Health belief model-based educational interventions for knowledge, beliefs, and intentions on mammography: a systematic review

Abstract

Background Breast cancer (BC) is a significant global health issue and the most common cancer among women. Early detection via mammography is crucial for improving survival rates. This systematic review (SR) explores the impact of educational interventions based on the Health Belief Model (HBM) on women’s BC knowledge, beliefs, and intentions regarding mammography among women aged 40 and older.lease be informed that I submitted Methods The SR was registered on PROSPERO (CRD42023402436) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA, 2020) guidelines. A comprehensive search was conducted across f ive databases—PubMed, CINAHL, Embase, Web of Science, and PsycINFO—for relevant English-language studies published from January 2003 to December 2024. The study quality was assessed using the Cochrane Risk of Bias 2 (RoB 2) and the Revised Risk of Bias Assessment 2 (RoBANS 2) tools. A narrative synthesis was conducted following established methodological guidance. Results Eight studies were included, consisting of five randomized controlled trials (RCTs) and three non-randomized controlled trials (NRCTs), with a total of 1,439 participants. The interventions included individual, group, and multimedia education and consultations. Six studies showed significant improvement in knowledge, while seven showed improvement in one or more constructs of the CHBMS related to beliefs about mammogram screening. Key factors influencing screening intentions were embarrassment, cost, income level, health insurance, age, and immigration status. Limitations of the studies included small sample sizes, reliance on self-reported data, lack of control groups, and short follow-up periods. Conclusion Educational interventions based on HBM generally improve BC knowledge, beliefs, and intentions about mammography in women aged 40 years and older. Interventions that incorporate multiple strategies within healthcare settings show the most significant improvements. Future approaches should be multifaceted, sensitive to cultural and socioeconomic contexts, and include ongoing follow-up to promote screening adherence and early BC detection.