Effectiveness of An Educational Intervention On Knowledge, Attitude and Practice Regarding Cervical Cancer Screening Among Yemeni Immigrant Women In Klang Valley, Malaysia: A Study Protocol for a Randomized Controlled Trial

The intervention is comprised of an online health education on cervical cancer and screening via zoom sessions for two weeks. This intervention is grounded in the Health Belief Model (HBM) and developed based on the American cancer Society, American Congress of Obstetricians and Gynaecologists, and the results of the systematic review in order to know the best method to deliver the intervention. This program also is prepared and designed to fill up the gap of cervical cancer and Pap smear knowledge and to modify beliefs related to cervical cancer screening. Providing this information may promote cervical screening practice. The education on cervical cancer will focus also on general information on the anatomy and physiology of a normal cervix in order for the participants to have a clear understanding of the topic, cause, predisposing factors, signs and symptoms, complications and methods of prevention. Regarding cervical cancer screening, participants will be introduced to where they can go for testing, persons who carry out the test and the part of the body needed for the test. The benefits of cervical cancer screening and the perceived barriers to screening will be addressed. The educational intervention involves a 30-60 minute session for one-day. One session will be carried out each week. The study researcher will conduct the session for all the intervention group (55 participants). The educational materials (PowerPoints and videos) will be shared with the intervention group before giving the educational intervention. The zoom session will be recorded and shared with participants to enable them to remember the information and the discussion with them. To avoid contamination with the control group, the intervention group will be asked in the consent form to not share any educational information or materials with others till the end of the study. Furthermore, all participants in the control group will receive education on healthy eating (55 participants) during the study period. However, they will be given the same educational materials at the end of the study. Content of the intervention: -- Anatomy of the cervix - Functions of cervix - What is cervical cancer - Cervical cancer risk factors - Signs and symptoms of cervical cancer - Pre-cancers and types of cervical cancer - Cervical cancer stages -What is the screening, types, time and benefit of doing the screening, source of knowledge about screening -Pap smear test To support the fidelity of the educational intervention, some strategies will be used. These include the strategy for preserving the consistency of the intervention delivery and for encouraging participants’ adherence to the intervention. To maintain consistency in the intervention delivery, the educational intervention is implemented independently by the same researcher. The researcher will commit to adopting a single educational intervention protocol to ensure a standard delivery across the respective groups. Other possible means of enhancing intervention fidelity include the monthly short reminder text messages. These are mainly employed to encourage participants, remind them of the importance of cervical cancer screening practice and to reinforce the intended messages. Participants must only be Yemeni immigrant women and who did not have a Pap smear test in the previous three years.