The Effect of Face-to-face and Online Health Education on the Health Beliefs of Women Aged 40-69 and Their Participation in Screening

Study Overview
=================
Brief Summary
-----------------
Objective: In this study, it was aimed to determine the effects of health education provided by two different methods on breast cancer and mammography knowledge self-evaluation status, perceived mammography benefit and barrier levels, mammography self-efficacy levels and mammography screening of women aged 40-69 years. Materials and Methods: The study was conducted in a parallel group design as a single-blind randomized controlled trial. The sample consisted of 126 healthy volunteers, 42 in each group, who were registered to Toprakkale Family Health Center between January and July 2023, met the inclusion criteria. In the study, 10-unit Visual Analogue Scale, mammography benefit and obstacle perception sub-dimension of Champion's Health Belief Model Scale and Mammography Self-Efficacy Scale were used for self-assessment of breast cancer and mammography knowledge. In the study, while the control group received standard care, the face-to-face education group was given health education and brochures through home visits, and a reminder interview was made over the phone. Health education and digital brochures were given to the online training group via video call, and a reminder meeting was held once. After a two-month follow-up, One-Way Analysis of Variance and Kruskal Wallis H test were used to compare the data of the three groups, multiple comparisons were analyzed with Tukey's test and Dunn's test. Generalized Linear Models were used for group and time comparisons.

Detailed Description
-----------------
This study was conducted as a parallel group, single-blind randomized controlled trial. The study was carried out in Osmaniye Province Toprakkale Family Health Center between January - July 2023. In this study, it was calculated that at least 96 participants should be included in three groups with effect size d=0.18, 95% power and 0.05 error level. G Power 3.1.9.2 package program was used in the calculation. Considering the possible data loss in the study, it was decided to add 30% of the participants. In this context, the sample of the study was determined as 126 participants, 42 in each group. After briefing the women aged 40-69 who came to the FHC for any reason about the purpose of the study, the researcher invited them to participate in the study. Subsequently, it examined the inclusion criteria of women who volunteered to participate in the study. The purpose of the study was explained to the participants who met the inclusion criteria and Form I was administered to the participants. In the randomization of the participants, the block randomization method was preferred. Following the administration of Form I, the participants were assigned to the group in the block randomization list according to the order of arrival at the FHC. No intervention was made to the control group during the application process. Participants in the online training group received online health training and a digital training brochure. Participants in the face-to-face training group received face-to-face health education through home visits and a training brochure. Four weeks later, the participants in the online and face-to-face training groups were given a telephone reminder call. At the end of eight weeks, Form II was administered to all groups.

Official Title
-----------------
The Effect of Two Different Methods of Health Education on Self-Efficacy and Health Beliefs of Mammography and Participation in the Screening Program of 40-69 Age Group Women

Conditions
-----------------
Breast Cancer

Intervention / Treatment
-----------------
* Behavioral: Online training group
* Behavioral: Face-to-face training group


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Volunteering to participate in the research, Being literate in Turkish Be in the age range of 40-69 years Being a woman To have technical equipment to make video calls Exclusion Criteria: Have any communication barrier Being pregnant or in puerperium Breastfeeding To have had a mammogram in the last two years Have had a previous benign breast disease or breast cancer Having a family history of breast cancer

Ages Eligible for Study
-----------------
Minimum Age: 40 Years
Maximum Age: 69 Years

Sexes Eligible for Study
-----------------
Female

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Parallel Assignment randomised control trial
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: control group<br>This group was receiving standard breast cancer screening program service during the study period. standard care; It is this standard health service applied to the whole country. | |
| Experimental: Online training group<br>In addition to the standard breast cancer screening program service, the participants in this group were provided with online health education about breast cancer and prevention from breast cancer, and a digital education brochure was given At the end of the fourth week from the day they were assigned to the study, they were called by phone and the participants were reminded in line with the summary information about the importance of screening. | Behavioral: Online training group<br>* online health education with video call<br>|
| Experimental: Face-to-face training group<br>In addition to the standard breast cancer screening program service, the participants in this group were given face-to-face health education about breast cancer and prevention of breast cancer through home visits, and a training brochure was given. At the end of the fourth week from the day they were assigned to the study, they were called by phone and the participants were reminded in line with the summary information about the importance of screening. | Behavioral: Face-to-face training group<br>* Face-to-face health education with home visit<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Self-Efficacy Scale for Mammography | The scale consists of 10 items in 5 likert type. The total score obtained varies between 10 and 50. | 60 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Champion's Health Belief Model Scale | Only two sub-dimensions of the scale were used, namely the perception of benefit related to mammography and the perception of barriers related to mammography. Benefits sub-dimension of the scale consists of 5 items, and barriers sub-dimension consists of 11 items. In the scale, perceived mammography benefits dimension is evaluated between 5 and 25 points, and perceived mammography barriers dimension is evaluated between 11 and 55 points. | 60 days | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Breast Cancer, Mammography, Health Education, Online Education, Home Visit