behaviour among Elderly Women with Malignant Gynaecological Tumours in Fujian, China. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:1904752. [PMID: 34659680 PMCID: PMC8516589 DOI: 10.1155/2021/1904752] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/26/2021] [Accepted: 09/28/2021] [Indexed: 12/15/2022]
Abstract
Objective This study evaluated the effect of a health belief model (HBM) educational intervention on the self-perception of and complications related to disease in elderly gynaecological malignancy patients. Methods This randomized controlled trial was conducted at the Fujian Maternal and Child Health Hospital, China. A total of 301 women aged 60 years and older who were diagnosed with gynaecological malignancies from January 2019 to August 2020 were recruited. Participants were randomly divided into the HBM education and basic nursing groups. The participants in the HBM education group received perioperative rehabilitation education based on the HBM, and the participants in the basic nursing group received routine basic nursing. Rehabilitation training compliance, psychological resilience, psychological flexibility, self-efficacy, self-care ability, and lower extremity deep venous thrombosis (LEDVT) incidence were assessed before and after the intervention. Results Thirty-three women were excluded based on the exclusion criteria, and 268 participants were eventually included and randomly divided into two groups: 134 participants in the HBM education group and 134 participants in the basic nursing group. Before HBM education, there were no significant differences in the mean scores of psychological resilience (50.43 ± 3.29 vs. 50.55 ± 2.29, P = 0.738), psychological flexibility (48.98 ± 3.45 vs. 49.29 ± 3.59, P = 0.465), self-efficacy (26.49 ± 5.26 vs. 26.29 ± 6.41, P = 0.781), or rehabilitation training compliance (28.4% vs. 27.8%, P = 0.922) between the two groups. After HBM education, the scores of training compliance (80.6% vs. 30.1%, P < 0.001), psychological resilience (55.47 ± 5.01 vs. 50.46 ± 2.62, P < 0.001), psychological flexibility (56.53 ± 4.51 vs. 49.13 ± 3.62, P < 0.001), self-efficacy (30.79 ± 4.56 vs. 26.41 ± 6.37, P < 0.001), self-care knowledge (43.36 ± 7.60 vs. 34.05 ± 6.99, P < 0.001), self-concept (29.57 ± 5.67 vs. 20.11 ± 3.86, P < 0.001), self-care responsibility (27.54 ± 5.09 vs. 20.86 ± 4.53, P < 0.001), and self-care skills (34.51 ± 5.62 vs. 21.62 ± 5.64, P < 0.001) were higher in the HBM education group than those in the basic nursing group. Additionally, the incidence of LEDVT was lower in the HBM group than that in the basic nursing group (2.2% vs. 8.3%, P = 0.027). Conclusion This study indicated that perioperative HBM education can improve the cognition and self-care ability of elderly gynaecological malignancy patients and reduce postoperative complications.
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Affiliation(s)
- Chenyin Liu
- Department of Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, Fujian, China
| | - Xianjing Chen
- Department of Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, Fujian, China
| | - Mengli Huang
- Department of Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, Fujian, China
| | - Qun Xie
- Department of Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, Fujian, China
| | - Qiaoming Lin
- Department of Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, Fujian, China
| | - Siai Chen
- Department of Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, Fujian, China
| | - Danfeng Shi
- Department of Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, Fujian, China
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Samami E, Seyedi- Andi SJ, Bayat B, Shojaeizadeh D, Tori NA. The effect of educational intervention based on the health belief model on knowledge, attitude, and function of women about Pap smear test at Iranian health centers: A randomized controlled clinical trial. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:22. [PMID: 33688531 PMCID: PMC7933686 DOI: 10.4103/jehp.jehp_33_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 08/22/2020] [Indexed: 05/14/2023]
Abstract
BACKGROUND AND OBJECTIVE This study aimed to examine the effect of educational intervention using the health belief model on knowledge, attitude, and function of women about Pap test at health centers. METHODOLOGY This randomized controlled clinical trial was conducted on 120 women who were allocated into two groups (intervention = 60 and control = 60). The sampling method was a multistage cluster. The training was provided in two sessions for 90 min. Data gathering tool was a 4-part researcher-made questionnaire including demographic characteristics, knowledge, health belief model structures, and function. Women were evaluated and completed the questionnaire in two stages (before and 2 months after training). Data were analyzed by Kolmogorov-Smirnov, Wilcoxon, linear regression, Mann-Whitney U-test, Fisher, Chi-square, and marginal homogeneity tests. RESULTS At baseline, there was no significant difference between the groups regarding the mean of knowledge and the structures of health belief model scores. The average scores of participants in terms of health belief model structures were increased significantly after the training sessions. Furthermore, the comparison of the performance of Pap smear before training showed that in the intervention group (23.3%) and in the control group (31.7%), there was no significant difference in terms of the history of performing the Pap smear test (P = 0.414). However, a significant difference (P = 0.001) was observed after training in the intervention group (31.7%) and in the control group (3.3%). CONCLUSION Educational intervention using the health belief model is effective in increasing knowledge, attitude, and function of women in terms of providing useful and required education.
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Affiliation(s)
- Elahe Samami
- Department of Reproductive Health and Midwifery, Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Jalil Seyedi- Andi
- Assistant Professor of Health Education and Promotion, Department of Public Health, School of Public Health Social Determinants of Health Research Center, Health Research Institute Babol University of Medical Sciences, Babol, Iran
| | - Beyrambibi Bayat
- Department of Health Education and Health Promotion, Tehran University of Medical Sciences, Tehran, Iran
| | - Davoud Shojaeizadeh
- Department of Health Education and Promotion, Faculty of Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Ahmadzadeh Tori
- Department of Health Education and Health Promotion, Tehran University of Medical Sciences, Tehran, Iran
- Address for correspondence: Neda Ahmadzadeh Tori, Ph.D Student Department of Health Education and Health Promotion, Tehran University of Medical Sciences, Tehran, Iran. E-mail:
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