Development and Effectiveness of a Health Promotion Program Applying the Health Belief Model to Enhance Cervical Cancer Screening Behaviors among Women in Mueang Samut Sakhon District, Samut Sakhon Province

Abstract

This research and development (R&D) aimed to develop and evaluate a Health Belief Model-based health promotion program to enhance cervical cancer screening behaviors among women in Muang District, Samut Sakhon Province. The study was conducted in four phases. Phase 1 (R1) involved a qualitative exploration among 34 public health personnel to identify local contexts, challenges, and implementation needs through group discussions. Phase 2 (D1) focused on developing a draft program by integrating Phase 1 findings with the core HBM constructs, which was subsequently assessed for content validity by a panel of experts. Phase 3 (R2) examined the effectiveness of the developed program using a quasi-experimental design. A total of 80 women aged 30-60 years were purposively selected and assigned to either an intervention group (n = 40) or a comparison group (n = 40). Data were collected between September and December 2025. Qualitative data were analyzed using content analysis, while quantitative data were analyzed using descriptive statistics, Chi-square test, Fisher’s exact test, Paired t-test and independent t-test. Phase 4 (D2) involved the synthesis and refinement of the program based on the findings from Phase 3.

The findings from Phase 1 indicated that public health personnel emphasized the importance of comprehensively applying the Health Belief Model as a guiding framework, as women in the area still lacked accurate knowledge and awareness regarding cervical cancer and screening. The developed program comprised six activities aligned with the core constructs of the Health Belief Model. The effectiveness evaluation revealed that, after the intervention, the intervention group demonstrated significantly increased scores in knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, and intention to undergo cervical cancer screening. Significant within-group improvements were observed, and some components also differed significantly from those of the comparison group (p-value <0.05).

The synthesis suggested that the program has strong potential to enhance psychosocial determinants that facilitate behavioral decision-making and can be adapted for use within community-based health service systems.