The Effect of Educational Intervention Based on the Theory of Planned Behavior on The Performance on Pap Smear Test Screening in Iranian Women

Abstract

Background: Cervical cancer is the second most common cancer and the fifth deadly cancer among women in Iran. Educational interventions based on proper behavior promoting models can lead to early diagnosis of cervical cancer. The theory of planned behavior pays attention to social factors and motivation for following the significant others. The aim of this study was to determine the factors related to performing regular Pap smear test based on the Theory of Planned Behavior (TPB) among the females living in Fasa, Iran.Methods: A cross-sectional study was conducted on 700 participants. Then the educational intervention based on the results of cross-sectional study was conducted in form of a workshop for 50 women as the intervention group, and 50 women were considered as the control group. After all, the data were entered into the SPSS statistical software and were analyzed via logistic regressions analysis, paired t-test, independent t-test, chi-square test, and McNemar test.Result: According to the results, 45.7% of the patients had a history of undergoing a Pap smear test, and 20.7% of them performed this test regularly. The knowledge, attitude, subjective norms, and perceived behavioral control were the predictors of intention and behavior of Pap smear test among the women (P<0.05). These components accounted for 57.4% and 31.6% of the intention and behavior variance, respectively. After the intervention, a significant increase was observed in the mean scores of attitude, subjective norms, and perceived behavioral control in the intervention group compared to the control group. The results revealed no significant difference between the two groups concerning the behavioral intention (p=0.41) and performance of the Pap smear test (p=0.583). The number of the participants who had undergone the Pap smear test increased from 10 to 26 in the intervention group three months after the intervention. The results of McNemar test indicated that this difference was statistically significant.Conclusion: The results indicated an increase in the women’s performance of the Pap smear screening test by appropriate planning, provision of educational packages based on the women’s needs, and using effective subjective norms.This clinical trial is registered in the Iranian Registry of Clinical Trials (IRCT20160830029608N3).