Effects of Education Based on the Health Belief Model on Screening Behavior in High Risk Women for Breast Cancer, Tehran, Iran


Background: Breast cancer is the most common malignancy in women. Early diagnosis allows efficienttreatment and increases survival, but the efficacy of breast self examination (BSE) is not sufficiently wellestablished. The American Cancer Society aims to give women the opportunity to recognize the utility,limitations and adverse effects of breast cancer screening through education models based on psychologicaltheories. With the Health Belief Model, people’s health perceptions and attitudes influence their practices, forexample with screening.
Objective: The purpose of this randomized controlled clinical trial was to determine theeffect of education based on this model on breast cancer screening in high risk Iranian women. Materials and
Methods: Participants were women with a family history of breast cancer (mother, sister, and daughter). Afterexplanation of the study objectives to participants, they were recruited on obtaining oral consent and each filledout the study questionnaire based on the Health Belief Model. Allocation was into two groups by computerizedrandomization, control and intervention, receiving education on breast cancer screening. Perceived susceptibilityto and seriousness of breast cancer, perceived usefulness of and barriers to BSE, clinical breast examination,and mammography, and self-efficacy in the ability to perform these, were assessed, with comparison of scoresfor BSE practice before and after education and doing mammography and clinical examination by a physicianin intervention and control group.
Results: The mean age was 37.8±11.7 (range 19-60). The mean rank in theintervention group significantly differed before and after the education, but except for “ perceived threat “and“perceived usefulness of breast self examination”, we did not find any significant differences from the controlgroup. After educational sessions, breast self examination and clinical examination practice rates were elevated.
Conclusion: Health education based on well known psychological theories for breast cancer screening should beextended to the entire populations in developing countries. In addition, we should pay attention to barriers towomen undergoing mammography, such as costs, shame and accessibility, and increase the target populationawareness and positive attitudes towards benefits of early breast cancer screening.