Impact of health education intervention on demand of women for cervical cancer screening: a cluster-randomized controlled trial

Abstract

Background Cervical cancer is considered preventable disease, though it is the second largest killer of women’s cancer in low and middle-income countries. Despite the government’s attempts to broaden screening facilities, the screening service utilization was poor. Our study evaluated the impact of health education intervention on women’s demand for cervical cancer screening. Methods Community-based cluster-randomized controlled trial was conducted in thirty district towns as clusters in Tigray region, Ethiopia. A total of 700 women aged 20 to 60 years were recruited for both groups using simple random sampling from April to July, 2018. After baseline data collection, health education intervention was given to the intervention group by trained health professionals using power point presentation and peer group discussion at the nearest health institution. The health education was given for three days followed by subsequent consultations for 6 months. The outcome variable was demand of women for cervical cancer screening. The intent-to-treat and per-protocol analysis were considered to evaluate the inflation of the loss to follow-up on effect size. Chi-square test was used to assess the difference of variables between control and intervention groups at baseline data. Finally, difference in difference analysis was used to see the true effect of the intervention on outcome variable. Results A total of 674 participants (340 in intervention and 334 in control groups) were able to complete the follow-up, making a response rate of 96.3%. At baseline, the differences in proportion of all outcome variables in control and intervention groups were not statistically significant. After follow-up, a statistically significant difference between control and intervention groups was observed in the proportion of willingness to screen (p value = 0.000), having plan to screen (p value = 0.000), ever screened (p value = 0.000), and the overall demand for cervical cancer screening (p value = 0.000). Finally, the impact of intervention was explained by the difference in differences in the proportion of willingness to screen (36.6%) (p value < 0.000), having plan to screen (14.6%) (p value < 0.000), ever screened (16.9%) (p value < 0.000), and overall demand for cervical cancer screening (36.9%) (p value < 0.000). Conclusion This study revealed that health education intervention could increase in overall demand of women for cervical cancer screening. Thus, it would be helpful to consider health education in health planning and service provision. Trial registration The registration number is PACTR201808126223676; date registered: 23 April 2018, and the type is “retrospectively registered.”

Effect of Educational program based on the Prevention Model on Women Knowledge Regarding Cervical Cancer Prevention

“…Regarding total knowledge, the satisfactory level of the total knowledge scores was increased from 34% in the pre-test to 86% in the post-test. This improvement was maintained during the follow-up assessment, with 77.3% of participants still demonstrating a satisfactory level of knowledge with statistically significant differences (P<0.001) these results were in agreement with several previous studies (Abera et al, 2022;Amin et al, 2021;Alkalash et al, 2020;Kazemi et al, 2022;Sonawane & G Mendagudli, 2020;Rosyda et al, 2019)…”

“…However, these findings exceeded those of a randomized trial examining the impact of an educational intervention on women's demand for cervical cancer screening. , Abera et al, (2022) found that after follow-up, the readiness for cervical cancer screening in the intervention group had increased by 46.4%. Additionally, Almutairi et al, (2022) revealed that the awareness and knowledge regarding Pap smear after the education session improved significantly by 1.5-3 times increase (p=0.000).…”

Knowledge and Practices Regarding Human Papillomavirus and Cervical Cancer Screening Among Women in low-income areas of China: A Cross-Sectional Study

“…This underscores the importance of health education in fostering women's participation in screening initiatives. [24][25][26] Nevertheless, notably, women in underdeveloped areas, particularly older women, may not have received systematic education, face challenges in reading and writing, or may have limited access to useful information via mobile phones. Additionally, owing to their geographical distance, they may encounter di culties in accessing public health services.…”

Cervical Cancer

“…Desse modo, se faz necessário a realização de ações educativas pelos os profissionais da saúde utilizando várias estratégias como: palestras orientando como se prevenir do câncer do colo do útero , visitas e interação ao autocuidado e prevenção nos estabelecimentos de acesso a saúde, também em outros estabelecimentos como empresas as quais as mulheres trabalham incentivando as mulheres a realizarem o exame preventivo, e dessa forma sanar e desmistificar as crenças prejudiciais para a prevenção em saúde (Dalazoana et al, 2020;Abu et al, 2020;Abera et al, 2022).…”