The Effect of Motivational Interviewing on Breast Cancer Screening Behaviors in Rural Women: A Randomized Clinical Trial

Abstract

Abstract Background and Objectives: Breast cancer is one of the most common cancers and the second leading cause of death from cancer among women. Despite the availability of breast cancer screening methods, there is little public acceptance for using these facilities. The fact is, people are not reluctant to adopt screening behaviors when feeling good, so the adoption of screening behaviors depends largely on motivational factors. Given the lack of easy access for women in rural areas to advanced breast cancer screening facilities, such as mammography, and considering rare of the motivational interviewing interventions for adopting breast cancer screening behaviors, this study was designed. Materials and Methods: This randomized clinical trial was conducted on 60 rural women. Sampling was conducted using cluster randomized method in which from 20 rural health houses and centers, about one third of them were selected randomly and then from the 6 selected clusters, 3 were randomly allocated as the control group and 3 as the intervention group. Then, using convenience sampling, 30 women between the ages of 40 - 69 were selected from the control group and 30 from the intervention group. For the intervention group, six group counseling sessions (two training sessions and four motivational interviewing sessions) were held with 8-12 participants twice a week. Data were gathered using demographic and obstetric characteristics questionnaire, checklist of stages of behavior change, and Breast cancer awareness measure, before and 2 months after the intervention by interviews and analyzed by SPSS24 software. Chi-square, Independent t-test, ANCOVA, and sequential logistic regression with generalized estimator equations were used to analyze the data. Results: In this study, the two groups did not differ significantly in terms of demographic and midwifery characteristics (p> 0.05). Before intervention, there was no significant difference between the two groups in relation to breast check, clinical breast examination and mammography, but two months after the intervention, there was a significant difference between the two groups in terms of changing stages of all three screening methods by considering the behavioral stages before the intervention (p <0.001). Conclusion: Motivational interviewing counseling had led to encouraging breast cancer screening behaviors. Therefore, it is suggested that a motivational interviewing approach be used in health centers along with educational programs to promote breast cancer screening behaviors.