Community-Based Health Education to Improve Knowledge, Attitudes, and Participation in Visual Inspection of Acetic Acid Testing

Abstract

Cervical cancer remains a major reproductive health problem with low Visual Inspection with Acetic Acid (VIA) screening coverage in Indonesia. This study aimed to evaluate the effects of community-based health education through the “Bincang Asik” program on knowledge, attitudes, and participation in visual inspection with acetic acid (VIA) screening among women of reproductive age. A pre-experimental one-group pretest–posttest design was conducted among 59 women selected via simple random sampling at Primary Health Center, West Lombok. The "Bincang Asik" intervention employed a participatory peer-group discussion approach, meeting weekly for one month to discuss cervical cancer prevention. Knowledge (25 items) and attitudes (10 items) questionnaires were administered, alongside tracking VIA attendance. Because the data violated normality assumptions, pre- and post-intervention scores were analyzed using the Wilcoxon signed-rank test. The results of the study show that  knowledge scores significantly increased from a baseline mean of 45.20 ± 8.13 to 79.77 ± 6.45 (mean difference: 34.57; p<0.001), with 94.9% achieving good knowledge post-test. Similarly, positive attitudes improved from a baseline mean of 52.30 ± 5.42 to 72.40 ± 4.11 (mean difference: 20.10; p<0.001; 94.9% positive attitudes). However, actual VIA screening participation only reached 25%. In conclusion, while the participatory approach of the "Bincang Asik" program positively influences cognitive and affective outcomes, it does not fully translate into behavior.However, actual VIA screening participation only reached 25%. In conclusion, while the participatory approach of the "Bincang Asik" program positively influences cognitive and affective outcomes, it does not fully translate into behavior.