Using a Social Marketing Approach to Increase the Pap-smear Test Uptake: Randomized Controlled Trial Among Women Residing in Urban Region

Overview

Journal BMC Womens Health

Publisher Biomed Central

Specialty Gynecology & Obstetrics

Date 2025 Mar 14

PMID 40082980

Authors

Aisa Maleki

Bahman Ahadinezhad

Ahad Alizadeh

Omid Khosravizadeh

Affiliations

Soon will be listed here.

Abstract

Background: Social marketing intervention is a strategy to improve intention and behavior in this field. Therefore, this study was conducted with the aim of determining the impact of social marketing intervention on Pap-smear test uptake.

Methods: The study conducted between June 5th 2023 and August 6th 2023. This study is registered in IRCT (code: IRCT20221126056609N1 & Registration date: 2023-04-27) The population studied were married women aged 18 to 65 living in Qazvin City. Comprehensive health service centers of Qazvin city were clustered for sampling and samples were randomly taken from each cluster and randomly divided into two control and intervention groups. Demographic, social, and economic information was collected before the intervention for both intervention and control groups. The intervention was based on four marketing mixes (product, price, place, and promotion). After three months, the pap smear test uptake was examined in both intervention and control groups. The data were analyzed by performing paired t-tests, chi-square, and odds ratio estimation in SPSS and Stata software.

Results: The findings showed that there was a significant difference in Pap smear test uptake between the intervention and control groups after the intervention. So the participant who intervened had about 12 times more chance of a test uptake and this chance in the follow-up period was 5 times more than the control group.

Conclusion: The findings of the present study showed that the intervention based on social marketing increases awareness, perceived risk, and the demand for Pap smear tests among women. By influencing women's intention and behavior, they can be led to participate in screening. For this purpose, a multifaceted intervention should be designed based on the barriers and facilitators of test's demand.

Trial Registration: This study is registered in IRCT (code: IRCT20221126056609N1 & Registration date: 2023-04-27).

References

Bray F, Ferlay J, Soerjomataram I, Siegel R, Torre L, Jemal A . Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018; 68(6):394-424. DOI: 10.3322/caac.21492. View

Guimaraes Y, Godoy L, Longatto-Filho A, Dos Reis R . Management of Early-Stage Cervical Cancer: A Literature Review. Cancers (Basel). 2022; 14(3). PMC: 8833411. DOI: 10.3390/cancers14030575. View

Ferrall L, Lin K, Roden R, Hung C, Wu T . Cervical Cancer Immunotherapy: Facts and Hopes. Clin Cancer Res. 2021; 27(18):4953-4973. PMC: 8448896. DOI: 10.1158/1078-0432.CCR-20-2833. View

Singh D, Vignat J, Lorenzoni V, Eslahi M, Ginsburg O, Lauby-Secretan B . Global estimates of incidence and mortality of cervical cancer in 2020: a baseline analysis of the WHO Global Cervical Cancer Elimination Initiative. Lancet Glob Health. 2022; 11(2):e197-e206. PMC: 9848409. DOI: 10.1016/S2214-109X(22)00501-0. View

Arbyn M, Weiderpass E, Bruni L, de Sanjose S, Saraiya M, Ferlay J . Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. Lancet Glob Health. 2019; 8(2):e191-e203. PMC: 7025157. DOI: 10.1016/S2214-109X(19)30482-6. View

Bouvard V, Wentzensen N, Mackie A, Berkhof J, Brotherton J, Giorgi-Rossi P . The IARC Perspective on Cervical Cancer Screening. N Engl J Med. 2021; 385(20):1908-1918. DOI: 10.1056/NEJMsr2030640. View

Hu K, Wang J, Sparen P, Herweijer E, Sjolander A, Adami H . Invasive cervical cancer, precancerous lesions, and cervical screening participation among women with mental illness in Sweden: a population-based observational study. Lancet Public Health. 2023; 8(4):e266-e275. DOI: 10.1016/S2468-2667(23)00026-9. View

Suk R, Hong Y, Rajan S, Xie Z, Zhu Y, Spencer J . Assessment of US Preventive Services Task Force Guideline-Concordant Cervical Cancer Screening Rates and Reasons for Underscreening by Age, Race and Ethnicity, Sexual Orientation, Rurality, and Insurance, 2005 to 2019. JAMA Netw Open. 2022; 5(1):e2143582. PMC: 8767443. DOI: 10.1001/jamanetworkopen.2021.43582. View

Mizota Y, Yamamoto S . Rainbow of KIBOU project: Effectiveness of invitation materials for improving cancer screening rate using social marketing and behavioral economics approaches. Soc Sci Med. 2021; 279:113961. DOI: 10.1016/j.socscimed.2021.113961. View

10.

Chichirez C, Purcarea V . Health marketing and behavioral change: a review of the literature. J Med Life. 2018; 11(1):15-19. PMC: 5909940. View

11.

Adamu A, Abiola A, Ibrahim M . The effect of health education on the knowledge, attitude, and uptake of free Pap smear among female teachers in Birnin-Kebbi, North-Western Nigeria. Niger J Clin Pract. 2012; 15(3):326-32. DOI: 10.4103/1119-3077.100632. View

12.

Olawepo J, Pharr J, Kachen A . The use of social marketing campaigns to increase HIV testing uptake: a systematic review. AIDS Care. 2018; 31(2):153-162. DOI: 10.1080/09540121.2018.1533631. View

13.

Garces-Palacio I, Ramos-Jaraba S, Rubio-Leon D . Health Beliefs Associated with the Follow-Up of Pap Smear Abnormalities Among Low-Income Women in Medellín, Colombia. J Cancer Educ. 2017; 33(2):417-423. DOI: 10.1007/s13187-017-1172-0. View

14.

Vermandere H, van Stam M, Naanyu V, Michielsen K, Degomme O, Oort F . Uptake of the human papillomavirus vaccine in Kenya: testing the health belief model through pathway modeling on cohort data. Global Health. 2016; 12(1):72. PMC: 5111174. DOI: 10.1186/s12992-016-0211-7. View

15.

McFarland D . Associations of demographic variables and the Health Belief Model constructs with Pap smear screening among urban women in Botswana. Int J Womens Health. 2013; 5:709-16. PMC: 3810782. DOI: 10.2147/IJWH.S50890. View

16.

Bayu H, Berhe Y, Mulat A, Alemu A . Cervical Cancer Screening Service Uptake and Associated Factors among Age Eligible Women in Mekelle Zone, Northern Ethiopia, 2015: A Community Based Study Using Health Belief Model. PLoS One. 2016; 11(3):e0149908. PMC: 4786115. DOI: 10.1371/journal.pone.0149908. View

17.

Simbar M, Ghazanfarpour M, Abdolahian S . Effects of training based on the health belief model on Iranian women's performance about cervical screening: A systematic review and meta-analysis. J Educ Health Promot. 2020; 9:179. PMC: 7482640. DOI: 10.4103/jehp.jehp_684_19. View

18.

Amir S, Idris I, Mohd Said Z, Yusoff H, Abdul Manaf M . A Comparison of the National Cervical Cancer Policies in Six Developing Countries with the World Health Organization Recommendations: A Narrative Review. Iran J Public Health. 2023; 52(6):1108-1120. PMC: 10362820. DOI: 10.18502/ijph.v52i6.12952. View

19.

Aoki E, Yin R, Li K, Bhatla N, Singhal S, Ocviyanti D . National screening programs for cervical cancer in Asian countries. J Gynecol Oncol. 2020; 31(3):e55. PMC: 7189071. DOI: 10.3802/jgo.2020.31.e55. View