The Effect of Culture-Based Breast Health Education Program on Breast Self-Examination Practice Among High-Risk Women: Randomized Controlled Trial

Abstract Background Breast cancer (BC) symptom awareness through screening measures, such as breast self-examination practice (BSEP), is promoted in low-resource countries. The Muslim culture has a unique impact on family support for women’s health care decisions, especially from the mother. Given the proven effect of educational intervention on breast health through interactive sessions and mobile health, implementation according to Muslim cultural values through family support, especially from the mother, was lacking, and this study was planned. Objective This study aimed to determine the effects of a culture-based breast health education program (CBBHEP) on BSEP in high-risk women. Methods A single-site randomized controlled trial was conducted in a hospital on 72 high-risk women, aged 20‐50 years, from August 19 to November 29, 2024. The trial was registered prospectively (ID: ISRCTN-39194106). The participants were matched in pairs by age and educational level, and randomly assigned to experimental and control groups. The intervention program was based on social cognitive theory and the cultural identity concept of the PEN-3 model. The program consisted of face-to-face interactive sessions and a health app called a Women’s Health app for promoting BSEP. The experimental group received CBBHEP, whereas the control group received the usual care. BSEP was measured at baseline and 12 weeks using a translated, valid, and reliable Toronto BSE frequency and proficiency of practice scale. Data analysis was performed using 1-way analysis of covariance and paired sample 1-tailed t test. Results The participants in the experimental group who received CBBHEP for 12 weeks increased their BSEP much better than those in the control group ( F 1, 69 =58.908, η 2 =0.46; P <.001). The results also revealed a statistically significant effect of a higher BSEP in the experimental group ( t 35 =7.21, Cohen d =0.88; P <.001). Conclusions The findings suggest that health care practitioners can apply this program to increase BSEP among high-risk women through their family support, especially from mothers.