Augmented Reality-Based Breast Self-Examination Education and Its Effects on Knowledge and Perceived Behavioral Control Among Indonesian Adolescent Girls: A Quasi-Experimental Study

Khasanah, Nur; Liliana, Anita; Wahyuningsih, Melania; Wijaya Sugiarto, Nurhadi

doi:10.31557/APJCP.2026.27.7.2653

Augmented Reality-Based Breast Self-Examination Education and Its Effects on Knowledge and Perceived Behavioral Control Among Indonesian Adolescent Girls: A Quasi-Experimental Study

Document Type : Research Articles

Authors

¹ Department of Nursing, Faculty of Health Sciences, Universitas Respati Yogyakarta, Yogyakarta, Indonesia.

² Department of Informatics Engineering, Faculty of Computer Science, Universitas Respati Yogyakarta, Yogyakarta, Indonesia.

³ Department of Nursing, Faculty of Health Sciences,Universitas Respati Yogyakarta, Yogyakarta, Indonesia.

10.31557/APJCP.2026.27.7.2653

Abstract

Background: Breast cancer is the most common malignancy among women, with an increasing burden among adolescents and young adults. Breast self-examination (BSE) is a simple and low-cost method for early detection; yet, its practice remains suboptimal in this age group. Augmented Reality (AR) is a promising approach to enhancing cancer education. Objective: This study aims to rigorously compare the effects of AR-based education and traditional learning on breast self-examination (BSE) knowledge and perceived behavioral control (PBC) among adolescent girls, with the goal of identifying the more effective approach for empowering this population. Methods: A quasi-experimental posttest-only non-equivalent control group design was conducted among tenth-grade female students at a public senior high school in Yogyakarta, Indonesia. A total of 140 adolescents were assigned to an intervention group (n = 70) or a control group (n = 70). The intervention group received AR-based BSE education using a three-dimensional mobile application, whereas the control group received lecture-based education with posters and leaflets. Knowledge and PBC were assessed three months after the intervention using validated, self-administered questionnaires, and data were analyzed using appropriate nonparametric tests (α = 0.05). Results: The AR group demonstrated a substantially higher proportion of participants with high knowledge compared to the control group (71.4% vs. 28.6%; p < 0.001, r = 0.26), as well as significantly higher total knowledge scores (p = 0.002). Participants in the AR group were significantly less likely to perceive BSE as time-consuming, expensive, complex, or embarrassing (all p < 0.01). Notably, perceived behavioral control (PBC) increased in the AR group (p < 0.001, r = 0.767). Conclusions: AR-based education was superior to conventional learning, resulting in significant improvements in BSE-related knowledge, substantial reductions in perceived barriers, and a marked increase in perceived behavioral control among adolescent girls.

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