基于社交媒体的癌症筛查意识的教育：一项随机对照试验

实验性的：Social Media-Based Education Group

Participants in this group received a Social Ecological Model-based educational program via closed WhatsApp and Instagram groups. During the eight-week program, 53 visual educational posters addressing breast, cervical, and colorectal cancer screenings and digital health literacy were shared. After completion of the scheduled poster-sharing period, four short reinforcement videos were also provided. A total of 57 educational materials were delivered.

行为的：Social Media-Based Education

The intervention consisted of a Social Ecological Model-based educational program delivered through closed WhatsApp and Instagram groups. Fifty-three visual educational posters were shared during the eight-week program. The materials addressed breast, cervical, and colorectal cancer epidemiology, risk factors, symptoms, screening methods, healthy lifestyle behaviors, access to screening services, and digital health literacy. After the scheduled poster-sharing period, four approximately one-minute reinforcement videos covering breast cancer, cervical cancer, colorectal cancer, and digital health literacy were shared. The intervention therefore comprised a total of 57 educational materials.

其他名称：

• Instagram和WhatsApp信息图教育
• WhatsApp and Instagram-Based Cancer Screening Education

有源比较器：Standard Education Group

Participants in this group received two standard online educational sessions via Zoom, delivered one week apart. Each session lasted approximately 45-60 minutes and used a standardized slide presentation. The sessions covered breast, cervical, and colorectal cancer screenings, digital health literacy, and the use of digital health services.

行为的：Standard Online Education

Participants received two standardized online educational sessions via Zoom, delivered one week apart. Each session lasted approximately 45-60 minutes. The sessions covered breast, cervical, and colorectal cancer screenings, preventive health information, digital health literacy, and the use of digital health services such as e-Nabız and MHRS. Participants were allowed to ask questions during the sessions; however, they did not receive the daily social media posts, repeated digital content, or continuous group interaction provided to the experimental group.

Change in Cancer Screening Knowledge Score

Cancer screening knowledge was assessed using the 25-item Cancer Screening Knowledge Scale developed in Turkish. Items are answered as correct, incorrect, or "I do not know." Correct responses are scored as 1, and incorrect or "I do not know" responses are scored as 0. The total score ranges from 0 to 25, with higher scores indicating greater knowledge regarding breast, cervical, and colorectal cancer screenings.

Change in Attitudes Toward Cancer Screening

Attitudes toward cancer screening were assessed using the 24-item Cancer Screening Attitude Scale developed in Turkish. Items are rated on a five-point Likert scale. The total score ranges from 24 to 120, with higher scores indicating a more positive attitude toward cancer screening.

Change in Digital Health Literacy Level

Self-reported digital health literacy was assessed using the validated Turkish version of the 18-item Digital Health Literacy Instrument. The instrument includes six dimensions: information searching, evaluating reliability, determining relevance, navigating, adding self-generated content, and protecting privacy. Total and dimension scores are calculated as mean scores ranging from 1 to 4, with higher scores indicating higher self-reported digital health literacy.