J Cancer Educ. 2025 Dec 13. doi: 10.1007/s13187-025-02797-7. Online ahead of print.
ABSTRACT
Guided by the Andersen Behavioral Model of Health Service Utilization, this study examined the impact of a structured educational intervention to improve uptake of cervical cancer preventive services (CCPS) among female students at Kenyatta University, Kenya. The study implemented a cluster randomized controlled trial allocating two Kenyatta University campuses (Kitui – intervention; Mombasa – control) to study arms. A total of 243 female students aged ≥ 18 years were recruited (Intervention = 121; Control = 122). The intervention comprised six bi-weekly, face-to-face health education sessions delivered over 12 weeks, combining didactic content, demonstrations and facilitated peer discussions. Data were collected from 1st January 2025 to 31st March 2025; at baseline and at 12 weeks post-intervention using structured researcher-administered questionnaires and self-reports triangulated with university clinic records. Analyses included descriptive statistics, χ2 tests for differences in proportions, difference-in-differences (DiD) estimation of the intervention effect, and multivariable logistic regression. All analyses were adjusted for clustering effect. At endline, uptake in the intervention arm was 44.2% while the control arm remained essentially unchanged (8.0%); the DiD estimate was + 39.4% (p < 0.001). Multivariable logistic regression including an interaction term for time × treatment produced an adjusted odds ratio (aOR) for the intervention effect of 8.02 (95% CI: 2.01-12.65; p = 0.005). Awareness of service availability (aOR = 3.52) and community/peer support (aOR = 2.13) were independent predictors of CCPS uptake. A structured, repeated educational intervention programme delivered within the university context significantly increased uptake of CCPS. For sustained impact, such interventions should be linked to visible, accessible campus services and embedded in university health promotion structures.
PMID:41389176 | DOI:10.1007/s13187-025-02797-7
