***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Few Iranian women take the Papanicolaou test despite its important role in preventing cervical cancer . This study aim ed to determine the effectiveness of an educational intervention based on the protection motivation theory ( PMT ) variables and implementation intentions in the first and second Pap test practice among Iranian women . MATERIAL S AND METHODS In this quasi-r and omized controlled trial , 200 women who were referred to 30 primary health care clinics in Tehran were r and omly selected .  PMT variables and Pap test practice  were measured at baseline and again after 3 and 15 months . The 4-week educational intervention program was conducted for the intervention group . RESULTS Following the intervention , the mean scores of self-efficacy , perceived vulnerability , and behavior intention variables were significantly higher in the intervention group when compared to the control group ( p<0.05 ) . No significant differences were found in the perceived severity , response efficacy , response cost , and fear between the two groups following the intervention . Higher percent of women in the intervention group had obtained first and second Pap test compared to the controls . CONCLUSIONS The PMT and implementation intentions provide a suitable theory-based framework for developing educational interventions regarding Pap test practice in Iran BACKGROUND Low-income African American women are more likely to die of breast cancer than their Caucasian counterparts , and at least part of the difference in mortality results from differential screening adherence . The purpose of this study was to identify more efficacious methods of promoting routine mammography screening in underserved population s. METHODS A prospect i ve r and omized intervention study of 344 low income African American women compared the impact of three interventions on mammography adherence and stage of readiness : ( 1 ) pamphlet only ; ( 2 ) culturally appropriate video ; and ( 3 ) interactive computer-assisted instruction program . RESULTS The interactive computer intervention program produced the greatest level of adherence to mammography ( 40.0 % ) compared to the video group ( 24.6 % ) and the pamphlet group ( 32.1 % ) . When subjects in the pamphlet and video groups were combined to form a non-interactive group , this group had a significantly lower adherence than the group who received the interactive computer intervention ( 27.0 % versus 40.0 % ) . There was also significantly more forward movement in mammography stage of readiness among participants in the computer group ( 52.0 % ) compared to those in the pamphlet group ( 46.4 % ) or the video group ( 31.3 % ) . When combining the non-interactive technology ( pamphlet and video ) there was also more forward movement in mammography stage of readiness for those in the interactive intervention group ( 52.0 % moved 1 or 2 stages ) compared to those in the non-interactive group ( 36.2 % ) . CONCLUSIONS These data indicate that tailored approaches are more effective than targeted messages either in print or video format . Another finding of this study is that interactive interventions are more effective than non-interactive interventions in increasing adherence and moving African American women forward in their mammogram stage of readiness The Pap smear test is recommended for early diagnosis of cervical cancer . The aim of this study was to assess knowledge and behavior regarding the Pap smear test based on the Health Belief Model ( HBM ) in women referred to premarital counseling classes , Hamadan , Iran . This quasi-experimental study was conducted on 330 women , who were allocated r and omly to two case and control groups ( n=165 ) .  Two educational session classes were performed in the case group . Two stages in before and after intervention groups were evaluated . Analysis of data was performed by SPSS/16.0 , using t-test , x2 , and McNemar 's test . P-values < 0.05 were regarded as significant . There was no significant difference between the mean scores of the various structures of this model in two groups before the intervention . However , after the intervention there were significant increase in mean score of knowledge and all variables of HBM in the intervention group(<0.001 ) . The findings of this study highlight the important role of education about cervical cancer on changing women 's beliefs about cervical screening Under-screening may increase the risk of cervical cancer in middle-aged women . This study aim ed to investigate cervical cancer screening behaviour and its predictors among women aged 50 years or above . A population -based sample of 959 women was recruited by telephone from domestic households in Hong Kong , using r and om methods , and a structured question naire developed to survey participants . Multivariable logistic regressions were performed to examine the factors independently associated with cervical screening behaviour . Nearly half the sample ( 48 % ) had never had a cervical smear test . Multivariable analyses showed that age , educational level , marital status , family history of cancer , smoking status , use of complementary therapy  , recommendation from health professionals , and believing that regular visits to a doctor or a Chinese herbalist were good for their health were predictors of cervical screening behaviour . Misconceptions concerned with menopause may reduce women ’s perceived susceptibility to cervical cancer , especially if they are 50 or above , and exert a negative effect on their screening behaviour . Healthcare professionals should actively approach these high-risk groups – older unmarried women , smokers , those less educated and who are generally not much concerned with their health Background Cervical cancer is the second most common form of cancer observed among women in Turkey . The participation of women in cervical cancer screening programs is strongly affected by Turkish attitudes , beliefs , and sociocultural structure . Aim This study was conducted to assess the effectiveness of health education that aim ed to raise awareness about Papanicolaou testing and to emphasize the importance of the early diagnosis of cervical cancer . Material s and Methods The study was conducted as a prospect i ve , r and omized , controlled trial and was carried out in 148 women . Seventy-five women in the control group were asked to fill out question naire forms . A 45-minute conference-style training was given to 73 women in the study group , and all of the subjects were asked to fill out the forms after the training . The sociodemographic characteristics of the 2 groups and the mean “ Health Belief Model Scale for Cervical Cancer and Pap Smear Test ” scores of the 2 groups were statistically analyzed by Statistical Package of Social Sciences ( SPSS ) , version 15 . Results There was no statistically significant difference noticed between the sociodemographic characteristics of the 2 groups ( P > 0.05 ) . The difference in test scores , which represented knowledge about cervical cancer and Papanicolaou testing , was statistically significant between the control group and the study group ( t = 10.122 , P < 0.05 ) . In the Health Belief Model Scale for Cervical Cancer and Pap Smear Test , there were statistically significant differences in the following measures : lower levels of susceptibility to cervical cancer score ( t = −2.035 , P < 0.05 ) , lower levels of perceived benefit from a Papanicolaou test score ( t = 3.278 , P < 0.05 ) and lower levels of perceived barriers to Papanicolaou test score ( t = −3.182 , P < 0.05 ) . Conclusion Nurses should be involved in educating women about cervical cancer and Papanicolaou testing . By doing so , they can change the attitudes , knowledge , and beliefs of the women Background Cervical cancer is a disease of public health importance affecting many women and contributing to avoidably high levels of cancer deaths in Nigeria . In spite of the relative ease of prevention , the incidence is on the increase . This study aim ed to determine the effect of health education on the awareness , knowledge and perception of cervical cancer and screening among women in rural Nigerian communities . Methods The study design was quasi-experimental . The study was carried out among adult women in Odogbolu ( intervention ) and Ikenne ( control ) local government areas ( LGA ) of Ogun state . Three hundred and fifty ( 350 ) women were selected per group by multistage r and om sampling technique . Data was collected by semi structured interviews with the aid of question naire . The intervention consisted of structured health education based on a movie . Result The intervention raised the level of awareness of cervical cancer and screening to 100 % ( p < 0.0001 ) . The proportion of women with very good knowledge of cervical cancer and screening rose from 2 % to 70.5 % ( χ2 = 503.7 , p < 0.0001 ) while the proportion of those with good perception rose from 5.1 % to 95.1 % ( p < 0.0001 ) . The mean knowledge and mean perception scores were also increased ( p < 0.0001 ) . There was increase in the proportion of women who had undertaken cervical screening from 4.3 % to 8.3 % ( p = 0.038 ) . The major reason stated by the women for not having had cervical screening done was lack of awareness about cervical cancer and screening . There was statistically significant difference between the intervention and control groups concerning their knowledge attitude and practice towards cervical and screening ( p < 0.05 ) after the intervention . Conclusion Multiple media health education based on a movie is effective in creating awareness for and improving the knowledge and perception of adult women about cervical cancer and screening . It also improves the uptake of cervical cancer screening . The creation of awareness is very crucial to the success of a cervical cancer prevention programme BACKGROUND Cervical cancer is one of the most common forms of carcinoma among women worldwide , accounting for about 12 % of all cancers . Tragically , studies have shown generally low awareness levels on its symptoms , risk factors and prevention . This study evaluated the effect of a health education program on knowledge of cervical cancer amongst women at risk in Africa . METHOD This study was conducted in the city of Lagos , Nigeria , using a multistage sampling technique . Two model markets were chosen by simple r and om sampling method from a total of 10 local governments with model markets . One was design ated the intervention/experimental group while the other was the control . Systematic sampling method was used in selecting 350 women comprising of 175 participants from each model market . A baseline survey on cervical cancer awareness and screening practice s was carried out in both sample groups with the aid of interviewer-administered , structured and pre-tested question naires . Thereafter , respondents in the intervention group received sessions of community-based educational messages on cervical cancer and its prevention . Subsequently , participants in both groups were reassessed to evaluate the effect of the educational program . Data analysis was conducted with Epi-info statistical software . RESULTS Knowledge level was low on cervical cancer at baseline ; only about 15 % and 6.9 % of participants in the intervention and control groups respectively had heard of cervical cancer . The most common sources of information were friends and media prior to the intervention . Significant increase in proportions were found in the intervention/experimental group on awareness of cervical cancer ( 61.7 % ) , associated symptoms and risk factors such as early sexual debut , promiscuity and smoking . CONCLUSION It is apparent that efforts must be put in place by all stakeholders in reaching women at risk of cervical cancer through well organized educational campaigns using culturally sensitive information , education and communication BACKGROUND North American Chinese women have lower levels of Papanicolaou ( Pap ) testing than other population subgroups . We conducted a r and omized controlled trial to evaluate the effectiveness of two alternative cervical cancer screening interventions for Chinese women living in North America . METHODS Four hundred and eighty-two Pap testing underutilizers were identified from community-based surveys of Chinese women conducted in Seattle , Washington , and Vancouver , British Columbia . These women were r and omly assigned to one of two experimental arms or control status . Several Chinese- language material s were used in both experimental arms : an education-entertainment video , a motivational pamphlet , an educational brochure , and a fact sheet . Women in the first experimental group ( outreach worker intervention ) received the material s , as well as tailored counseling and logistic assistance , during home visits by trilingual , bicultural outreach workers . Those in the second experimental group ( direct mail intervention ) received the material s by mail . The control group received usual care . Follow-up surveys were completed 6 months after r and omization to ascertain participants ' Pap testing behavior . All statistical tests were two-sided . RESULTS A total of 402 women responded to the follow-up survey ( 83 % response rate ) . Of these women , 50 ( 39 % ) of the 129 women in the outreach group , 35 ( 25 % ) of the 139 women in the direct mail group , and 20 ( 15 % ) of the 134 women in the control group reported Pap testing in the interval between r and omization and follow-up data collection ( P<.001 for outreach worker versus control , P = .03 for direct mail versus control , and P = .02 for outreach worker versus direct mail ) . Intervention effects were greater in Vancouver than in Seattle . CONCLUSION Culturally and linguistically appropriate interventions may improve Pap testing levels among Chinese women in North America Despite declines in cervical cancer mortality in developed countries , cervical cancer incidence and mortality rates remain high in Jamaica due to low levels of screening . Effective interventions are needed to decrease barriers to preventive behaviors and increase adoption of behaviors and services to improve prospect s of survival . We enrolled 225 women attending health facilities in an intervention consisting of a pre-test , educational presentation and post-test . The question naires assessed attitudes , knowledge , risk factors , and symptoms of cervical cancer among women . Changes in knowledge and intention to screen were assessed using paired t-tests and tests for correlated proportions . Participants were followed approximately six months post-intervention to determine cervical cancer screening rates . We found statistically significant increases from pre-test to post-test in the percentage of questions correctly answered and in participants ’ intention to screen for cervical cancer . The greatest improvements were observed in responses to questions on knowledge , symptoms and prevention , with some items increasing up to 62 % from pre-test to post-test 
    Output:
    
The heath belief model is the most popular used framework for cervical cancer screening interventions .
The results of our study showed that different health education methods ( such as  calls , mailed postcards , mother/daughter education .
consultation sessions , picture books , videos , PowerPoint slides , small group discussion s , educational brochures , radio broadcast education , lecture presentations , tailored counseling and a fact sheet , Self-learning package , face-to- face interviews and etc ) are effective in modifying cervical cancer screening behavior of women .
Conclusions : Our results showed that the different interventions and health behavior change frameworks provide an effective base for cervical cancer prevention .