Promoting Pap Smear Uptake in Dehloran Housewives: a randomized Control trial (RCT) Using the Extended Parallel Process Model

Promoting Pap Smear Uptake in Dehloran Housewives: a randomized Control trial (RCT) Using the Extended Parallel Process Model | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Promoting Pap Smear Uptake in Dehloran Housewives: a randomized Control trial (RCT) Using the Extended Parallel Process Model Shirin Javid, Hassan Ahmadinia, Molouk Jaafarpour, Mahmood Mahbobi Rad, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7463258/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 8 You are reading this latest preprint version Abstract Background: Cervical cancer is one of the preventable and curable cancers among women, but due to low participation in screening programs, especially in less-privileged areas, it remains one of the major causes of mortality. The aim of this study was to determine the effectiveness of an educational intervention based on the Extended Parallel Process model (EPPM) on encouraging housewives in Dehloran to undergo Pap smear tests. Methods: The randomized control trial (RCT) conducted in 2024 among 120 housewives aged 30 to 59 years, and the participants were randomly allocated to two intervention and control groups (60 women in each group). The data collection tool was a researcher-made questionnaire based on EPPM constructs. The educational intervention consisted of four 60-minute group sessions that were designed using interactive and media methods. Data were collected in two stages: pre-test and two-month follow-up and analyzed using chi-square, independent t-test, and paired t-test in SPSS version 24. Results: After the intervention, the mean score of susceptibility, severity, threat appraisal, self-efficacy, response efficacy, and efficacy appraisal in the intervention group increased significantly (P<0.001). Also, the proportion of women in the danger control process in this group increased from 8.3% to 26.7% (P<0.001). Two months after training, 60% of the women in the intervention group had undergone a Pap smear test compared to 18.3% in the control group (P<0.001). Conclusions: The results showed that the educational intervention based on the EPPM can be used as an effective approach in promoting Pap smear screening behavior in housewives. Especially in less-privileged areas, we recommend using this model to design educational programs. Trial Registration: IRCT86081. Registered 09/24/2025. Available at: https://irct.behdasht.gov.ir/trial/86081 Uterine Cervical Neoplasms Pap smear test Health Education Extended Parallel Process Model Housewives Randomized Control Trial Full Text Additional Declarations No competing interests reported. Supplementary Files TheQuestionnaireofPromotingPapSmearUptakeinDehloranHousewives.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 08 Jan, 2026 Reviewers agreed at journal 08 Jan, 2026 Reviews received at journal 06 Nov, 2025 Reviewers agreed at journal 28 Oct, 2025 Reviewers invited by journal 30 Sep, 2025 Editor assigned by journal 29 Sep, 2025 Submission checks completed at journal 28 Sep, 2025 First submitted to journal 28 Sep, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7463258","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":527698199,"identity":"61a9ad6d-cd7b-4b0e-82c3-1d0dfd2c44c2","order_by":0,"name":"Shirin Javid","email":"","orcid":"","institution":"Rafsanjan University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Shirin","middleName":"","lastName":"Javid","suffix":""},{"id":527698202,"identity":"c2e58839-7ff9-4297-b16e-b7f06179a5e4","order_by":1,"name":"Hassan Ahmadinia","email":"","orcid":"","institution":"Rafsanjan University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Hassan","middleName":"","lastName":"Ahmadinia","suffix":""},{"id":527698203,"identity":"207a377b-0758-4375-9446-26b6a4a3f8d4","order_by":2,"name":"Molouk Jaafarpour","email":"","orcid":"","institution":"Ilam University of Medical sciences","correspondingAuthor":false,"prefix":"","firstName":"Molouk","middleName":"","lastName":"Jaafarpour","suffix":""},{"id":527698204,"identity":"eed3d3e2-b218-4833-8cae-14da2069bf0a","order_by":3,"name":"Mahmood Mahbobi Rad","email":"","orcid":"","institution":"Rafsanjan University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Mahmood","middleName":"Mahbobi","lastName":"Rad","suffix":""},{"id":527698207,"identity":"8ee17be7-28d3-40fa-ba85-c672c70903b4","order_by":4,"name":"Mohammad Aligol","email":"","orcid":"","institution":"Associate Professor of Health Education and Promotion, Qom University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Mohammad","middleName":"","lastName":"Aligol","suffix":""},{"id":527698209,"identity":"21844c78-a94f-4b75-b1c9-04e2c77e4906","order_by":5,"name":"Mostafa Nasirzadeh","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA7UlEQVRIiWNgGAWjYLCCBBBxgIfh4IcKBgYDUrQwHpY4Q6wWBogW5gO8bURo0Z3d/PjDwz118nzHew8ckJx3WN6cvfkAw4+KbTi1mN05ZiaR8IzNcOaZcwkHCrcdNtzZcyyBsefMbdxabiSYMSQA/bHhRo7BAclth8EMZsY2fFrSP39IOCBhv+H+G4MDvHMO2xOhJcdAIuGAQeKGGzxALQ2HE4nRUgbUkpA880yOwWGJY+nJG84cSziI3y/pmz/+OFBn23f8jPHHDzXWthuONx988KMCtxZ00AwmDxCtHgjqSFE8CkbBKBgFIwQAAGcGZ7+GnUeuAAAAAElFTkSuQmCC","orcid":"","institution":"Rafsanjan University of Medical Sciences","correspondingAuthor":true,"prefix":"","firstName":"Mostafa","middleName":"","lastName":"Nasirzadeh","suffix":""}],"badges":[],"createdAt":"2025-08-26 13:08:22","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7463258/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7463258/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":93359631,"identity":"d7c56add-4a73-421d-8be2-6cfbf33d717d","added_by":"auto","created_at":"2025-10-13 02:51:48","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":192878,"visible":true,"origin":"","legend":"","description":"","filename":"PromotingPapsmearUptakeinDehloranHousewivesENGLISH1.docx","url":"https://assets-eu.researchsquare.com/files/rs-7463258/v1/fd1a97c3220649c0311758c7.docx"},{"id":93359483,"identity":"46a79a46-72f8-4d1f-b039-0c7bdbe4fd2a","added_by":"auto","created_at":"2025-10-13 02:43:48","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":7771,"visible":true,"origin":"","legend":"","description":"","filename":"22ce2d3823554bdda303399209f9d33b.json","url":"https://assets-eu.researchsquare.com/files/rs-7463258/v1/869c43be8ec6209cb642e25c.json"},{"id":93360018,"identity":"60069136-8d50-419f-9798-f7fbf19d8a6b","added_by":"auto","created_at":"2025-10-13 02:59:48","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":14209,"visible":true,"origin":"","legend":"","description":"","filename":"TheQuestionnaireofPromotingPapSmearUptakeinDehloranHousewives.docx","url":"https://assets-eu.researchsquare.com/files/rs-7463258/v1/a730b9a2e2e21d3f9e12d0e0.docx"},{"id":93359480,"identity":"2580f36b-cfc4-4bc2-bf56-3405df3bf1e8","added_by":"auto","created_at":"2025-10-13 02:43:48","extension":"png","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":44088,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7463258/v1/4d4c68c8fed4de6ead80007f.png"},{"id":93359486,"identity":"d21cc791-0d02-4cf5-a467-4a9ac924ccc3","added_by":"auto","created_at":"2025-10-13 02:43:48","extension":"jpeg","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":494909,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage2.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7463258/v1/3aad024c00fd9d9627182773.jpeg"},{"id":93359633,"identity":"7159b071-f3a6-436f-9708-79975ae0038e","added_by":"auto","created_at":"2025-10-13 02:51:48","extension":"png","order_by":5,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":24431,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7463258/v1/98ad7bb2fa5287b140081b54.png"},{"id":93359487,"identity":"2bc3e401-e3dd-49db-9e07-d3eab45965a6","added_by":"auto","created_at":"2025-10-13 02:43:48","extension":"png","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":107311,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-7463258/v1/61a62063398db0a37a65bf0c.png"},{"id":93360266,"identity":"27b8633d-3ee4-4b73-8914-174ddc4da80b","added_by":"auto","created_at":"2025-10-13 03:07:50","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":555838,"visible":true,"origin":"","legend":"","description":"","filename":"PromotingPapsmearUptakeinDehloranHousewivesENGLISH1.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7463258/v1_covered_2be00607-17df-4312-835f-946c2b80b6d4.pdf"},{"id":93359485,"identity":"a1bd7299-8124-4dd6-a029-142da63e1f90","added_by":"auto","created_at":"2025-10-13 02:43:48","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":14209,"visible":true,"origin":"","legend":"","description":"","filename":"TheQuestionnaireofPromotingPapSmearUptakeinDehloranHousewives.docx","url":"https://assets-eu.researchsquare.com/files/rs-7463258/v1/82b32231f4a6b1de46b0017e.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Promoting Pap Smear Uptake in Dehloran Housewives: a randomized Control trial (RCT) Using the Extended Parallel Process Model","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Uterine Cervical Neoplasms, Pap smear test, Health Education, Extended Parallel Process Model, Housewives, Randomized Control Trial","lastPublishedDoi":"10.21203/rs.3.rs-7463258/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7463258/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Cervical cancer is one of the preventable and curable cancers among women, but due to low participation in screening programs, especially in less-privileged areas, it remains one of the major causes of mortality. The aim of this study was to determine the effectiveness of an educational intervention based on the Extended Parallel Process model (EPPM) on encouraging housewives in Dehloran to undergo Pap smear tests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e The randomized control trial (RCT) conducted in 2024 among 120 housewives aged 30 to 59 years, and the participants were randomly allocated to two intervention and control groups (60 women in each group). The data collection tool was a researcher-made questionnaire based on EPPM constructs. The educational intervention consisted of four 60-minute group sessions that were designed using interactive and media methods. Data were collected in two stages: pre-test and two-month follow-up and analyzed using chi-square, independent t-test, and paired t-test in SPSS version 24.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e After the intervention, the mean score of susceptibility, severity, threat appraisal, self-efficacy, response efficacy, and efficacy appraisal in the intervention group increased significantly (P\u0026lt;0.001). Also, the proportion of women in the danger control process in this group increased from 8.3% to 26.7% (P\u0026lt;0.001). Two months after training, 60% of the women in the intervention group had undergone a Pap smear test compared to 18.3% in the control group (P\u0026lt;0.001).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e The results showed that the educational intervention based on the EPPM can be used as an effective approach in promoting Pap smear screening behavior in housewives. Especially in less-privileged areas, we recommend using this model to design educational programs.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTrial Registration:\u003c/strong\u003eIRCT86081. Registered 09/24/2025. Available at: https://irct.behdasht.gov.ir/trial/86081\u003c/p\u003e","manuscriptTitle":"Promoting Pap Smear Uptake in Dehloran Housewives: a randomized Control trial (RCT) Using the Extended Parallel Process Model","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-13 02:43:44","doi":"10.21203/rs.3.rs-7463258/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-01-08T11:41:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"244215081457755972530726128868444795484","date":"2026-01-08T06:31:14+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-06T08:01:44+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"196831575584558031230972653441004273311","date":"2025-10-28T13:35:03+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-09-30T13:09:42+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-09-29T05:34:50+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-09-28T04:54:09+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2025-09-28T04:52:16+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f3d50b8a-6040-4ef0-967b-73b2a36ed7a6","owner":[],"postedDate":"October 13th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-10-13T02:43:44+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-13 02:43:44","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7463258","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7463258","identity":"rs-7463258","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}