Examining the Impact of Health Education Interventions on Breast Cancer Knowledge (Awareness) Among Women in Underserved Communities of West Coast Region, The Gambia

Abstract

Background The burden of breast cancer among women in the underserved areas continue to remain high despite availability of modern screening and diagnosis facilities. It is believed that most women have limited access to such services due to limited awareness on breast cancer signs and symptoms, risk factors and screening services thus leading to a late-stage detection of the condition in many. This research seeks to address this gap by examining the impact of health education interventions on breast cancer knowledge and awareness among women aged 25 years and above in underserved communities of West Coast region of the Gambia and highlight associated barriers. Methods A cross-sectional study was conducted involving 315 women from two Urban and two Peri-Urban communities (Western Health Region 2) of the West Coast region of the Gambia. We administered an adopted structured questionnaire using face to face interviews in pre and post health education intervention in a 3-month interval. To evaluate the effect of the intervention, the mean knowledge score after three months was compared with the baseline phase using a paired sample t-test, Pearson chi square, binary and multiple logistic regression analyses. The differences in the means were compared and the knowledge enhancement percentage was established. Results The participants knowledge improved from 16.5% before the intervention to 61.3% after the intervention on the 20 points knowledge and awareness item including signs and symptoms, and risk factors of breast cancer. The paired sample t-test reveals that participants knowledge has improved in all the various dimensions of the assessment with a general increase from pre (M = 6.08; SD = ± 3.35) to Post (M = 13.34; SD = ± 5.33) at the 0.05 level of significance, t(-24.2) = 5.23, n = 305, p < 0.05, [95% CI: -6.67,-7.85]. There was a statistically significant association between sociodemographic variables and the increase in the knowledge score. Participants from urban and peri-urban have different options of public health education measures suitable for such intervention in underserved communities. Conclusions The use of health education intervention was very effective in improving breast cancer knowledge and awareness among women living in underserved communities despite so many challenges. Lack of information and cultural belief or stigma remains as major barriers to breast cancer awareness.