Effectiveness of face to face and virtual education to promote breast self-examination based on the theory of planned behavior: a randomized controlled trial study.

Abstract

Background: Breast cancer (BC) is the most prevalent cancer among women in both developed and developing countries. Breast self-examination (BSE) is crucial for the early detection of BC. This study aimed to assess the effectiveness of face-to-face and virtual education on BSE, based on the theory of planned behavior (TPB).

Methods: This randomized controlled trial was conducted on 240 women aged 30-55 in northern Iran from 2020 to 2022. Participants were selected using a random sampling method and were randomly assigned to three groups of 80 each (face to face, virtual, and control). The face to face educational intervention consisted of four consecutive weekly sessions (50 min each), with 20 participants per session. In the virtual training group, all teaching materials were delivered once a week via WhatsApp messenger. The control group did not receive any intervention. All participants completed questionnaires assessing demographic and fertility characteristics, BSE barriers, knowledge, and practice regarding BSE, as well as TPB constructs (attitude, subjective norm, perceived behavioral control, behavioral intention, and behavior) before, one month, and three months after the intervention. Data analysis was performed using SPSS version 23.0. Statistical tests included the chi-square test, t-test, analysis of variance, repeated measures RMANOVA, and Pearson's correlation coefficient. The significance level was set at P < 0.05.

Results: The study results indicated that the mean BSE and TPB constructs increased in both the face to face and virtual education groups one and three months after the intervention (P < 0.001). In the face-to-face group, knowledge one month after the education was correlated with practice at both one and three months post-education (r = 0.304, P = 0.006, and r = 0.232, P = 0.038, respectively). Similarly, in the virtual group, knowledge and practice one month after the education was correlated with knowledge and practice three months post-education (r = 0.814, P = 0.001, and r = 0.722, P = 0.001, respectively).

Conclusions: The results of this study demonstrated that TPB is an effective theory for promoting BSE. Both face to face and virtual education interventions proved to be successful, with no significant difference between them.

Trial registration: IRCT20230130057274N4 Date of registration: 2024-04-29 Retrospectively registered.