Effect of structured training programme on the knowledge and behaviors of breast and cervical cancer screening among the female teachers in Turkey

The effect of educational intervention based on the PEN-3 model on breast cancer screening behaviors

Background

Breast cancer is the most important malignancy and the main cause of cancer deaths among women worldwide. Breast cancer screening is an effective way to reduce breast cancer deaths.

Objectives

The present study aimed to provide breast cancer screening behavior training for female teachers in Isfahan, Iran.

Materials and methods

This randomized controlled trial included 120 teachers who have randomly divided into two groups (60 in the control group and 60 in the intervention group). The data collection tool was a PEN-3 model-based questionnaire. Four 90 min training sessions were held for the intervention group to modify perception and enablers. Breast self-examination (BSE), Clinical breast exam (CBE), and mammography (MMG) were investigated in both groups before and after 6 months after the last training using SPSS20 and appropriate statistical tests.

Results

The frequency of BSE (p = 0.02), CBE (p = 0.04), and MMG (p = 0.01) in the intervention group was significantly higher than in the control group 6 months after training. The mean scores of perception and enablers were significantly higher in the intervention group than in the control group 3 and 6 months after training (p < 0.001). The logistic regression analysis indicated that perception factors were the strongest predictors of breast cancer screening behavior in teachers.

Conclusion

Results of the present study indicated that using the PEN-3 model in the educational intervention was effective in improving breast cancer screening behavior.

Evaluation of Breast Self-examination Training in Turkish Women Living in Northwestern Turkey

Introduction

Breast cancer (BC) is one of the most significant health problems among the women. Breast self-examination (BSE) is an examination method which is used by women to detect breast cancer as much early as possible. Training of women about BSE is crucial.

Methods

The current study was semi-experimentally single-group pretest-posttest designed in order to evaluate breast self-examination (BSE) training efficacy on Turkish women's knowledge and skills. The study was performed on 119 Turkish women. The data were collected with a three questionnaires and BSE Training Skills Evaluation Form in three phases.

Results

81.5% of the women did not perform BSE regularly. Rate of correct responses about knowledge on BC, risk factors and screening increased after posttest. Significant improvements were observed in the post-test (after training, after one month and three months training) scores for knowledge of Turkish women' towards BC, risk factors and screening, steps of BSE after the intervention (p < 0.001). To quantify the efficiency of training, effect size (Cohen's d) was derived. For knowledge and ability to do BSE scores, Cohen's d was 1,01 ≤ with large effect size indicating highly effective impact of the training.

Conclusions

It seems that BSE training is beneficial in women. However, women should receive regular BSE training to renew their knowledge and skills. Long follow-up is required.

The Effect of Peer-Led Navigation Approach as a Form of Task Shifting in Promoting Cervical Cancer Screening Knowledge, Intention, and Practices Among Urban Women in Tanzania: A Randomized Controlled Trial

BACKGROUND

Even though the government's priorities in preventing cervical cancer are implemented in urban areas, the screening rate remains unsatisfactory at 6%, compared to 70% recommended by the world health organization. The ongoing public health education has not resulted in sufficient screening rates. The study aims to assess peer-led navigation (PLNav) in promoting cervical cancer screening knowledge, intention, and practices among urban women in Tanzania. Since PLNav is the form of task shifting, it involves delegating cervical-cancer-related tasks from healthcare professionals to community health workers (CHWs).

METHODS

It is a community-based randomized controlled trial conducted in Dar es Salaam in Tanzania March-Sept 2020. The PLNav involved the CHWs delivering health education, counselling and navigation assistance to community women (COMW). The CHWs help women who have never undergone cervical cancer screening (CCS) and those who have undergone CCS but with a precancerous cervical lesion to overcome screening barriers. The data related to PLNav were analyzed by descriptive statistics, an independent-samples t-test, repeated measures ANOVA and linear regression.

RESULTS

The repeated measures ANOVA across time showed that PLNav intervention on mean knowledge score changes was statistically significant in the intervention group compared with the control group's usual care, [F (1, 43) = 56.9, P < .001]. At the six-month follow-up, 32 (72.7%) out of 44 participants from the intervention group had screened for cervical cancer, and only one participant (2.3%) from the control group screened. The PLNav intervention on CCS uptake changes was statistically significant in the intervention group compared with usual care in the control group [F (1, 43) = 100.4, P < .001]. The effect of time on CCS uptake in the intervention and control groups was statistically significant [F (1.64, 70.62) = 73.4, P < .001].

CONCLUSION

Peer-led navigation (PLNav) was effective in promoting cervical cancer screening knowledge, intention, and uptake.

The application of health behavior theories to promote cervical cancer screening uptake

BACKGROUND

While cervical cancer is a major cause of mortality, its progress and survival rate can be improved through screening. Yet despite their wide availability, women's participation in cervical cancer screening (CCS) programs is often suboptimal, especially in low- and middle-income countries. Besides demographic and organizational characteristics, screening uptake is influenced by psychological factors, most of which are included in health behavior theories. This systematic review compared different health behavior theories in terms of their capacity to explain CCS uptake and inform CCS promotion campaigns.

METHODS

A comprehensive search and analysis of published intervention and non-intervention (observational) studies that applied at least one health behavior theory to CCS participation.

RESULTS

After quality screening, 48 observational and 21 intervention studies were identified that applied the Health Belief Model (HBM), Theory of Reasoned Action (TRA), Theory of Planned Behaviour (TPB), Transtheoretical model (TTM), Social-ecological Model (SEM), and/or Theory of Triadic Influence (TTI) to CCS. The HBM was most frequently used to explain behavior, whereas the TPB was better at explaining screening intentions. Tailored intervention studies focusing on all theoretical constructs were most effective in modifying perceptions and increasing CCS uptake.

CONCLUSIONS

Despite their inconsistent use, health behavior theories can explain CCS intentions and behavior and contribute to the development of targeted interventions to promote screening uptake.

Attributes of screening and vaccination for cervical cancer: insights of an online survey among female school teachers of Kota, Rajasthan, India

Background: Cervical cancer is largely preventable. The study was aimed to find out the attributes of screening and vaccination for cervical cancer among female school teachers of Kota, Rajasthan, India.

Methods: It was an observational study, cross-sectional in design conducted among female school teachers of Kota, Rajasthan, India using a predesigned structured questionnaire administered by Google Form during the months of March to May, 2020. In total, 397 schoolteachers from 18 different schools of Kota participated in our survey.

Results: Among the study subjects, 33 (8.3%) had ever undergone screening for cervical cancer, whereas only 12 (3.0%) had taken vaccine against it. In multivariable logistic regression analysis; age (>40 years) [adjusted odds ratio (AOR): 5.7 (2.0-15.8)], correct knowledge regarding frequency of screening (yes) [AOR: 6.0 (2.4-15.5)], positive attitude for the disease (yes) [AOR:3.0 (1.1-8.0)] and gynaecologist consultation behaviour (periodic) [AOR: 1.4 (1.1-8.6)] were significant attributes of ever undergoing screening for cervical cancer. On the other hand, themultivariable significant attributes of vaccination were age (≤40 years) [AOR: 7.6 (1.5-38.9)]and positive attitude for the disease (yes) [AOR: 6.4 (1.1-38.2)].

Conclusion: Acceptance of screening and vaccination for cervical cancer among the study subjects was found to be quite low. Policymakers should more actively involve school teachers in generating awareness and in raising the demand for cervical cancer screening and vaccination in their native communities to curb the disease in the country.

Fundamental Elements in Training Patient Navigators and Their Involvement in Promoting Public Cervical Cancer Screening Knowledge and Practices: A Systematic Review

BACKGROUND

Cervical cancer screening remains unsatisfactory in some regions due to hindrances. This study aims to explore fundamental elements in training patient navigators and their involvement in promoting screening knowledge and practices.

METHODS

This systematic review study included only English published articles between 2014 and 2019 from PubMed/Medline, EBSCO, Science Direct, and Wiley online library.

RESULTS

Healthcare professionals trained patient navigators in 3 days regarding screening basics, along with group discussions and role-plays. They delivered effective health education and navigation assistance.

CONCLUSION

The group education session facilitated by patient navigators, coupled with navigation care, resulted in a high screening rate.

The Effectiveness of Educational Interventions on Breast Cancer Screening Uptake, Knowledge, and Beliefs among Women: A Systematic Review

There have been various systematic reviews on the significance of educational interventions as necessary components to encourage breast cancer screening (BCS) and reduce the burden of breast cancer (BC). However, only a few studies have attempted to examine these educational interventions comprehensively. This review paper aimed to systematically evaluate the effectiveness of various educational interventions in improving BCS uptake, knowledge, and beliefs among women in different parts of the world. Following the PRISMA guidelines, a comprehensive literature search on four electronic databases, specifically PubMed, Scopus, Web of Science, and ScienceDirect, was performed in May 2019. A total of 22 interventional studies were reviewed. Theory- and language-based multiple intervention strategies, which were mainly performed in community and healthcare settings, were the commonly shared characteristics of the educational interventions. Most of these studies on the effectiveness of interventions showed favorable outcomes in terms of the BCS uptake, knowledge, and beliefs among women. Educational interventions potentially increase BCS among women. The interpretation of the reported findings should be treated with caution due to the heterogeneity of the studies in terms of the characteristics of the participants, research designs, intervention strategies, and outcome measures.

Effectiveness of An Educational Intervention of Breast Cancer Screening Practices Uptake, Knowledge, and Beliefs among Yemeni Female School Teachers in Klang Valley, Malaysia: A Study Protocol for a Cluster-Randomized Controlled Trial

Breast cancer is the most common cancer spread among women worldwide. Whereas many studies have discussed the significance of breast cancer screening among women in various countries, few have attempted to discuss this topic among female school teachers. As teachers educate and communicate with students, this may play an essential role in health education and in promoting healthy behavior, such as breast cancer screening. The primary goal of this study is to develop and implement an educational intervention of breast cancer screening and evaluate its effectiveness among Yemeni female school teachers in Malaysia. This was carried out as per the health belief model. A cluster-randomized controlled trial was conducted among 183 Yemeni female school teachers in twelve schools in Klang Valley, Malaysia. A random assignment of the target schools was made to include them within the intervention or control group. Participants in the intervention group were offered a 90-min session for one-day educational intervention on breast cancer screening. On the other hand, participants in the control group were offered the same educational materials at the end of the study. Relevant data was collected at baseline, one month following the intervention, and then three- and six-months follow-up assessments. Analysis of such data was done via IBM SPSS software 25.0 by generalized estimating equations (GEE) to assess the differential changes over time. A primary outcome embodied in breast cancer screening practice uptake was expected. Secondary outcomes include the target group’s knowledge on and beliefs of breast cancer screening. This study intends to contribute to the credibility and effectiveness of utilizing a theory-based breast cancer screening intervention in order to raise the awareness of women on conducting breast cancer screening.

The effect of web-based education on Pap smear behaviours of teachers

OBJECTIVE

Web-based education would be useful for gaining health-related behaviours. The aim of the study was to determine the effect of web-based education on Pap smear behaviours of teachers.

METHODS

The study was an experimental-control groups with a longitudinal type. The sample consisted of 1,290 teachers (experimental: 678, control: 612). The educational videos about cervical cancer and Pap smear test were sent to the experimental group via the web. Three months later, the teachers in both groups were contacted by telephone and asked whether they have a Pap smear test or not, reasons for not having it and test results. A qualitative interview was conducted with 20 teachers in the experimental group to evaluate the web-based education.

RESULTS

At the beginning of the study, 25.9% of the teachers in both groups had a Pap smear test. After three months, having a Pap smear test was found to be statistically significantly higher in the experimental group (31.6%) than the control group (23.2%). According to the result of pathology, in the control group cervical cancer (n = 1), in the experimental group CIN1 (n = 1) and HPV53 (n = 1) were diagnosed.

CONCLUSION

The web-based education was found to be effective in Pap smear behaviours of teachers.

Predictive Power of PEN-3 Model Constructs in Breast Cancer Screening Behaviors among Teachers: A Cross- Sectional Study in Central Iran

Objective

Identifying the factors influencing screening is necessary to promote early detection of breast cancer. This study aims to determine the predictive power of PEN-3 model structures in breast cancer screening behaviors among teachers of Isfahan city in Iran.

Materials and Methods

This cross-sectional study was conducted on 192 female teachers in Isfahan selected by the multi-stage random sampling method. A questionnaire based on PEN-3 model was used for data collection. Statistical analysis was conducted using SPSS version 20 (multiple linear regression analysis, independent t-test, Pearson correlation coefficient), and p<0.05 was considered statistically significant.

Results

The mean score of behavior, perceptual, enabling and nurturer factors in early detection of breast cancer was 36.5±30.5, 74.6±8.9, 65.5±19.9 and 68.1±20.7, respectively. The mean score of behavior in early detection of breast cancer in women with individual and familial history of breast disease was significantly higher than that of those who did not have such history. Perceptual and nurturer factors as the best predictors of screening behaviors were associated with screening behaviors.

Conclusion

The study results indicate that nurturer and perceptual factors were the best predictors of breast cancer screening behaviors among teachers. Therefore, attention to these constructs in developing educational interventions is highly recommended.

Comparing individual and peer education on the constructs of theory of planned behavior in mammography

INTRODUCTION

Breast cancer is the most common cancer in women. It can be diagnosed in the first stage by screening. One of the methods for screening breast cancer is mammography. Mammography as a health behavior needs education. The theory of planned behavior examines the factors associated with the behavior.

AIM

This research was conducted to compare the individual and peer education on the constructs of the theory of planned behavior in mammography.

METHODS

This study was a clinical trial. A total of 100 women who attending the selected health centers of Isfahan city were classified randomly into two groups: peer and individual education. Education was based on the constructs of the theory of planned behavior (attitude relative to the mammography behavior, subjective norms, perceived behavioral control, and behavioral intention). The data were collected using a researcher-made questionnaire. Data were analyzed using descriptive-analytical statistics.

RESULTS

The mean score of attitude toward behavior in the individual education group was significantly higher than peer education (P < 0.05). In addition, the average score of subjective norms in peer education group was significantly higher than individual education (P < 0.05). The mean scores of perceived behavioral control constructs and behavioral intention were not significantly different (P > 0.05).

DISCUSSION

The results of this study showed the effectiveness of education (individual and peer) based on the theory of planned behavior on attitude toward behavior, subjective norms, perceived behavioral control, and behavioral intention related to performing mammography in women. It seems that using educational intervention can be useful to promote the screening behaviors of breast cancer. In general, there were no significant differences between the two methods in changing theoretical constructs.