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A Systematic Review of the Effectiveness of Health Education Programs for Cervical Cancer Prevention in Rural Communities: Implications for Promoting Health Equity

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Abstract

Rural women face an increased risk of cervical cancer diagnosis in comparison to women living in metropolitan areas. This review synthesized and critically evaluated cervical cancer screening interventions that target women living in rural communities in the USA. EBSCO, JSTOR, Medline, PsychINFO, Psychology and Behavioral Sciences Collection, PubMed, and Cochrane Library were searched using keywords related to cervical cancer screening, rural communities, and prevention interventions. Study eligibility included randomized controlled trials or quasi-experimental designs, a psychosocial or educational intervention targeting cervical cancer prevention, and implementation in a rural setting. Eleven articles met criteria for the systematic review and 6 of those included information sufficient for meta-analysis. Cochrane guidelines, CONSORT-Equity 2017, and PROGRESS-Plus were used to assess included studies. The systematic review encompassed 9720 participants who were involved in a variety of intervention types: social media campaigns, faith-based, and patient navigation with lay health advisors. None of the studies met all criteria for the health equity assessment. The meta-analysis found that women in the intervention groups were more likely to participate in cervical cancer screening than women in control groups (OR: 2.43, 95% CI: 1.49 to 3.97). The type of intervention mattered in increasing cervical cancer screening participation for women living in rural communities. Educational interventions in combination with patient navigation saw the most success in promoting cervical cancer screening. Further, health inequities focus is lacking robust consideration. Our results highlight a continued need to develop multicomponent interventions with a health equity focus to address barriers to screening and prevention.

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Funding

Dr. Randall received research support from the National Cancer Institute institutional training grant T32-CA-236621. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the National Cancer Institute.

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Authors and Affiliations

  1. Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA

    Ariel Washington

  2. Grace Abbott School of Social Work, University of Nebraska Omaha, Omaha, NE, USA

    Lisa Smith

  3. College of Allied Health Sciences, School of Social Work, University of Cincinnati, Cincinnati, OH, USA

    Georgia Anderson

  4. School of Nursing, University of Michigan, Ann Arbor, MI, USA

    Jill Randall

  5. Kent School of Social Work, University of Louisville, Louisville, KY, USA

    Karen Kayser

  6. School of Public Health & Information Sciences, University of Louisville, Louisville, KY, USA

    Scott LaJoie

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  1. Ariel Washington
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Correspondence to Ariel Washington.

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Washington, A., Smith, L., Anderson, G. et al. A Systematic Review of the Effectiveness of Health Education Programs for Cervical Cancer Prevention in Rural Communities: Implications for Promoting Health Equity. J Canc Educ 39, 126–138 (2024). https://doi.org/10.1007/s13187-023-02385-7

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