Background
In Iran, 82% of breast cancer cases are diagnosed in late stages, resulting in low survival rates. In the present study, the Stages of Change Theory and Health Belief Model were used as theoretical frameworks for assessing Women Health Volunteer readiness to act on different breast cancer screening behaviors.
Methods
A total of 1,410 Women Health Volunteers were enrolled in this cross-sectional study. The breast self-examination (BSE) and mammography stages of change were measured independently. A standardized questionnaire based on the Health Belief Model was used to assess their beliefs about breast cancer screening methods. A path analysis using PASW SPSS ver. 18.0 (SPSS Inc., Chicago, IL, USA) was used to test the effects of individual beliefs on breast cancer screening stages of change.
Results
Most participants were classified in the pre-contemplation stage of breast cancer screening behaviors. Perceived barriers, benefits, and susceptibility emerged as BSE stages of change predictors. No beliefs were significant mammography stages of change predictors.
Conclusion
Iranian Women Health Volunteers had a very low adherence to common BSE and mammography practices. Healthy beliefs have a strong association with the stages of change for performing BSE, but not for mammography. The impact of health beliefs on an individual’s readiness to act on different breast cancer screening methods may vary with respect to the type of screening method.

Citations

• The impact of educational interventions on breast self-examination practice, knowledge, and beliefs among women: A systematic review and meta-analysis
  Benazir Mahar, Malina Binti Osman, Fatimah Ahmad Fauzi, Sani Aliyu
  Journal of Public Health Research.2026;[Epub]     CrossRef
• SAĞLIĞIN SOSYAL BELİRLEYİCİLERİNİN MEME KANSERİ BİLGİ DÜZEYİ VE TARAMALARINA ETKİSİ: BİR SİSTEMATİK DERLEME
  Özlem Durmuş, Keziban Avcı
  Eskişehir Türk Dünyası Uygulama ve Araştırma Merkezi Halk Sağlığı Dergisi.2025; 10(2): 246.     CrossRef
• Analysis of the Distribution Characteristics and Influencing Factors of Apparent Temperature in Chang–Zhu–Tan
  Dongshui Zhang, Junjie Liu, Yanlu Xiao, Xiuquan Li, Xinbao Chen, Pin Zhong, Zhe Ning
  Sustainability.2025; 17(16): 7225.     CrossRef
• Mammography screening status of women aged 40 and older in eastern Iran using the precaution adoption process model (PAPM)
  Mahbobe Sadat Sahebi, Gholamreza Sharifzadeh, Mitra Moodi
  Scientific Reports.2025;[Epub]     CrossRef
• Exploring Theoretical Models and Frameworks Used to Explain Factors Influencing Breast Cancer Screening Participation: A Scoping Review
  Dandan Zheng, Pichitra Lekdamrongkul, Xiaofen Gao, Aurawamon Sriyuktasuth
  International Journal of Women's Health.2025; Volume 17: 5639.     CrossRef

Background
: Breast cancer is increasing cause of cancer-related mortality among Korean women. Early detection and treatment are the most important strategy for reducing breast cancer mortality. Despite of its importance as an early detection method, a low percentage of women practice breast self-examination(BSE) regularly. The aim of this study was to describe the effectiveness of patient education on performing BSE regularly and to identify predisposing factors associated with these activities.

Methods : Sixty-six women who did not have experience in BSE in the past were randomly assigned to the experimental group and the control group. We taught BSE knowledge and skill about BSE using breast models and audiovisual equipment for experimental group in patient education class. Women in control group, however, were simply educated by their physician about BSE knowledge and skill with only educational booklet during their outpatient visits. We observed the difference in regular BSE performance proportion between two groups 6, 12 months later and analyzed the predisposing factors affecting on the education effect. Direct and telephone interview methods were used to gather the information. Data were analyzed with t-test, x²-analysis and logistic regression using SAS 6.10, EGRET program.

Results : There were no differences in sociodemographic characteristics between study groups. They were followed for 12 months. At follow-up after 6 months 44.1% of women performed BSE regularly among experimental group and 18.8% of women did it among control group(OR= 3.4, 95% CI 1.1-10.4, p<0.05). At follow-up after 12 months proportion of women performed BSE regularly in experimental group(28.6%) was slightly higher than that of control group(22.2%), but that difference was not statistically significant. The prevalence of performing BSE regularly was higher among women who had experience in periodic health examination(OR=6.0, 95% CI 1.9-18.8, p<0.01), who had experience in mammography(OR=4.0, 95% CI 1.0-15.6, p<0.05). And the prevalence of performing BSE regularly also was higher among women who were older than 40 years old, married, had experience in cervical Pap smear, had knowledge about BSE before education, have done exercise regularly, had less number of health risk factors, but without statistical significance.

Conclusion : These results showed that effectiveness of patient education on BSE, if we determine the effectiveness of BSE education with regular performance of BSE, is relatively low among Korean women. We could see, however, that if we use breast models for demonstration in addition to usual educational material, the effectiveness of BSE education can be more effective. We also recognized that effectiveness of BSE education will not be continued for long time without any maintenance strategy. There were lots of predisposing factors which could affect the effectiveness of BSE education positively or negatively. So, family physicians who plan BSE patient education at their clinics must consider these factors.