The effect of health education on hypertension, diabetes mellitus, and cervical cancer screening service utilization among eligible adults in a district around Bahir Dar city, Ethiopia: a cluster randomized controlled community trial
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While screening service utilization is a proven strategy for early detection of noncommunicable diseases, population-based health checkup service utilization is very low in Ethiopia. This study aimed to assess the effect of health education in improving hypertension, diabetes mellitus, and cervical cancer screening service utilization in a district around Bahir Dar City, Ethiopia in 2024. A cluster randomized controlled community trial was conducted in a district around Bahir Dar City among 214 adults in the intervention and control groups each. The intervention was health education. Trained parent-teacher association members provided a 30 min to 1 h education for the community using the existing social structures. Adults in the control group continue receiving the routine education through the health care system A structured interviewer-administered questionnaire was used to collect data. MacNemar's test was used to assess the intervention effect. Binary logistic regression was also used to assess the intervention effect after controlling confounders. Overall difference in knowledge level of adults between the intervention and control groups was 34.4% (P < 0.005). This difference persists after controlling potential confounders. Respondents in the intervention group had 2.2 times better knowledge about noncommunicable diseases compared with respondents in the control group [AOR = 2.22, 95% CI: (1.4, 3.4)]. The overall difference in utilization of screening services for targeted NCDs between the intervention and control groups was 28.1% (P < 0.001). This difference persists after potential confounders were controlled. Respondents in the intervention group were 4.8 times more likely to utilize screening services compared with respondents in the control group [AOR = 4.83, 95% CI: (2.7, 8.5)]. Health education intervention through parent-teacher association members was an effective approach to improve screening service utilization. This study suggests to use parent-teacher association members to promote screening service utilization through the existing social structures. The trial was registered in Clinical Trials.gov (NCT06639412).