The impact of theory-based educational interventions: A three-arm randomized controlled trial comparing face-to-face, mobile-based, and control approaches on pap smear acceptance.

Objective: This study aimed to evaluate the effectiveness of face-to-face and mobile-based educational interventions, grounded in the Health Belief Model (HBM), in promoting Pap smear acceptance.

Methods: A three-arm randomized controlled trial was conducted among 135 women attending urban health centers under the supervision of the Zanjan Health Center in Alborz, Iran. Participants were randomly assigned to one of three groups: face-to-face education, mobile-based education via Telegram, and a control group receiving no immediate intervention. Statistical analyses included repeated measures ANOVA (RMANOVA) and analysis of covariance (ANCOVA) to adjust for confounding factors. The data collection period spanned from November 1, 2023, to September 5, 2024.

Results: Both face-to-face and mobile-based interventions significantly improved awareness and HBM constructs compared to the control group. The mobile-based group demonstrated the greatest increase in perceived susceptibility and self-efficacy immediately post-intervention. Behavioral intention and actual Pap smear uptake also showed significant improvement in the intervention groups. However, perceived barriers did not differ significantly between the groups.

Conclusions: Theory-based educational interventions-especially mobile-based strategies-effectively promote Pap smear acceptance. Their accessibility supports national screening efforts and aligns with global policies aimed at reducing disparities. Integrating mobile education into public health programs may enhance coverage and improve preventive outcomes.