Effect of health education on cervical cancer screening uptake and knowledge among target women in Addis Ababa: A randomized controlled trial.

Abstract

Health education can improve cervical cancer screening uptake, however evidence from randomized controlled trials in the general population of Addis Ababa is limited. The aim of this study is to assess the effect of health education on screening uptake and knowledge among women aged 30-49 years in Addis Ababa, Ethiopia. A randomized controlled trial was conducted involving 1,300 women who had never been screened before. The intervention group received home-based health education about cervical cancer, supplemented by brochures. Chi-square test, independent sample t-test and Paired t-tests were used to assess pre- and post-intervention differences. The impact of the intervention was measured using the differences in differences (DID) approach. Three months after intervention, 1,154 (88.8%) were interviewed. Screening uptake was significantly higher in the intervention group, 241(41.8%) of women screened compared to 93 (16.1%) in the control group. Post-intervention, awareness increased by 42.2%, knowledge of symptoms rose by 23.1%, knowledge of risk factors increased by 15.2%, positive attitudes improved by 26.7% and overall knowledge increased by 19.5%, among the intervention group indicating the change is statistically significant. The difference in differences analysis indicated 51% of change in overall knowledge due to intervention. Age, occupation and income were significantly associated with uptake of screening while lack of time was a common barrier. Structured home-based education significantly increases cervical cancer knowledge and screening uptake. Scaling up home-based health education can significantly improve screening uptake.