The Impact of an Educational Program on the Stages of Change for Mammography Screening Among Rural Women with Low Health Literacy

Abstract

Background: The aim of the study was to investigate the effect of an educational program on the mammography screening stage of change among rural women with low health literacy. Methods: In general, 52 rural women participated in this experimental study. The samples were selected using a multi-stage cluster sampling method and divided into two intervention (n=26) and control (n=26) groups. An educational program was implemented for the intervention group for one month. The data collection tool was a valid questionnaire based on constructs of the transtheoretical model (TTM) related to mammography screening, which was completed in the pre-test phase and after three and six months. The data were analyzed using SPSS 16 at the significant level of 0.05. Results: There was no significant difference between the control and intervention groups at the pre-test phase (P>0.05). The intervention group demonstrated considerable progress in the stage of change for mammography screening after three- and six-month follow-ups (P<0.001, odds ratio [OR]=2.54). The odds ratio of progress in the stages of change in the intervention group compared to the control group significantly increased after three (P<0.001, OR=4.29) and six (P<0.001, OR=5.45) months of follow-up. In addition, the findings indicated a significant increase in the mean scores of decisional balance, processes of change, and self-efficacy in the intervention group compared to the control group three and six months after the educational intervention (P<0.005). Conclusion: The educational program significantly advanced mammography screening stages among rural women with low health literacy. These results highlight the program’s effectiveness in enhancing screening behaviors in this underserved population.