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Shariati Sarcheshme M, Mahdizadeh M, Tehrani H, Vahedian-Shahroodi M. Exploring the barriers to Pap smear test compliance: A qualitative study for improving cervical cancer screening in the primary health care. Health Promot Perspect 2024; 14:80-88. [PMID: 38623347 PMCID: PMC11016146 DOI: 10.34172/hpp.42485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 02/19/2024] [Indexed: 04/17/2024] Open
Abstract
Background Cervical cancer in Iran ranks as the fourth most frequent cancer among women. Pap smear (PS) is the best standard for detecting cervical cancer, but many people, even healthcare providers (HCPs), do not maintain it. HCPs play a critical role in promoting PS uptake. The purpose of the study was to explore barriers to cervical cancer PS screening compliance from the HCPs' perspective. Methods The present qualitative content analysis was conducted through semi-structured in-depth interviews. A total of 28 HCPs were interviewed between July and August 2020. A diverse sample of HCPs was selected using purposive sampling. Data analysis was based on the five steps proposed by Graneheim and Lundman. MAXQDA (2020) was used for data analyzing. Results Ten key sub-categories were identified and organized into three categories: individual, environmental, and socio-cultural factors. The sub-categories included inadequate risk perception, inappropriate attitude, low commitment, emotional factors, low priority over health, requirements and consequences of the test, deficiencies of health centers, organizational factors, traditions and religious believes. Conclusion HCPs face multiple barriers for PS. Exploring and decreasing barriers of PS in HCPs may increase compliance in them and their clients because they play an influential role in instructing and persuading women to take the PS. There is need to explore these barriers and identify possible interventions to change them. Insights from this study are useful for developing policies around national PS programs, too.
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Affiliation(s)
- Mansoore Shariati Sarcheshme
- Department of Midwifery, Neyshabur Branch, Islamic Azad University, Neyshabur, Iran
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehrsadat Mahdizadeh
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Tehrani
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Vahedian-Shahroodi
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
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Ahadinezhad B, Maleki A, Amerzadeh M, Mohtashamzadeh B, Khosravizadeh O. What rate of Iranian women perform Pap smear test? Results from a meta-analysis. Prev Med 2024; 180:107871. [PMID: 38262561 DOI: 10.1016/j.ypmed.2024.107871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 12/30/2023] [Accepted: 01/18/2024] [Indexed: 01/25/2024]
Abstract
In this study, an attempt was made to estimate the aggregated proportion of Pap smear test uptake among women in Iran from 2012 to 2022 using meta-analysis. The data collection process involved reviewing records registered in databases between January 1, 2012, and September 11, 2022. The final data was analyzed using random effects models, and potential heterogeneity was assessed using the I2 index. To examine publication bias, Egger's test and Funnel Plot were employed. Sensitivity analysis, specifically single study exclusion Meta-analysis, was conducted to assess the influence of each individual study on the aggregated percentage of Pap smear test uptake. A total of 28,754 women were included across the 33 articles analyzed. The pooled percentage of Pap smear test uptake for both one-time and regular screenings was found to be 46.52% (95% CI: 40.91 to 52.14) and 17.80% (95% CI: 12.42 to 23.18), respectively. No significant evidence of publication bias was detected, although the influence of smaller studies was confirmed. Sensitivity analysis indicated that the overall rate of Pap smear test uptake was not highly sensitive to the results of individual studies. The findings emphasize the low rate of regular Pap smear testing among Iranian women and suggest that tailored interventions considering cultural and geographical factors specific to different provinces in Iran could help increase the utilization of this screening service.
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Affiliation(s)
- Bahman Ahadinezhad
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Aisa Maleki
- Student Research Committee, Qazvin University of Medical Sciences, Iran
| | - Mohammad Amerzadeh
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | | | - Omid Khosravizadeh
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
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Safari-Faramani B, Safari-Faramani R, Najafi F, Zavareh DK, Karyani AK, Darbandi M. Socioeconomic disparities in Papanicolaou test utilization in Western Iran. BMC Public Health 2024; 24:471. [PMID: 38355473 PMCID: PMC10868049 DOI: 10.1186/s12889-024-17927-x] [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: 02/27/2023] [Accepted: 01/30/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Cervical cancer remains the fourth most frequently diagnosed cancer among women, and its impact is particularly significant in women residing in less developed countries. This study aims to assess socioeconomic inequality in using Papanicolaou tests, commonly known as Pap tests, which are crucial for detecting cervical cancer. The research also seeks to decompose this inequality, identifying its contributing factors. This investigation is conducted within a sizable population-based study focused on the Kurdish population, with an additional examination of potential variations between urban and rural areas. METHOD The study utilized baseline data from the Ravansar Non-Communicable Disease Cohort Study (RaNCD), involving 3,074 ever-married women aged 35-65. Asset data was employed to determine socioeconomic status (SES), and Principal Component Analysis was applied. The uptake of Papanicolaou tests was assessed for inequality using the Concentration Index (Cn). Additionally, decomposition analysis was conducted to identify and understand the factors contributing to socioeconomic inequality. RESULTS The study found that overall, 86% of women reported having undergone cervical cancer screening at least once in their lifetime. The Concentration Index (Cn) for the total population was 0.21 (p < 0.0001), indicating a higher concentration of Papanicolaou test uptake among wealthier groups. In urban areas, the Cn was 0.34 (p < 0.0001), reflecting a significant concentration among the rich. However, in rural areas, the Cn was -0.10 (p = 0.3006), suggesting no significant socioeconomic inequality. Factors such as socioeconomic status (SES), education, and age contributed to reducing inequality, explaining 62.7%, 36.0%, and 1.7% of the observed inequality, respectively. Interestingly, place of residence had a negative influence on inequality. CONCLUSION The uptake of Papanicolaou tests varies across different socioeconomic status levels, with a higher concentration among wealthier groups. The results enable health policymakers and researchers to tailor health intervention toward increasing public awareness, especially among women with lower levels of education women in economically deprived groups.
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Affiliation(s)
- Bahare Safari-Faramani
- Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Roya Safari-Faramani
- Social Development and Health Promotion Research Center, Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Farid Najafi
- Social Development and Health Promotion Research Center, Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Davoud Khorasani Zavareh
- Department of Health in Emergencies and Disasters, Workplace Health Promotion Research Center (WHPRC), School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Neurobiology, Care Sciences and Society (NVS), H1, Division of Family Medicine and Primary Care, Huddinge, Sweden
| | - Ali Kazemi Karyani
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mitra Darbandi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Motamedinasab M, Karimi-Zarchi M, Marzbanrad Z, Mirmajidi SR, Vakili-Ojarood M, Azizi S, Barahman M, Yeganegy M, Aghasipour M, Khajehnoori S, Aghili K, Neamatzadeh H. Lack of Association between TP73 G4C14-A4T14 Polymorphism and Cervical Cancer Risk in Overall and Asian Women: A Meta-Analysis. Asian Pac J Cancer Prev 2024; 25:661-670. [PMID: 38415554 PMCID: PMC11077128 DOI: 10.31557/apjcp.2024.25.2.661] [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: 10/22/2023] [Accepted: 02/19/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Growing studies revealed the association between polymorphisms in Tumor Protein TP73 (TP73) and susceptibility to cancer, especially with gynecological cancers. but, the results remained inconsistent. This meta-analysis was carried out to examine the relationship of the TP73 G4C14-to-A4T14 polymorphism (hereafter, G4C14-to-A4T14) with susceptibility to cervical cancer globally and by ethnicity. METHODS Eligible studies were collected by retrieving PubMed, Scopus, Web of Science, Embase, Wan Fang, and CNKI published before 25 October, 2023. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of such association. RESULTS A total of 10 case-control studies with 1804 cervical cancer cases and 2433 healthy controls were included to this study. The pooled results showed that TP73 G4C14-to-A4T14 polymorphism was not associated with cervical cancer risk in overall. in terms of stratified analyses by ethnicity, this polymorphism was not associated with risk of cervical cancer among East-Asian women. however, there was a significant association based source of control among hospital-based studies. CONCLUSIONS Inconsistent with previous meta-analyses, our pooled results revealed that TP73 G4C14-to-A4T14 polymorphism might not be a risk factor for development of cervical cancer globally and among East-Asian women. Moreover, further studies examining the effect of gene-gene and gene-environment interactions may eventually provide a better knowledge.
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Affiliation(s)
- Maryam Motamedinasab
- Department of Obstetrics and Gynecology, Firoozgar Clinical Research Development Center, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
- Department of Obstetrics and Gynecology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Mojgan Karimi-Zarchi
- Department of Gynecologic Oncology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
| | - Zahra Marzbanrad
- Department of Obstetrics and Gynecology, Firoozgar Clinical Research Development Center, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
| | - Seyedeh Roghayeh Mirmajidi
- Department of Obstetrics and Gynecology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
| | - Mohammad Vakili-Ojarood
- Department of Surgery, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
| | - Sepideh Azizi
- Shahid Akbarabadi Clinical Research Development Unit, Iran University of Medical Sciences, Tehran, Iran.
| | - Maedeh Barahman
- Department of Radiation Oncology, Firoozgar Clinical Research Development Center, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
| | - Maryam Yeganegy
- Department of Obstetrics and Gynecology, Iranshahr University of Medical Sciences, Iranshahr, Iran.
| | - Maryam Aghasipour
- Department of Cancer Biology, College of Medicine, University of Cincinnati, Ohio, USA.
| | - Sahel Khajehnoori
- Hematology and Oncology Research Center, Shahid Sadoughi Hospital, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Kazem Aghili
- Department of Radiology, Shahid Rahnemoun Hospital, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Hossein Neamatzadeh
- Mother and Newborn Health Research Center, Shahid Sadoughi Hospital, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Shariati-Sarcheshme M, Mahdizdeh M, Tehrani H, Jamali J, Vahedian-Shahroodi M. Women's perception of barriers and facilitators of cervical cancer Pap smear screening: a qualitative study. BMJ Open 2024; 14:e072954. [PMID: 38191254 PMCID: PMC10806721 DOI: 10.1136/bmjopen-2023-072954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 11/16/2023] [Indexed: 01/10/2024] Open
Abstract
OBJECTIVE Although Pap smear (PS) is considered the best standard in detecting cervical cancer, adherence to timely and regular PS is often lower than global standards in developing countries. Thus, the present study aimed to identify barriers and facilitators of adherence to cervical cancer screening in Mashhad, Iran. DESIGN A qualitative content analysis was done from July to December 2022 using semistructured in-depth interviews. SETTING The study was conducted in health centres in Mashhad, Iran. PARTICIPANTS A sample of 36 married women aged 18-70 years was selected using a purposive sampling, with maximum diversity. RESULTS The mean age of participants was 42.8±7.6 years. Among all, 66.7% had the PS test at least once; only 8.3% regularly had the test. The qualitative content analysis led to the extraction of four major themes: (1) individual challenges, (2) environmental limitations, (3) individual motivators, and (4) supportive and efficient environments. The most significant barriers were psychological stress, unhealthy attitudes, insufficient information, cultural issues and insufficient healthcare services. Facilitators included an active and efficient healthcare system, advice and support of important others, and positive emotions and individual beliefs. CONCLUSIONS Participants' perceptions showed that the main factors influencing the PS testing were supportive environments, individual motivators, individual challenges and environmental limitations. To encourage women to take the PS and reduce barriers, it may be necessary to revise current health system policies, promote individual and public awareness, reduce psychological stress and correct negative beliefs and attitudes.
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Affiliation(s)
- Mansoore Shariati-Sarcheshme
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehrsadat Mahdizdeh
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinant of Health Research center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Tehrani
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinant of Health Research center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Jamshid Jamali
- Social Determinant of Health Research center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Vahedian-Shahroodi
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinant of Health Research center, Mashhad University of Medical Sciences, Mashhad, Iran
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Yoosefi Lebni J, Irandoost SF, Ziapour A, Ahmadi A, Mehedi N, Azizi SA. Identification of causes and consequences of Kolberi among Iranian Kurdish women: a grounded theory study. BMC Womens Health 2023; 23:648. [PMID: 38053054 PMCID: PMC10696815 DOI: 10.1186/s12905-023-02791-5] [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: 01/10/2023] [Accepted: 11/19/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Women turn to Kolberi for various reasons, which cause numerous challenges for them. Thus, it is imperative to identify these causes and problems. Since no study has ever been undertaken to deal with this participant, the present research aims to identify the causes and consequences of Kolberi among Kurdish women in Iran. METHOD The present research uses the grounded theory approach to investigate 28 female Kurdish Kolbers. To achieve several participants, purposive, snowball, and theoretical sampling methods were used, while face-to-face semi-structured interviews were used to gather data. The process of data collection and analysis took 10 months, from April to December 2022. The data were analyzed using the Strauss and Corbin method and MAXQDA-20018 software. The Guba and Lincoln criteria were also met to increase the trustworthiness of the results. FINDINGS Analysis of the data led to 143 initial codes, 31 subcategories, and 9 main categories: Causal condition (individual characteristics and economic factors); predisposing conditions (social and cultural factors, familial factors); intervening conditions (advantages and characteristics of Kolberi); strategies (strengthening compatibility with Kolberi); and consequences (individual problems, social problems and positive consequences). CONCLUSION Measures such as training occupational skills for women and providing employment conditions for them, increasing social, financial, and mental support for women without guardians, creating border markets, and expanding women's handicrafts can help prevent female Kolberi.
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Affiliation(s)
- Javad Yoosefi Lebni
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Seyed Fahim Irandoost
- Department of Community Medicine, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Arash Ziapour
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ahmad Ahmadi
- Faculty of Psychology and Educational Sciences, Allameh Tabataba'i University, Tehran, Iran
| | - Nafiul Mehedi
- Department of Social Work, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Seyyed Amar Azizi
- Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran.
- University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
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Xue Y, Zheng X, Wu G, Wang J. Rapid diagnosis of cervical cancer based on serum FTIR spectroscopy and support vector machines. Lasers Med Sci 2023; 38:276. [PMID: 38001244 DOI: 10.1007/s10103-023-03930-y] [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: 09/15/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023]
Abstract
Cervical cancer is one of the most common malignant tumors among female gynecological diseases. This paper aims to explore the feasibility of utilizing serum Fourier Transform Infrared (FTIR) spectroscopy, combined with machine learning and deep learning algorithms, to efficiently differentiate between healthy individuals, hysteromyoma patients, and cervical cancer patients. In this study, serum samples from 30 groups of hysteromyoma, 36 groups of cervical cancer, and 30 healthy groups were collected and FTIR spectra of each group were recorded. In addition, the raw datasets were averaged according to the number of scans to obtain an average dataset, and the raw datasets were spectrally enhanced to obtain an augmentation dataset, resulting in a total of three sets of data with sizes of 258, 96, and 1806, respectively. Then, the hyperparameters in the four kernel functions of the Support Vector Machine (SVM) model were optimized by grid search and leave-one-out (LOO) cross-validation. The resulting SVM models achieved recognition accuracies ranging from 85.0% to 100.0% on the test set. Furthermore, a one-dimensional convolutional neural network (1D-CNN) demonstrated a recognition accuracy of 75.0% to 90.0% on the test set. It can be concluded that the use of serum FTIR spectroscopy combined with the SVM algorithm for the diagnosis of cervical cancer has important medical significance.
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Affiliation(s)
- Yunfei Xue
- College of Software, Xinjiang University, 830046, Urumqi, China
| | - Xiangxiang Zheng
- Tianjin Key Laboratory for Control Theory & Applications in Complicated Systems, School of Electrical Engineering and Automation, Tianjin University of Technology, 300384, Tianjin, China
| | - Guohua Wu
- School of Electronic Engineering, Beijing University of Posts and Telecommunicationsn, 100876, Beijing, China.
| | - Jing Wang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Department of Gynecology, The First Affiliated Hospital of Xinjiang Medical University, 830054, Urumqi, China
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Safarnavadeh M, Ghanbari M, Salehi L. Dietary Fiber Intake and Related Factors in Community-Based Iranian's Elderly. Med J Islam Repub Iran 2023; 37:75. [PMID: 37600630 PMCID: PMC10439697 DOI: 10.47176/mjiri.37.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Indexed: 08/22/2023] Open
Abstract
Background There are considerable documents suggesting that inadequate fiber intake (FI) is a key risk factor for various chronic diseases. The aim of this study was to investigate Dietary FI in the Persian elderly. Methods This descriptive-analytic study was performed to investigate FI in a sample of the elderly who received free services from healthcare centers in Karaj, Iran. For sampling method: at first, the names of 36 centers were written on small pieces of paper and poured into a container, then another person was asked to randomly select the names of 10 centers, then referring to each of the centers and preparing a list of elderly people, the study subjects were selected, The study was conducted between September 2018, and April 2019Several questionnaires were used to collect data regarding DF: characteristics, daily FI , knowledge, SE (self-efficacy), perceived benefits, and barriers towards FI as well as stage of readiness of FI. t-test and ANOVA were used to compare independent mean values. Data were checked for normality before analysis by using Kolmogorov-Smirnov (K-S) test to check data normality. Results Totally of 400 elderly individuals entered the study with the average amount of fiber per day. The data analysis indicated they did not know the recommended intake of at least 25 gr each day. feeling less hungry and fiber's price was the most frequent perceived benefits and barriers towards FI , respectively. Gastrointestinal diseases ( P < 0.001), smoking (P < 0.001), and perceived barriers (P < 0.001), were statistically significant independent positive predictors of FI. Conclusion The findings of the current study indicated that FI among elderly people in Iran was very low and varied a great by gender, education, marital status, income level, employment status, smoking, stage of change, and gastrointestinal disease.
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Affiliation(s)
- Maryam Safarnavadeh
- Vice Chancellery for Education, Iran Ministry of Health and Medical Education,
Tehran, Iran
| | - Mahin Ghanbari
- Department of Health Promotion and Education, Alborz University of Medical
Sciences, Karaj, Iran
| | - Leili Salehi
- Department of Health Promotion and Education, Alborz University of Medical
Sciences, Karaj, Iran
- Research Center for Health, Safety and Environment, Alborz University of
Medical Sciences, Karaj, Iran
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Utilization of cervical cancer screening services and its associated factors in Iran: a case-control study. Infect Agent Cancer 2023; 18:17. [PMID: 36906592 PMCID: PMC10008011 DOI: 10.1186/s13027-023-00496-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 03/07/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND Considering the high incidence rate of cervical cancer (CC) in Iran, screening is an effective way of reducing the impact of the disease due to early detection. Thus, the recognition of the factors affecting the use of cervical cancer screening (CCS) services is essential.The present study aimed to determine the associated factors of CCS in women living in the suburbs of Bandar Abbas in the south of Iran. METHODS The present case-control study was conducted between January and March 2022 in the suburban areas of Bandar abbas. Two hundred participants were assigned to the case group and 400 participants were assigned to the control group. A self-constructed questionnaire was used to collect the data. This questionnaire contained demographic information, reproductive information, knowledge of CC, knowledge of CCS and access to the screening. Univariate and multivariate regression analyses were run to analyze the data. The data were analyzed in STATA 14.2 at a significance level of p < 0.05. RESULTS The mean and standard deviation of participants' age in the case group was 30.33 ± 4.892, and in the control group was 31.35 ± 6.149. The mean and standard deviation of knowledge in the case group was 10.21 ± 1.815 and in the control group was 7.24 ± 2.447. The mean and standard deviation of access was 43.72 ± 6.339 in the case and 37.17 ± 4.828 in the control group. The results of multivariate regression analysis showed the following factors increased the odds of CCS: knowledge (OR medium = 18.697, OR high = 13.413), access (OR medium = 4.028, OR high = 8.126), being married (OR = 3.193), being educated (OR diploma = 2.587, OR university degree = 1.432), middle and high SES (OR Middle = 6.078, OR Upper = 6.608), and not smoking (OR = 1.144). Also, women's reproductive status, including history of sexually transmitted diseases (OR = 2.612), use of oral contraceptives (OR = 1.579), sexual hygiene (OR = 8.718). CONCLUSIONS In the light of the present findings, it can be concluded that besides increasing suburban women's knowledge, their access to screening facilities should be improved. The present findings showed the need to remove the barriers to CCS in women of low SES to increase the rate of CCS. The present findings contribute to a better understanding of factors involved in CCS.
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Kazemi S, Zarei F, Heidarnia A, Alhani F. Improve the cervical cancer prevention behaviors through mobile-based educational intervention based on I-CHANGE model: study protocol for a randomized controlled trial. Trials 2022; 23:805. [PMID: 36153560 PMCID: PMC9509552 DOI: 10.1186/s13063-022-06744-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 09/13/2022] [Indexed: 12/24/2022] Open
Abstract
Background Applications of mobile technologies (mHealth) have the potential to reduce health inequalities, give patients more control over their health, and improve health care’s cost-effectiveness. The widespread use of mobile phones offers us a new way to prevent cervical cancer. The objective of the study was to design and develop a mobile phone application (app) that aims to conduct a behavioral intervention for women and to evaluate the efficacy of the app-based intervention. Methods This study involves 5 phases. In the first phase, understanding women’s perspectives will be identified using a qualitative approach based on the I-Change model. In phase 2, the results from the qualitative approach and requirement prioritization through providing experts’ perspectives will be done. The main outputs of this phase will be resulted in prioritizing the main measurable effective variables of the I-Change model. Phase 3 will be processed for the development and psychometric of an assessment tool regarding selected constructs. In phase 4, the App framework and content development will be performed. In phase 5, a three-armed, parallel-design randomized controlled trial will be conducted on women. Two hundred ten women will be randomly assigned to three groups including two intervention groups and one control group. The intervention groups included the following: (1) a mobile application and (2) a digital book. The data will be evaluated using tools designed and constructed in phase 3 of the study at baseline in 3-month follow-up assessments. The impact of the two interventions on cervical cancer prevention behaviors through mobile-based educational intervention will then be evaluated. Discussion A theory-based health education program using a mobile app to improve cervical cancer-preventive behaviors will be implemented for the first time in Iran. With an effective health mobile-based educational design, it is very important to determine whether Iranian women will be motivated to adhere to preventive behavior related to CC. Trial registration Iranian Clinical Trial Register IRCT20181205041861N3. Registered V2.0 on 26 October 2021.
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