Effect of a Nurse-led Health Education Intervention on Behavioural Intention and Health Belief Model Constructs Towards Cervical Cancer Screening Among Women Attending Primary Healthcare Facilities in Kwara State, Nigeria
Keywords:
Behavioural Intention, Cervical Cancer, Cervical Cancer Screening, Health Belief Model, Health Education Intervention, Primary HealthcareAbstract
Cervical cancer remains a leading cause of morbidity and mortality among women in Nigeria, yet behavioural intention to undergo screening and uptake of screening services remain critically low. This study assessed the effect of a structured health education intervention on behavioural intention and Health Belief Model (HBM) constructs perceived benefit, perceived susceptibility, and perceived severity towards cervical cancer screening among women attending primary healthcare (PHC) facilities in Kwara State, Nigeria. A quasi-experimental pre-test post-test design with a non-equivalent control group was employed among 452 women of reproductive age (226 intervention, 226 control) recruited from PHC facilities using multistage sampling, from May to November 2025. A structured, interviewer administered questionnaire adapted from validated instruments (Cronbach's α = 0.878; content validity ratio = +1.00) was used. The intervention comprised a three-day, face-to-face health education programme using Information, Education, and Communication (IEC) materials, with post-intervention assessment conducted six weeks later. McNemar's test and Pearson chi-square were applied using SPSS version 27; significance was set at p < 0.05. All 452 participants completed both assessments. Following the intervention, behavioural intention improved significantly in the intervention group (χ² = 37.500, p < 0.001). Perceived benefit (χ² = 36.161, p < 0.001), perceived susceptibility (χ² = 50.667, p < 0.001), and perceived severity (χ² = 27.176, p < 0.001) all improved significantly in the intervention group. No corresponding significant changes were observed in the control group. The health education intervention significantly improved behavioural
intention towards cervical cancer screening and positively modified key HBM constructs in the intervention group. These findings support integration of structured health education into routine PHC services, expansion of cervical cancer screening programmes, and policy support for addressing structural barriers such as affordability and service availability. Trial registration: Pan African Clinical Trials Registry, PACTR202607679243122, registered 10th July, 2026.
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