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

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...

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Main Authors: Sara Kazemi, Fatemeh Zarei, Alireza Hidarnia, Fatemeh Alhani
Format: Article
Language:English
Published: Tabriz University of Medical Sciences 2025-05-01
Series:Health Promotion Perspectives
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Online Access:https://hpp.tbzmed.ac.ir/PDF/hpp-15-44.pdf
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author Sara Kazemi
Fatemeh Zarei
Alireza Hidarnia
Fatemeh Alhani
author_facet Sara Kazemi
Fatemeh Zarei
Alireza Hidarnia
Fatemeh Alhani
author_sort Sara Kazemi
collection DOAJ
description 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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spelling doaj-art-95887b363ab9440f90ec9e44de15eaf22025-08-20T02:17:29ZengTabriz University of Medical SciencesHealth Promotion Perspectives2228-64972025-05-01151445310.34172/hpp.025.43722hpp-43722Efficacy of digital educational intervention using I-Change model in promoting preventive behaviors for cervical cancer among Iranian women: A randomized controlled trialSara Kazemi0Fatemeh Zarei1Alireza Hidarnia2Fatemeh Alhani3Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University (TMU), Tehran, IranDepartment of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University (TMU), Tehran, IranDepartment of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University (TMU), Tehran, IranDepartment of Nursing, Faculty of Medical Sciences, Tarbiat Modares University (TMU), Tehran, IranBackground: 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.https://hpp.tbzmed.ac.ir/PDF/hpp-15-44.pdfhealth behaviorhealth educationrandomized controlled trialuterine cervical neoplasms
spellingShingle Sara Kazemi
Fatemeh Zarei
Alireza Hidarnia
Fatemeh Alhani
Efficacy of digital educational intervention using I-Change model in promoting preventive behaviors for cervical cancer among Iranian women: A randomized controlled trial
Health Promotion Perspectives
health behavior
health education
randomized controlled trial
uterine cervical neoplasms
title Efficacy of digital educational intervention using I-Change model in promoting preventive behaviors for cervical cancer among Iranian women: A randomized controlled trial
title_full Efficacy of digital educational intervention using I-Change model in promoting preventive behaviors for cervical cancer among Iranian women: A randomized controlled trial
title_fullStr Efficacy of digital educational intervention using I-Change model in promoting preventive behaviors for cervical cancer among Iranian women: A randomized controlled trial
title_full_unstemmed Efficacy of digital educational intervention using I-Change model in promoting preventive behaviors for cervical cancer among Iranian women: A randomized controlled trial
title_short Efficacy of digital educational intervention using I-Change model in promoting preventive behaviors for cervical cancer among Iranian women: A randomized controlled trial
title_sort efficacy of digital educational intervention using i change model in promoting preventive behaviors for cervical cancer among iranian women a randomized controlled trial
topic health behavior
health education
randomized controlled trial
uterine cervical neoplasms
url https://hpp.tbzmed.ac.ir/PDF/hpp-15-44.pdf
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