Background and Objectives: For women, health literacy level is an important factor directly affecting their health protection and development behaviors. The aim of this study was to evaluate the effect of health literacy interventions on breast cancer knowledge and health literacy breast cancer screening beliefs and behaviors.
Materials and Methods: This randomized controlled experimental study was conducted with women working in two different municipalities in Istanbul/Turkey. The study was completed with a total of 86 participants, 43 in the training group and 43 in the control group. The participants in the training group were given a comprehensive training program by the researchers in groups of 10-12 people in 3-hour sessions per day for 3 consecutive days.
Results: In the first and second measurements after the intervention, it was observed that the training group’s Health Literacy Scale Total Score means increased compared to those of control group (training and control group post-test-1 scores, respectively; 98.395 ± 21.388 vs. 86.372 ± 24.752, p=0.018, increased by 13.95%; training and control group post-test-2 scores, respectively; 112.904 ± 10.178 vs. 87.581 ± 26.531, p<0.001, increased by 28.73%. Also, in the first and second measurements after the intervention, it was observed that the control group’s Breast Cancer Screening Beliefs Scale Total Score means increased compared to those of the control group (training and control group post-test-1 scores, respectively; 77.862 ± 14.767 vs. 58.604 ± 16.001, p<0.001, increased by 32.75%; training and control group post-test-2 scores, respectively; 81.574 ± 12.478 vs. 58.917 ± 15.860, p<0.001, increased by 39.65%.
Conclusion: The comprehensive training program given to women, including what breast cancer is, its risk factors, etiology, early screening methods, treatment and breast self-examination, has positively changed their breast cancer screening beliefs, health literacy levels, and beliefs and practices regarding early diagnosis. |
- Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024 May 4;74(3):229-63. https://doi.org/10.3322/caac.21834 PMid:38572751
- Coleman C. Early Detection and Screening for Breast Cancer. Semin Oncol Nurs. 2017 May;33(2):141-55. https://doi.org/10.1016/j.soncn.2017.02.009 PMid:28365057
- Khrouf S, Letaief Ksontini F, Ayadi M, Belhaj Ali Rais H, Mezlini A. Breast cancer screening: a dividing controversy. Tunis Med. 2020 Jan;98(1):22-34.
- Nielsen S, Narayan AK. Breast Cancer Screening Modalities, Recommendations, and Novel Imaging Techniques. Surgical Clinics of North America. 2023 Feb;103(1):63-82. https://doi.org/10.1016/j.suc.2022.08.004 PMid:36410354
- Rahman WT, Helvie MA. Breast cancer screening in average and high-risk women. Best Pract Res Clin Obstet Gynaecol. 2022 Sep;83:3-14. https://doi.org/10.1016/j.bpobgyn.2021.11.007 PMid:34903436
- Mann RM, Athanasiou A, Baltzer PAT, Camps-Herrero J, Clauser P, Fallenberg EM, et al. Breast cancer screening in women with extremely dense breasts recommendations of the European Society of Breast Imaging (EUSOBI). Eur Radiol. 2022 Jun 8;32(6):4036-45. https://doi.org/10.1007/s00330-022-08617-6 PMid:35258677 PMCid:PMC9122856
- Sarker R, Islam MdS, Moonajilin MstS, Rahman M, Gesesew HA, Ward PR. Effectiveness of educational intervention on breast cancer knowledge and breast self-examination among female university students in Bangladesh: a pre-post quasi-experimental study. BMC Cancer. 2022 Dec 22;22(1):199. https://doi.org/10.1186/s12885-022-09311-y PMid:35193526 PMCid:PMC8862195
- Gkiouleka A, Wong G, Sowden S, Bambra C, Siersbaek R, Manji S, et al. Reducing health inequalities through general practice. Lancet Public Health. 2023 Jun;8(6):e463-72. https://doi.org/10.1016/S2468-2667(23)00093-2 PMid:37244675
- Batterham RW, Hawkins M, Collins PA, Buchbinder R, Osborne RH. Health literacy: applying current concepts to improve health services and reduce health inequalities. Public Health. 2016 Mar;132:3-12. https://doi.org/10.1016/j.puhe.2016.01.001 PMid:26872738
- Juvinyà-Canal D, Suñer-Soler R, Boixadós Porquet A, Vernay M, Blanchard H, Bertran-Noguer C. Health Literacy among Health and Social Care University Students. Int J Environ Res Public Health. 2020 Mar 27;17(7):2273. https://doi.org/10.3390/ijerph17072273 PMid:32230985 PMCid:PMC7177671
- Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low Health Literacy and Health Outcomes: An Updated Systematic Review. Ann Intern Med. 2011 Jul 19;155(2):97. https://doi.org/10.7326/0003-4819-155-2-201107190-00005 PMid:21768583
- Xie L, Zhang S, Xin M, Zhu M, Lu W, Mo PKH. Electronic health literacy and health-related outcomes among older adults: A systematic review. Prev Med (Baltim). 2022 Apr;157:106997. https://doi.org/10.1016/j.ypmed.2022.106997 PMid:35189203
- Kilfoyle KA, Vitko M, O'Conor R, Bailey SC. Health Literacy and Women's Reproductive Health: A Systematic Review. J Womens Health. 2016 Dec;25(12):1237-55. https://doi.org/10.1089/jwh.2016.5810 PMid:27564780 PMCid:PMC5175428
- Moore L, Hayes A. Cancer Health Literacy in Black Women With Breast Cancer: A Comprehensive Literature Review. Clin J Oncol Nurs. 2023 Oct 1;
- Ayaz Alyaka S, Ozturk FO. Health Literacy Levels of Women and Related Factors in Turkey. Journal of Nursing Research. 2021 Dec;29(6):e180. https://doi.org/10.1097/JNR.0000000000000452 PMid:34380974
- Huang CH, Lo YJ, Kuo KM, Lu IC, Wu H, Hsieh MT, et al. Health literacy and cancer screening behaviors among community-dwelling female adults in Taiwan. Women Health. 2021 May 28;61(5):408-19. https://doi.org/10.1080/03630242.2021.1917477 PMid:33902386
- Oldach BR, Katz ML. Health literacy and cancer screening: A systematic review. Patient Educ Couns. 2014 Feb;94(2):149-57. https://doi.org/10.1016/j.pec.2013.10.001 PMid:24207115 PMCid:PMC3946869
- Çelikkanat Ş, Akbaş M, Gökyıldız Sürücü Ş. Yetişkin Kadınların Sağlık Okuryazarlığı Düzeylerinin Belirlenmesi. Social Sciences Studies Journal. 2020 Jan 1;6(54):19-27. https://doi.org/10.26449/sssj.2009
- Hersh L, Salzman B, Snyderman D. Health Literacy in Primary Care Practice. Am Fam Physician. 2015 Jul 15;92(2):118-24.
- Wang YJ, Wang F, Yu LX, Xiang YJ, Zhou F, Huang SY, et al. Worldwide review with meta-analysis of women's awareness about breast cancer. Patient Educ Couns. 2022 Jul;105(7):1818-27. https://doi.org/10.1016/j.pec.2021.12.012 PMid:34952749
- Luque JS, Logan A, Soulen G, Armeson KE, Garrett DM, Davila CB, et al. Systematic Review of Mammography Screening Educational Interventions for Hispanic Women in the United States. Journal of Cancer Education. 2019 Jun 12;34(3):412-22. https://doi.org/10.1007/s13187-018-1321-0 PMid:29330754 PMCid:PMC6043417
- Berger S, Huang CC, Rubin CL. The Role of Community Education in Increasing Knowledge of Breast Health and Cancer: Findings from the Asian Breast Cancer Project in Boston, Massachusetts. Journal of Cancer Education. 2017 Mar 15;32(1):16-23. https://doi.org/10.1007/s13187-015-0911-3 PMid:26373418 PMCid:PMC6528474
- Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007 May;39(2):175-91. https://doi.org/10.3758/BF03193146 PMid:17695343
- Arifin WN. Random sampling and allocation using SPSS. Education in Medicine Journal. 2012 May 7;4(1). https://doi.org/10.5959/eimj.v4i1.4
- Kwok C, Fethney J, White K. Chinese Breast Cancer Screening Beliefs Questionnaire: development and psychometric testing with Chinese‐Australian women. J Adv Nurs. 2010 Jan 9;66(1):191-200. https://doi.org/10.1111/j.1365-2648.2009.05177.x PMid:20423444
- Türkoğlu N, Sis Çelik A. Validity and Reliability of the Turkish Version of the Breast Cancer Screening Beliefs Scale. Eur J Breast Health. 2021 Apr 1;17(2):116-22. https://doi.org/10.4274/ejbh.galenos.2020.5565 PMid:33870110 PMCid:PMC8025720
- Toci E, Burazeri G, Sorensen K, Kamberi H, Brand H. Concurrent validation of two key health literacy instruments in a South Eastern European population. The European Journal of Public Health. 2015 Jun 1;25(3):482-6. https://doi.org/10.1093/eurpub/cku190 PMid:25395401
- Aras Z, Bayık Temel A. Sağlık Okuryazarlığı Ölçeğinin Türkçe Formunun Geçerlilik Ve Güvenirliğinin Değerlendirilmesi. Florence Nightingale Hemşirelik Dergisi. 2017 Jul 14;25(2):85. https://doi.org/10.17672/fnhd.94626
- Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007 May;39(2):175-91. https://doi.org/10.3758/BF03193146 PMid:17695343
- Akhtari-Zavare M, Juni MH, Said SM, Ismail IZ, Latiff LA, Ataollahi Eshkoor S. Result of randomized control trial to increase breast health awareness among young females in Malaysia. BMC Public Health. 2016 Dec 8;16(1):738. https://doi.org/10.1186/s12889-016-3414-1 PMid:27502284 PMCid:PMC4977616
- Wu TY, Lee J. Promoting Breast Cancer Awareness and Screening Practices for Early Detection in Low-Resource Settings. Eur J Breast Health. 2019 Jan 7;15(1):18-25. https://doi.org/10.5152/ejbh.2018.4305 PMid:30816360 PMCid:PMC6385717
- Rabbani SA, Salem Khalaf Al Marzooqi AM, Mousa Srouji AE, Hamad EA, Mahtab A. Impact of community-based educational intervention on breast cancer and its screening awareness among Arab women in the United Arab Emirates. Clin Epidemiol Glob Health. 2019 Dec;7(4):600-5. https://doi.org/10.1016/j.cegh.2019.01.008
- Gözüm S, Karayurt Ö, Kav S, Platin N. Effectiveness of Peer Education for Breast Cancer Screening and Health Beliefs in Eastern Turkey. Cancer Nurs. 2010 May;33(3):213-20. https://doi.org/10.1097/NCC.0b013e3181cb40a8 PMid:20357655
- Baccolini V, Isonne C, Salerno C, Giffi M, Migliara G, Mazzalai E, et al. The association between adherence to cancer screening programs and health literacy: A systematic review and meta-analysis. Prev Med (Baltim). 2022 Feb;155:106927. https://doi.org/10.1016/j.ypmed.2021.106927 PMid:34954244
- Jung SM, Jo HS, Oh HW. Internal Motivation, Perceived Health Competency, and Health Literacy in Primary and Secondary Cancer Prevention. Asian Pac J Cancer Prev. 2016 Dec 1;17(12):5127-32.
- Pagán JA, Brown CJ, Asch DA, Armstrong K, Bastida E, Guerra C. Health Literacy and Breast Cancer Screening among Mexican American Women in South Texas. Journal of Cancer Education. 2012 Mar 15;27(1):132-7. https://doi.org/10.1007/s13187-011-0239-6 PMid:21573944
- Yılmazel G. Health Literacy, Mammogram Awareness and Screening Among Tertiary Hospital Women Patients. Journal of Cancer Education. 2018 Feb 28;33(1):89-94. https://doi.org/10.1007/s13187-016-1053-y PMid:27236309
- Ooi C, Hanafi N, Liew S. Knowledge and practice of colorectal cancer screening in an urban setting: cross-sectional survey of primary care physicians in government clinics in Malaysia. Singapore Med J. 2019 Nov;60(11):596-604. https://doi.org/10.11622/smedj.2019011 PMid:30644527 PMCid:PMC6875808
- Huang SC, Kuo SF, Tsai PS, Tsai CY, Chen SS, Lin CY, et al. Effectiveness of Tailored Rehabilitation Education in Improving the Health Literacy and Health Status of Postoperative Patients With Breast Cancer. Cancer Nurs. 2020 Jan;43(1):E38-46. https://doi.org/10.1097/NCC.0000000000000665 PMid:31805025
- Damiani G, Federico B, Basso D, Ronconi A, Bianchi CBNA, Anzellotti GM, et al. Socioeconomic disparities in the uptake of breast and cervical cancer screening in Italy: a cross sectional study. BMC Public Health. 2012 Dec 3;12(1):99. https://doi.org/10.1186/1471-2458-12-99 PMid:22305108 PMCid:PMC3314546
- Karami M, Ashtarian H, Rajati M, Hamzeh B, Rajati F. The effect of health literacy intervention on adherence to medication of uncontrolled hypertensive patients using the M-health. BMC Med Inform Decis Mak. 2023 Dec 15;23(1):289. https://doi.org/10.1186/s12911-023-02393-z PMid:38102648 PMCid:PMC10724893
- Zanobini P, Bonaccorsi G, Giusti M, Minardi V, Possenti V, Masocco M, et al. Health literacy and breast cancer screening adherence: results from the population of Tuscany, Italy. Health Promot Int. 2023 Dec 1;38(6). https://doi.org/10.1093/heapro/daad177 PMid:38146742
- Meng K, Heß V, Schulte T, Faller H, Schuler M. Health literacy bei onkologischen Rehabilitanden und deren Relevanz für den subjektiven Rehabilitationsverlauf. Rehabilitation (Stuttg). 2021 Apr 15;60(02):102-9. https://doi.org/10.1055/a-1361-4072 PMid:33858019
- Keim-Malpass J, Doede A, Camacho F, Kennedy C, Showalter SL. Impact of patient health literacy on surgical treatment of breast cancer. Breast J. 2018 Jul;24(4):633-6. https://doi.org/10.1111/tbj.13011 PMid:29537708
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