Department of Clinical Epidemiology and Medical Technology Assessment, Care And Public Health Research Institute (CAPHRI), Maastricht University Medical Center, Maastricht, the Netherlands.
Department of Clinical Epidemiology and Medical Technology Assessment, Care And Public Health Research Institute (CAPHRI), Maastricht University Medical Center, Maastricht, the Netherlands.
Prev Med. 2022 Nov;164:107219. doi: 10.1016/j.ypmed.2022.107219. Epub 2022 Aug 22.
Low levels of knowledge and awareness on cervical cancer play a role in limiting cervical cancer prevention uptake. This systematic review aimed to identify effective educational interventions to increase cervical cancer awareness, knowledge, and subsequently screening or vaccination uptake in African women. A literature search was conducted in Medline and EMBASE databases. We examined original, peer-reviewed English literature published between 2005 and 2020. Nineteen studies examining health education interventions' impact on awareness, knowledge, and screening or vaccination uptake in African women were included. Ten studies were controlled trials, nine performed pre- and post-measurements in one group. Most studies were published between 2015 and 2020 (86%), many were from Nigeria (47%). Studies were mostly set up in communities and schools. The most frequently used intervention was lectures, alone or combined with videos and practical demonstrations. Sixteen studies evaluated knowledge or awareness, and all showed a statistically significant improvement following the intervention. Of the ten studies that evaluated screening uptake, either as the single outcome or combined with knowledge or awareness, six found a significant rise in screening uptake after intervention. Educational interventions increased knowledge and awareness in African women, some boosted uptake of cervical cancer screening, especially when using peer health educators and culturally tailored methods. Innovative approaches such as self-collected HPV testing and mHealth also demonstrated a potential to increase uptake of screening. More research is needed to identify and analyse barriers to screening uptake, which can still be present even after a successful educational intervention.
宫颈癌相关知识和认知水平较低，这在一定程度上限制了宫颈癌的预防措施的普及。本系统综述旨在确定有效的教育干预措施，以提高非洲女性对宫颈癌的认知、知识水平，并促进其进行宫颈癌筛查或接种疫苗。研究人员在 Medline 和 EMBASE 数据库中进行了文献检索。研究纳入了 2005 年至 2020 年间发表的原创性、同行评审的英文文献，共 19 项研究检验了健康教育干预对非洲女性对宫颈癌的认知、知识水平，以及筛查或疫苗接种的影响。其中 10 项研究为对照试验，9 项研究在同一组中进行了干预前后的测量。大多数研究发表于 2015 年至 2020 年（86%），其中许多来自尼日利亚（47%）。研究大多在社区和学校进行。最常使用的干预措施是讲座，单独使用或与视频和实际演示相结合。16 项研究评估了知识或认知水平，所有研究均表明干预后有统计学意义上的显著提高。在评估筛查参与度的 10 项研究中，无论是作为单一结果还是与知识或认知相结合进行评估，有 6 项研究发现干预后筛查参与度显著上升。教育干预措施提高了非洲女性的知识和认知水平，一些措施还提高了宫颈癌筛查的参与度，特别是在使用同伴健康教育者和文化适应方法时。一些创新方法，如自我采集 HPV 检测和移动医疗也显示出增加筛查参与度的潜力。需要进一步研究以确定和分析筛查参与度的障碍，即使在成功的教育干预之后，这些障碍仍可能存在。
