Effects of a theory driven and culturally tailored educational program on promoting cervical cancer screening in rural populations

Urban-rural disparities in the uptake rate of cervical cancer screening are significant, while one major barrier to rural populations completing the screening is a lack of knowledge. Therefore, implementing health education targeted towards rural populations is crucial. This study aimed to investigate the impact of a theory-driven, culture-tailored educational program on promoting cervical cancer screening among rural Chinese women. The study, a two-arm parallel, non-randomized controlled trial, was conducted in 10 villages. A total of 362 rural women aged 25-64 years (Mean = 45.18, SD = 9.11) were recruited and assigned to the intervention arm or the control arm, with 181 participants in each. Both groups received routine local health education on cervical cancer screening, while the intervention arm also participated in a five-session nurse-led educational program based on social cognitive theory and adapted to the rural Chinese sociocultural context. The primary outcome measured was the cervical cancer screening uptake rate, with secondary outcomes including self-efficacy and knowledge of cervical cancer screening. Data analysis was performed using Chi-square and generalized estimating equation (GEE) models. Results indicated that the intervention arm demonstrated significantly greater improvements in self-efficacy and knowledge than the control arm immediately after the intervention and at three months post-intervention (p < 0.001). At six months post-intervention, the screening uptake rate in the intervention arm was significantly higher (p < 0.001). Furthermore, 18 months post-intervention, the self-efficacy and knowledge of the intervention arm remained at relatively high levels (p < 0.001). The study findings demonstrated that the educational program had a positive impact on increasing participation in cervical cancer screening within rural communities. As a result, the theory-driven and culture-tailored educational program could be incorporated into cancer prevention promotion strategies in rural areas. However, further high-quality randomized control trials are necessary to assess and generalize this educational approach more widely.Trial registration Chinese Clinical Trial Registry, ChiCTR2200055954. Registered 29 January 2022, https://www.chictr.org.cn/showprojEN.html?proj=150955 .