Effectiveness of a health education program to improve health literacy among females in their 20s: A quasi-experimental study
Abstract Background Japanese women cervical cancer rates are rising aged 20-30 years, few opportunities for sex education of appropriate for age are provided to females. Health literacy (HL) is an important concept in women’s health. To improve HL for cervical cancer prevention, we developed a health program for females in their 20s. This study aimed to examine the effectiveness of the program. Methods A quasi-experimental design with control groups was conducted on female undergraduate students. The inclusion criteria for both groups were: (i) Japanese females, (ii) aged 20 years or older. The sample size for each group was set at ≥13 people based in a previous study. The participants were evaluated HL variables: HL scale score, confidence in explaining one’s own body to a medical practitioner (Y/N), knowledge of women’s health, and indicated whether they had undergone cervical cancer screening. Assessments were conducted baseline and 6 months after (follow-up) the program was implemented. Analysis of the results consisted of calculating intergroup comparisons of HL variables at follow-up using the Mann-Whitney U test and Fisher’s exact test or chi-square test. Results 14 students for the intervention group participated in the study, while 60 students for the control group participated. Intergroup pair matching using the variables of concern for one’s own body and HL scale score yielded a total final analysis population of 28 participants (n=14 in each group). Comparison of both groups at follow-up revealed a significant difference in median HL scale score, at 66 in the intervention group versus 60 in the control group (P=.002), also a significant difference in the percentage of participants who felt confident in explaining their own body to a medical practitioner (P<.001), and median knowledge score was 16 in the intervention group and 14 in the control group, which was significantly different (P=.008). There were no significant intergroup differences in cervical cancer screening behaviors. Conclusions The results indicated that the program was effective in improving HL, but was not effective in changing cervical cancer screening behavior. Further research is needed to determine how to provide appropriate sex education among females in their 20s.