Carmen W. H. Chan

Educational Interventions to Promote Cervical Cancer Screening among Rural Populations: A Systematic Review

The urban–rural gap in cervical cancer screening uptake is a significant public health consideration. Educational interventions are commonly adopted to promote cervical cancer screening among females in rural areas; however, the characteristics and effectiveness of these educational interventions remain unclear. In this review, we aimed to identify the characteristics of educational interventions used in rural populations and to evaluate the effects of these interventions on cervical cancer screening-related outcomes. Seven English databases were searched in January 2022. Randomized controlled trials (RCTs) and quasi-experimental studies were included. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Randomized Controlled Trials and the JBI Critical Appraisal Checklist for Quasi-Experimental Studies were used for quality appraisal. RevMan 5.4 software was used for the meta-analysis. A narrative synthesis was conducted in instances where a meta-analysis was inappropriate. Three RCTs and seven quasi-experimental studies conducted in six countries were included. A social cognitive theory-based framework, the community setting, group sessions, healthcare professional-led approaches, and culture-tailored materials were implemented in the educational interventions for cervical cancer screening. The educational content mainly included basic information on cervical cancer screening, psychological issues, barriers and strategies to overcome them, and locally available resources. Educational interventions increased the knowledge and uptake of cervical cancer screening in the rural population. However, the studies only evaluated the short-term effects of these educational interventions, with the cervical screening behavior only being assessed in one instance for each participant. Educational interventions promote cervical cancer screening among females in rural areas. Theory-driven, community-involved, group-based, and healthcare professional-led approaches should be prioritized in the application of educational interventions in rural populations. Both the short- and long-term, influences of educational interventions on the cervical cancer screening behavior of females in rural areas need to be recognized.

Randomised controlled trial of music listening combined with progressive muscle relaxation for mood management in women receiving chemotherapy for cancer

Abstract Aims To evaluate the effects of passive music listening combined with progressive muscle relaxation on anxiety, depression, stress, coping, and quality-of-life in women with breast and gynaecological cancers receiving chemotherapy. Methods This was an assessor-blinded, randomised wait-list controlled trial. A total of 120 participants were randomly allocated into an intervention group or a wait-list control group. The intervention group received an intervention comprising training on passive music listening and progressive muscle relaxation, with once-daily self-practice at home for 3 weeks. The wait-list control group received the same intervention after the outcome assessment at week 6. All outcome data were collected before (T0) and 3 weeks (T1), 6 weeks (T2), and 12 months (T3) after randomisation. A generalised estimating equations model was used to compare the changes in each outcome at different time points. Process evaluation was conducted using data from the patient’s self-report forms and interviews. Results The findings indicated that at T1 and T2, the intervention group’s reductions in anxiety were significantly larger than those of the control group. Additionally, the intervention group exhibited significantly better decreases in depression at T2, stress at T1, and dysfunctional coping at T2, and a greater improvement in quality-of-life score at T1 and T2 when compared to the control group. Most of the interviewed participants provided positive feedback on the intervention. Conclusions The intervention was beneficial for lowering anxiety, depression, and stress and increasing the quality-of-life of women receiving chemotherapy for breast and gynaecological cancers. Trial registration. The trial was prospectively registered with ClinicalTrials.gov on 9 February 2022 (registration number: NCT05262621).