الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 215 |  |  |
| | | from | 215 | | |
Abstract
The period of university study represents many new challenges for emerging
adults, including organization of everyday life, studies, and social environment, as
well as taking responsibility for one’s own health during a period where one is
generally assumed to be in good to very good health. Hence, the university period
is frequently accompanied by new unhealthy practices and routines that could
impact students’ health and lifestyles into adulthood, which is crucial as behavioral
modifications are more difficult to implement in later life.
Health-promoting lifestyle behaviors are one of the main determinative
components of health known as an underlying factor in the prevention of many
diseases. Health promotion and prevention of disease are directly associated with
these behaviors, so following these health-promoting behaviors is one of the best
ways by which university students can protect and control their health against
breast cancer disease.
Breast cancer is a major worldwide health problem as it is the most
diagnosed cancer in women. The best method to increase the rate of early
diagnosis of breast carcinoma is to enhance awareness and positive attitudes
towards breast cancer and its screening methods. The commonest screening
methods for the early detection of mammary cancer are Breast Self -Examination
(BSE), Clinical Breast Examination (CBE), and Screening Mammography.
Improving awareness is an important aspect of BC control. This study explored
whether a web-based educational intervention was an effective approach for
improving the awareness of university female students about breast cancer, its
screening procedures and promoting health behavior change.
A Randomized educational intervention trial (pre- post) design was
conducted at Damanhour University that includes both scientific and literature
faculties. one faculty from scientific group (that not studying health topics in their
curriculum) and two faculties from group of literature faculties were selected
randomly using lottery method to compose the 3 faculties (Agriculture, Arts, and
Early childhood) were represented the setting of this study.
The present study subjects included total of 640 fourth grade female
university students aged 20-23 years were included in the sample. Students were
randomly allocated and selected from a list; every odd number was assigned to the
intervention group (n= 320 students), and every even number was assigned to the
control group (n= 320 students).
Summary
149
Four tools were used in this study:
Tool
(I):
Online
Breast
Cancer
knowledge
assessment
structured
questionnaire: it was used to assess female student knowledge of breast cancer
with different categories; it included knowledge of breast cancer risk factors,
Knowledge of breast cancer warning signs and symptoms and knowledge of Breast
Self-Examination (BSE).
Student personal data was assessed and included data such as age, faculty
name, residence, marital status, family history of breast cancer, parents’ education,
and occupation. In addition to these: source of student BC knowledge assessed,
and body mass index calculated according to WHO standard.
Tool (II): Online Healthy Promoting Life-Style Behaviors Profile Scale
(HPLP): It used to measure the behavior improving one’s health in relation to their
healthy lifestyle; the scale includes six sub-scales: namely, self-actualization,
health responsibility, exercises, nutrition, interpersonal support, and stress
management.
Tool (III): Online behaviors questionnaire sheet toward Breast self-
examination: It used to assess attitudes, practices of female students and included
participants’ attitudes towards BSE and their practices of BSE.
Tool (IV): Web-based educational intervention satisfaction scale: It used to
assess female students’ satisfaction with the web-based educational program
(overall web site design, structure, content, font typography and font size, graphics
and photographs, prototype, knowledge presentation, usability, and functionality).
Tool I, II, III were downloaded to all selected students who preferred
Telegram application to be the mode of communication with the researcher
to perform the pretest phase and collect the base line data. The theoretical content
of the website program was planned and organized based on assessment phase and
Health Belief Model (HBM) that is one of the most important behaviors change
models.
Several web pages were created, contents were displayed through written
information accompanied by info-graphs, images, and videos. The windows pages
were consisted of:
Summary
150
Main Page: this page includes three main icons for moving to other page, namely
(main, connect with us, and life stories), as the home page banner shows the
program title “pinky step for healthy life” accompanied by visual effects.
Menu’s page: contains the subject headings of the preventive health education
website, and when the students press the title of the subject it moves directly to the
main screen of the content of the subject, and through it begins to involve within
its elements which contains 8 topics (Breast cancer statistics-Overview about
breast cancer- Types of breast cancer- Diagnosis of breast cancer- Prevention and
treatment- Ways of Breast Self-Examination- False perceptions about breast
cancer- Most common queries on breast cancer).
Daily Short health messages were sent to all students of the intervention
group through Telegram application; these messages included important Breast
Self-Examination skills, and healthy lifestyle instruction. Moreover, the researcher
replied to any questions from the students on Telegram chat and through yahoo
mail messages that were available on the main page of website.
The main findings obtained from the study were as follows:
• The most reported common source of information about BC among studied
students was mass media& internet as less than half of intervention and
control groups respectively received their information from mass media&
internet, while about one fifth (of them respectively received their breast
cancer information from parents and friends.
• Most of the intervention group had a poor total level of knowledge about BC
pre-program compared to more than three quarters of them who had good
knowledge post program intervention. On the other hand, the majority of
control group pre and post program respectively had poor total level of
knowledge about BC.
• More than half of the intervention students at age ≥ 22 years old, and around
one third of students at age (21-22) years old had good level of BC
knowledge post and follow up program intervention respectively.
• Students from rural areas had a poorer level of BC knowledge than students
from urban areas, as less than two thirds of students from rural areas and just
Summary
151
more than one third of students from urban areas had poor knowledge
preprogram intervention.
• Less than three quarters of intervention groups had good score of HPLP post
program intervention, while most of them had poor score of HPLP pre-
program intervention. On contrast, the majority of control group had poor
score of HPLP at pre, post and follow up program intervention respectively.
Meanwhile, there was a highly statistically significance difference between
both groups in the post and follow up program intervention.
• Only one third of students aged ≥22 years old had good HPLP score at
preprogram stage, where more than half of them had good HPLP score at
post and follow up program intervention.
• Three quarters and more than half of intervention group post and follow up
program intervention respectively had positive attitude towards BSE; on the
other hand, more than half of them had negative attitude toward BSE
preprogram intervention.
• The majority of students who reported absence of BC family history had
negative attitude toward BSE at preprogram stage while the majority of them
had positive attitude post program intervention.
• Less than three quarters of intervention group had poor score of total BSE
practices preprogram compared to more than three quarters and more than
half of them had good score post and follow up program intervention
respectively, while around two thirds of control group had poor score of total
BSE practices post and follow up program intervention respectively.
• Most students with no family history of BC had poor level of BSE practices
at preprogram stage that were more than the percentage of students with
family history of BC, which was only, while the majority of them had good
level of BSE practices post and follow up program intervention.
• There was a highly significant improvement in students’ BSE practices
accompanied with significant improvement of their scores of HPLP scale
post intervention of educational website with highly statistically significant
differences between pre, post, and follow-up intervention program.
Summary
152
• There was a strong positive correlation between students’ BSE practices,
their total level of BC knowledge, attitudes toward BSE and their total score
of HPLP scale respectively, as while there was a positive direction when one
variable increase, the other would increase and vice versa.
• Most of intervention group were satisfied with the educational website at
post and follow up program intervention respectively, compared to the
minority of them who were dissatisfied at post and follow up program
intervention respectively.
• Statistically significant relation was found between intervention group’s
satisfaction with the preventive educational website and the total score of
BC knowledge, as the majority of satisfied students with website were had
good level of BC knowledge post program intervention. Otherwise, the
minority of dissatisfied students had a good level of BC knowledge.
In light of the present study findings, it was recommended that:
1. Maintaining widespread of outreach free breast cancer screening programs
for women across the nation, to provide them with information, education
and communication about breast cancer as well as screening services.
2. Implementing innovative chatbots applications in higher education as it is a
good first step towards improving staff and student services.
3. Creating and maintaining faculty-based health promotion programs, such as
offering students access to a range of healthy food options on campus,
promoting a culture that values exercise, allowing for more scheduling
flexibility, and enforcing a faculty tobacco-free policy.
4. Developing the evidence for using simulation applications to improve
nursing students’ educational skills and increase their understanding of
breast cancer and prevention strategies, inspiring them to deliver impactful
education to target audiences.
5. Developing innovative prevention measures that may be used at different
stages of life by pursuing integrated and transdisciplinary studies that
provide evidence on the causes of breast cancer and its determinants across
the life course.
References