Designing and evaluation of the effect of community-based intervention on breast self-examination among reproductive-aged women in Ethiopia: A Cluster Randomized Controlled Trial.
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BACKGROUND: Though early intervention saves many lives worldwide, breast cancer remains a leading cause of cancer among women in Ethiopia. This study, therefore, aimed to evaluate community-based interventions promoting breast self-examination using the Health Belief Model. METHODS: A cluster randomized controlled trial followed by a cross-sectional study lasting six months was used to evaluate the effectiveness of the community-based educational intervention on breast self-examination among reproductive-aged women in Ethiopia. A total of 810 participants were randomly assigned in a 1:1 ratio and assessed at baseline, three months, and six months post-intervention. A general linear model for repeated measures was used to examine the mean differences in study variables across time points. Non-parametric tests (Cochran's Q) were employed to analyze dichotomous variables related to breast self-examination practices. Path analysis was conducted to examine the interactions among the constructs of the Health Belief Model. RESULTS: A total of 810 reproductive-aged women participated in the study, yielding a 100% response rate at baseline. The mean age of participants was 33.2 ± 7.7 years in the intervention group and 33.5 ± 8.1 years in the control group. The proportion of women performing breast self-examinations increased from 33.3% at baseline to 59.9% at the end of the intervention. And the Comprehensive knowledge about breast self-examination rose from 11.7% to 69.1% over the same period. Perceived susceptibility, perceived severity, knowledge, and health motivations had a statistically significant mean difference between the intervention and control groups (p < 0.0001). We registered PACTR database (https://pactr.samrc.ac.za/): "PACTR201802002902886". CONCLUSIONS: The study found that there is a strong interplay between the likelihood of performing breast self-examination and perceived susceptibility, perceived severity, knowledge, and health motivations. Field specialists should figure out the problem related to perception and awareness through intensive health promotion interventions. TRIAL REGISTRATION: Registered in the Pan African Clinical Trial Registry (www.pactr.org) database, and the unique identification number for the registry is PACTR201802002902886.