Hyun Suk Mo; Keum Bong Choi; Jin Sun Kim

doi:10.7469/KJAN.2013.25.6.736

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Mo, Choi, and Kim: Effects of a Peer Cervical Cancer Prevention Education Program on Korean Female College Students’ Knowledge, Attitude, Self-efficacy, and Intention

Original Research

Korean J Adult Nurs 2013;25(6):736-746.

Published online: 18 December 2013

DOI: https://doi.org/10.7469/KJAN.2013.25.6.736

Effects of a Peer Cervical Cancer Prevention Education Program on Korean Female College Students’ Knowledge, Attitude, Self-efficacy, and Intention

Hyun Suk Mo¹, Keum Bong Choi¹, Jin Sun Kim^2,

^¹Chosun Nursing College, Gwangju

^²Department of Nursing, Chosun University, Gwangju, Korea

Corresponding author: Kim, Jin Sun Department of Nursing, Chosun University, 375 Seosuk-dong, Dong-gu, Gwangju 501-759, Korea. Tel: +82-62-230-6327, Fax: +82-62-230-6329, E-mail: jinsun@chosun.ac.kr

Received 3 July 201314 December 2013 Accepted 19 December 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to evaluate the effectiveness of a peer cervical cancer prevention education program on Korean female college students’ knowledge, attitude, self-efficacy, and intention.

Methods

A quasi-experimental pretest-posttest design with a non-equivalent control group was used. The participants were 58 female college students in a metropolitan city in Korea. The sample consisted of an intervention group (n=28) that participated in a peer education program and a control group (n=30). Data were measured using self-administered questionnaires at two time points: prior to the intervention and after the intervention.

Results

Compared to the control group, the experimental group reported significantly positive changes for knowledge, attitude, self-efficacy, and intent to practice cervical cancer prevention behaviors.

Conclusion

The findings of this study indicated that a peer education program developed for Korean female college students was a useful and effective intervention strategy to promote cervical cancer prevention behaviors in Korean sociocultural contexts.

Keywords: Cervical cancer, Prevention, Health behavior, Peer group, Health education

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Table 1.

Peer Education Program to Promote Cervical Cancer Preventive Behaviors

Session	Topic	Contents	Activity/method
1	Introduction	․ Explain educational objectives	․ Pretest
	Introduction	․ Build rapport between the peer educators and participants	․ Ice-breaking
	Growth and development	․ Raise issues of cervical cancer	․ Activity 1: 6 Questions
		․ Changes of body and mind	․ Activity 2: Sexual slang
		․ Protect our bodies: gynecological examinations	․ Activity 3: We are changing/discussion, group contest
	Sexual rights and responsibilities	․ Sexual morals and values	․ Activity 4: Pros and cons
	Sexual rights and responsibilities	․ Respect different values in others	․ Activity 4: Pros and cons
	Condom use	․ How to use condoms	․ Activity 5: Condom bomb
		․ The effects of alcohol on our bodies	․ Activity 6: Condom wrapping
		․ Negotiation strategies for condom use at refusal	․ Activity 7: Role-playing/PPT, Q&A, discussion
		․ Importance of standing by sexual decisions
	Sexual culture	․ Keep yourself safe in sexual culture	․ Activity 8: Stop motion-play
	HPV infection	․ HPV/STD	․ Activity 9: STD mission
	HPV infection	․ HPV infection	․ PPT
	Finish	․ Summary & evaluation	․ Quiz, Q & A
2	Introduction	․ Review	․ Ice-breaking, Q & A
	Introduction	․ Build rapport	․ Ice-breaking, Q & A
	Cervical cancer	․ Cervical cancer facts	․ Activity 10: Speed quiz
		․ STD examination and treatment	․ Activity 11: Telling examples activity/PPT, video, discussion
		․ Preventive behaviors for cervical cancer: condom use, pap tests, HPV vaccine
	Safe/unsafe sexual behaviors	․ Strategies to decrease unsafe sexual behaviors	․ Activity 12: HPV/Infection of STD
	Role of peers	․ Importance of preventive behaviors of cervical cancer	․ Activity 13: Keeping on story
	Role of peers	․ Help and support each other to practice cervical cancer preventive behaviors	․ Activity 14: Our role
	Finish	․ Summary & evaluation	․ Q & A
	Finish	․ Summary & evaluation	․ Post-test

Table 2.

Homogeneity Test for Characteristics between Groups (N=58)

Characteristics	Categories	Exp. (n=28)	Cont. (n=30)	x² or t	p
Characteristics	Categories	n (%) or M±SD	n (%) or M±SD	x² or t	p
Age (year)		19.3±0.66	19.3±0.66	-0.28	.785
Economic status	＜Middle school	3 (10.7)	10 (33.3)	4.80	.091
	Middle school	22 (78.6)	16 (53.3)
	≥Middle school	3 (10.7)	4 (13.3)
Smoking^†	Yes	2 (7.1)	3 (10.0)		.999
Smoking^†	No	26 (92.9)	27 (90.0)		.999
Alcohol^†	Yes	26 (92.9)	27 (90.0)		.999
Alcohol^†	No	2 (7.1)	3 (10.0)		.999
Sexual experience^†	Yes	3 (3.6)	4 (13.3)		.999
Sexual experience^†	No	25 (96.4)	26 (86.7)		.999
Suggested HPV vaccination?	Yes	17 (60.7)	14 (46.7)	1.15	.284
Suggested HPV vaccination?	No	11 (39.3)	16 (53.3)	1.15	.284
Educational need^†	Yes	27 (96.4)	27 (90.0)		.612
Educational need^†	No	1 (3.6)	3 (10.0)		.612

Exp.=experimental group; Cont.=control group.

^† Fisher's exact probability test.

Table 3.

Homogeneity Test for Outcome Variables between Groups at Baseline (N=58)

Variables	Exp. (n=28)	Cont. (n=30)	t	p
Variables	M±SD	M±SD	t	p
Knowledge	12.25±5.18	12.30±5.73	-0.04	.972
Attitude	55.07±7.38	53.76±7.16	0.68	.497
Self-efficacy	26.46±4.20	26.80±4.78	-0.28	.778
Intent to practice prevention behaviors	218.92±44.83	216.00±46.65	0.24	.809

Exp.=experimental group; Cont.=control group.

Table 4.

Effects of a Peer Education Program (N=58)

Variables	Groups	Pretest	Posttest	MD of post-pre	t	p
Variables	Groups	M±SD	M±SD	M±SD	t	p
Knowledge	Exp.	12.25±5.18	19.79±14.33	7.54±4.89	4.32	＜.001
Knowledge	Cont.	12.30±5.74	14.33±4.21	2.03±4.81	4.32	＜.001
Attitude	Exp.	55.07±7.38	62.71±5.37	7.64±7.29	4.01	＜.001
Attitude	Cont.	53.76±7.16	52.57±7.38	-1.20±9.42	4.01	＜.001
Susceptibility	Exp.	2.80±0.90	3.99±0.81	1.19±0.80	5.26	＜.001
Susceptibility	Cont.	2.60±0.75	2.73±0.85	0.13±0.72	5.26	＜.001
Severity	Exp.	3.86±0.65	4.59±0.50	0.73±0.64	3.11	.003
Severity	Cont.	3.64±0.72	3.63±0.76	-0.01±1.10	3.11	.003
Benefit	Exp.	3.20±0.66	4.64±0.59	1.44±0.85	7.68	＜.011
Benefit	Cont.	3.32±0.72	3.18±0.47	-0.14±0.72	7.68	＜.011
Barrier	Exp.	3.42±0.76	2.82±0.71	-0.60±0.96	-2.27	.027
Barrier	Cont.	3.52±0.81	3.43±0.67	-0.09±0.74	-2.27	.027
Cues to action	Exp.	3.65±0.83	3.95±0.70	0.30±0.98	1.72	.090
Cues to action	Cont.	3.40±0.74	3.24±0.74	-0.16±1.12	1.72	.090
Self-efficacy	Exp.	26.46±4.20	34.65±4.12	8.19±4.21	7.24	＜.001
Self-efficacy	Cont.	26.80±4.78	25.70±4.65	-1.10±5.42	7.24	＜.001
Intention	Exp.	218.93±44.80	277.32±20.48	58.39±40.34	7.06	＜.001
Intention	Cont.	216.00±46.65	210.33±51.09	-5.66±27.00	7.06	＜.001
Condom use	Exp.	93.21±12.78	99.29±3.78	6.07±11.97	3.67	.001
Condom use	Cont.	92.00±12.14	88.67±13.32	-3.33±7.11	3.67	.001
Pap test	Exp.	59.28±20.17	85.72±12.60	26.43±16.82	5.89	＜.001
Pap test	Cont.	62.33±20.28	60.67±24.77	-1.67±19.31	5.89	＜.001
HPV vaccine	Exp.	66.42±23.12	92.32±11.18	25.90±22.90	5.60	＜.001
HPV vaccine	Cont.	61.66±24.64	61.00±25.78	-0.66±12.01	5.60	＜.001

Exp.=experimental group; Cont.=control group; MD of post-pre=mean difference of posttest-pretest.

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