Effectiveness of a Health Education Program to Improve Knowledge and Attitude Towards Cervical Cancer and Pap Smear: A Controlled Community Trial in Malaysia
Open accessAbstract
OBJECTIVE: We examined the effectiveness of a health education program to improve; knowledge and attitude towards cervical cancer and Pap smear, and uptake of Pap smear test among female entrepreneurs in Kedah, a northern state of Malaysia. METHODS: This controlled community trial involved 210 women from the districts of Alor Setar and Sungai Petani. Simple random sampling was applied to select 105 women from each district. Self-administered questionnaires were used to obtain information about the variables of interest. Health education intervention program included educational talk, demo video, experience sharing, pamphlet distribution, and text message reminders. Evaluation of outcomes was performed twice. The text message reminders acted as the cues to action that were sent between the two evaluation times at one-month interval. Women in the control group received educational talk alone. In the control group, evaluation of outcomes was done only once, which was one month after the educational talk. RESULTS: Knowledge on cervical cancer and Pap smear, and attitude towards Pap smear among women in both intervention and control group improved significantly at Evaluation stage 1. However, no further improvements were observed in the intervention group at Evaluation stage 2. The uptake of Pap smear in the intervention group increased significantly from 48.0% at Baseline to 68.0% at Evaluation stage 1 (P<0.001), and from 68.0% to 79.0% at Evaluation stage 2 (P<0.001). A significant increase in Pap smear uptake was also seen in the control group from 63.0% at Baseline to 76.0% at Evaluation stage 1 (P=0.003). CONCLUSIONS: Educational talk alone was effective in improving knowledge on cervical cancer and Pap smear, attitude towards the test, and the actual uptake of the test. However, text reminders were more effective than having an educational talk alone in increasing uptake of Pap smear test among participants. .
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The behavior finding was in line with some studies and inconsistent with another.
“This finding was in line with the results of the studies conducted by Jeihooni et al. [24], Pirzadeh and Amidi Mazaheri [19], Romli et al. [30], Daryani et al. [31], yet inconsistent with the results of the study conducted by Adamu et al. [20].”
From Effectiveness of educational intervention on women’s participation to cervical cancer screening: a quasi-experimental study based on PEN-3 model (2022) · cites this paper as [30]
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A Meta-Analysis of the Effectiveness of Health Belief Model Variables in Predicting Behavior
Carpenter, C. J. (2010) · Health Communication · doi:10.1080/10410236.2010.521906 · Cited by 1,604 · see citing works
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Seyrafi, N., Homayuni, A., Hosseini, Z., Aghamolaei, T., Ghanbarnejad, A., & Mouseli, A. (2022) · BMC Cancer · doi:10.1186/s12885-022-10331-x · Cited by 14 · see citing works
“[30] recruited female entrepreneurs in the northern state of Malaysia and found that the Pap smear test in the intervention group changed significantly from 48% (in the baseline state) to 68% (in evaluation 1) and from 68 to 79% in the next evaluation.”
Background
- Authors
- Romli, R., Shahabudin, S., Saddki, N., & Mokhtar, N.
- Affiliations
- Universiti Sains Malaysia (MY)
- Corresponding author
- Shahabudin, Sa’adiah
- Venue
- Asian Pacific Journal of Cancer Prevention
- Publisher
- EpiSmart Science Vector Ltd
- Published
- 2020-03-01
- Volume
- 21
- Issue
- 3
- Pages
- 853-859
- ISSN
- 1513-7368 (ISSN-L)
- 2476-762X
- PMC
- PMC7437328
- OpenAlex
- W3013926748
- Cited by
- 54
- References
- 1
- Citations by year
- 2026: 10 · 2025: 4 · 2024: 11 · 2023: 4 · 2022: 15 · 2021: 8 · 2020: 2
- FWCI
- 5.44
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Asian Pacific Journal of Cancer Prevention (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Greater South Information System
- Funders
- Universiti Sains Malaysia
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- cervical cancer, Pap smear, health education, cervical cancer screening uptake, knowledge and attitudes, SMS reminders, women entrepreneurs, Kedah
- MeSH terms
- Adult, Aged, Attitude to Health, Uterine Cervical Neoplasms, Female, Health Education, Health Promotion, Humans, Malaysia, Middle Aged, Young Adult, Papanicolaou Test
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