Fatemeh Zarei

From screen to screening: a randomized controlled trial on mHealth vs. traditional training on knowledge, attitudes, practice, self-efficacy, and adherence intention to pap smear

Cervical cancer (CC) is a significant global health concern, particularly in low- and middle-income countries, where screening participation remains low. This study aimed to compare the effectiveness of two educational interventions, a mobile application-based program (mHealth) and face-to-face training (F2F), in improving knowledge, attitudes, self-efficacy, practices, and Adherence Intention to Pap smear testing among women in Saveh, Iran. This study was a parallel-group randomized controlled trial (RCT) conducted between 2023 and 2024. The participants were randomly assigned to three groups: (A) control, (B) F2F training, and (C) mHealth-based education (via the PapTest smartphone app). Data were collected at four time points: baseline (pretest), immediately postintervention, four weeks postintervention, and twelve weeks postintervention. The primary outcomes were measured via two validated instruments: the Cervical Cancer Screening Self-Efficacy Scale and the Self-Efficacy Scale for Pap Smear Screening Participation (SES-PSSP). Statistical analyses, including correlation tests, chi-square tests, ANOVAs, and Kruskal‒Wallis tests were performed via SPSS version 24. The intervention phase results revealed significant differences over time and across groups in terms of knowledge, attitudes, self-efficacy, and practices (P  0.05). Both mHealth-based education and F2F training significantly improved knowledge, attitudes, self-efficacy, and practices related to Pap smear screening. However, the mobile app intervention demonstrated greater and more sustained improvements than did face-to-face training. Given their accessibility, cost-effectiveness, and scalability, mHealth interventions represent a promising strategy for enhancing cervical cancer screening Adherence Intention. Future research should explore longer follow-up periods and hybrid education models to optimize screening participation and Adherence Intention in diverse populations. Iranian Clinical Trial Register (IRCT20231130060228N1). Registration date: 2024-02-19, 1402/11/30. URL: https://irct.behdasht.gov.ir/trial/74165 .

A blended educational intervention program on Pap-test related behavior among Iranian women

Abstract Objective To assess the effect of a blended educational program to promote performing the PST among Iranian women. Design In a randomized control trial four main variables; knowledge, attitude, self-efficacy, and practice about PST was evaluated using a man–made questionnaire for PST. Setting Women aged 18–49 living in Andimeshk (Khuzestan, Iran), covered by 16 health centers, participated in study from November 2019 till April 2019. Method The educational intervention conducted to increasing women’s performing the PST. The experimental group received an intervention, whereas the control group received usual care. Participants were tested at four-time points: pre-test (baseline), post-test 1 (immediately after the program’s completion) post-test 2 (4 weeks after the program’s completion) and post-test 3 (12 weeks after the program completion). Results A total of 84 women with average aged 32.27 (42 in the experimental group, 42 in the control group) were recruited from 16 health centers in Andimeshk, southern Iran. Significant group differences were found at different times in knowledge, attitude, self-efficacy, and practice about PST. Conclusion A blended method was effective in sustaining the effects of the educational program in the experimental group. The development of appropriate teaching method on restricted situation such as COVID-19 pandemic to promote participation is suggested.

Improve the cervical cancer prevention behaviors through mobile-based educational intervention based on I-CHANGE model: study protocol for a randomized controlled trial

AbstractBackgroundApplications 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.MethodsThis 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.DiscussionA 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 registrationIranian Clinical Trial Register IRCT20181205041861N3. Registered V2.0 on 26 October 2021.