Health Belief Model-Based Breast Self-Examination Education in University Students

Participants in this arm receive Health Belief Model-based education on breast health and breast self-examination.

Participants in the intervention group receive Health Belief Model-based education on breast health and breast self-examination. The educational intervention is designed to improve health beliefs related to breast self-examination and facilitate progression through the stages of the Precaution Adoption Process Model.

Participants in this arm do not receive the Health Belief Model-based breast self-examination education during the study period.

The Precaution Adoption Process Model (PAPM) is used to assess participants' stage of adoption of breast self-examination (BSE) approximately one month after the intervention. PAPM stage is assessed using a single-choice staging question adapted to BSE. Participants select the statement that best describes their current status regarding BSE and are classified into one of seven stages: (1) never performed BSE, (2) aware of BSE but has not considered it personally relevant or necessary, (3) undecided about performing BSE, (4) decided not to perform BSE, (5) decided to perform BSE but has not yet started, (6) started performing BSE within the last six months but does not yet perform it regularly, or (7) regularly performs BSE, defined as at least once per month during the last six months. The outcome is reported as the number and percentage of participants in each PAPM stage, and the distribution of stages is compared between the intervention and control groups.

Health beliefs related to breast self-examination (BSE) are assessed using Karayurt's Turkish adaptation of the Champion Health Belief Model Scale. The scale consists of 42 items rated on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree), and each subscale is scored separately. The subscales and possible score ranges are: susceptibility (3-15), seriousness (7-35), perceived benefits of BSE (4-20), perceived barriers to BSE (11-55), BSE self-efficacy/confidence (10-50), and health motivation (7-35). Higher scores indicate higher levels of the corresponding construct. Thus, higher susceptibility, seriousness, perceived benefits, self-efficacy/confidence, and health motivation scores indicate higher levels of these beliefs, whereas higher perceived barriers scores indicate greater perceived barriers to BSE. Changes in each subscale score from baseline to approximately one month after the intervention are compared between the intervention and control groups.