Efficacy of digital educational intervention using I-Change model in promoting preventive behaviors for cervical cancer among Iranian women: A randomized controlled trial.

IF 2.8 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health Promotion Perspectives Pub Date : 2025-05-06 eCollection Date: 2025-05-01 DOI:10.34172/hpp.025.43722

Sara Kazemi, Fatemeh Zarei, Alireza Hidarnia, Fatemeh Alhani

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Abstract

Background: Cervical cancer (CC) is a major health concern for women, yet stigma and embarrassment often prevent preventive care. Digital health education offers a private, accessible way to learn about CC prevention. This study evaluated the effectiveness of a digital educational intervention based on the I-Change model in promoting preventive behaviors among Iranian women.

Methods: A randomized controlled trial (RCT) was conducted with 210 women (18-49 years) from Ramsar, Iran. Participants were assigned to three groups: two intervention groups (mobile app and digital booklet) and a control group. The "Evaluation of Preventive Behaviors Against CC (PERCICA)" questionnaire assessed outcomes. The intervention included a pre-test, digital education, and follow-ups immediately and at 12 weeks post-intervention. Data were analyzed using t-tests, analysis of Variance (ANOVA), analysis of covariance (ANCOVA), and repeated measures ANOVA.

Results: The app group showed significant improvements in knowledge, perceived risk, self-efficacy, cognitive barriers, and social support (P<0.05). Preventive behaviors (e.g., condom use, Pap tests, genital exams) were highest in the app group (67.12%, 95% CI: [29.32±2.35]), followed by the booklet group (38.57%, 95% CI: [9.55±2.17]).

Conclusion: The app was more effective in sustaining behavioral changes and promoting CC prevention than the booklet, highlighting the value of tailored digital education for sensitive health topics.

Trial registration: ClinicalTrials.gov IRCT20181205041861N3. Registered V2.0 on 26 October 2021 with the IRCTID, V1.0. https://irct.behdasht.gov.ir/trial/57157.

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使用I-Change模型的数字教育干预在促进伊朗妇女宫颈癌预防行为方面的效果：一项随机对照试验

背景：宫颈癌（CC）是妇女的主要健康问题，但耻辱和尴尬往往阻碍预防保健。数字健康教育为了解CC预防提供了一种私人的、可访问的方式。本研究评估了基于I-Change模型的数字教育干预在促进伊朗妇女预防行为方面的有效性。方法：随机对照试验（RCT）对来自伊朗拉姆萨尔的210名女性（18-49岁）进行了研究。参与者被分为三组：两个干预组（移动应用程序和数字小册子）和一个对照组。“预防CC行为评估（PERCICA）”问卷评估结果。干预包括预测试、数字教育、立即随访和干预后12周随访。数据分析采用t检验、方差分析（ANOVA）、协方差分析（ANCOVA）和重复测量方差分析（ANOVA）。结果：应用程序组在知识、感知风险、自我效能、认知障碍和社会支持方面表现出显着改善(p结论：应用程序在维持行为改变和促进CC预防方面比小册子更有效，突出了针对敏感健康话题量身定制的数字教育的价值。试验注册：ClinicalTrials.gov IRCT20181205041861N3。于2021年10月26日在IRCTID注册V1.0。https://irct.behdasht.gov.ir/trial/57157。

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