Effects of Health Education Intervention on Health Literacy Regarding Breast and Cervical Cancer Screening Among Women in Prison

Main Article Content

admin admin
Hj. Ruslinawati
Yenny Okvitasari
Kristina Yuniarti
Hj. Noor Khalilati
Hanura Aprilia
Afiatun Rahmah
Alit Suwandewi
Hakim Zulkarnain

Abstract

Background: Woman inmate faces significant health literacy gaps, especially in breast and cervical cancer awareness. Moreover, 55.4% of incarcerated women are at risk of HPV. Almost 10% of women in the Martapura prison were screened as high risk of cancer. Inclusive, gender-sensitive health education interventions are urgently needed to address this issue. Objective: To determine the effectiveness of health education using a booklet on health literacy of BSE (Breast Self-Examination) and VIA (Visual Inspection with Acetic Acid) in Martapura prison, Indonesia. Method: The study used a one-group pre-post design involving 208 incarcerated women from Martapura Prison. A health education booklet on breast and cervical cancer was used to improve health literacy, measured through validated BSE and VIA questionnaires. Data were analyzed descriptively and using a paired T-test (α≤0.05) to assess differences. Ethical approval was obtained, and strict confidentiality measures were taken to ensure participant anonymity and data security. Results: The study found a significant difference in health literacy for BSE and VIA after the booklet intervention. The pre-intervention average health literacy score was 20,89 (SD±2,5). The post-intervention score increased to 21,17 (SD±3). The mean improvement was 0.28 (SD±0,5). The T-test yielded a p-value of 0.070, indicating that the educational intervention effectively improved health literacy regarding BSE and VIA among the inmates. Conclusions: The study concludes that booklet-based health education effectively improves BSE and VIA literacy among woman inmates. In clinical settings, increased health literacy may encourage regular BSE and VIA screening, reducing late-stage cancer risks in marginalized women in prison.

Downloads

Download data is not yet available.

Article Details

How to Cite
admin, admin, Hj. Ruslinawati, Yenny Okvitasari, Kristina Yuniarti, Hj. Noor Khalilati, Hanura Aprilia, Afiatun Rahmah, Alit Suwandewi, & Hakim Zulkarnain. (2026). Effects of Health Education Intervention on Health Literacy Regarding Breast and Cervical Cancer Screening Among Women in Prison . Malaysian Journal of Medicine and Health Sciences, 22(1), 1497.1–1497.7. https://doi.org/10.47836/mjmhs.v22.i1.1497
Section
Original Articles

References

Kab. Banjar. Class II Women’s Prison in Banjar Regency Undergoes IVA Test 2. HomeBanjarkabGoId 2019. https://doi.org/https://home.banjarkab.go.id/lapas-perempuan-kelas-ii-kabupaten-banjar-jalani-pemeriksaan-iva-test-2/.

Ministry of Law and Human Rights of Indonesia. CORRECTIONAL SERVICE STANDARDS - DIRECTOR GENERAL OF CORRECTIONS. Indonesia: 2014. https://doi.org/https://www.ditjenpas.go.id/Standar%20Pelayanan%20Pemasyarakatan.

SILOAM HOSPITAL. Martapura Class IIA Women’s Penitentiary Free Breast Cancer Screening at Martapura LPP Collaboration with Siloam Hospital Group. Berita 2024. https://doi.org/https://www.siloamhospitals.com/selangkah/artikel/selangkah-hadirkan-skrining-kanker-payudara-di-lapas-perempuan-kelas-iia-martapura.

Hariyanto AP, Mugni FF, Khumaira L, Sensusiati AD, Nursela AL, Suprijanto, et al. Fabrication and evaluation of breast tissue equivalent phantoms for image quality assessment in ultrasound imaging. Radiography 2025;31:254–63. https://doi.org/10.1016/j.radi.2024.11.023.

Housten AJ, Gunn CM, Paasche-Orlow MK, Basen-Engquist KM. Health Literacy Interventions in Cancer: A Systematic Review. J Cancer Educ 2021;36:240. https://doi.org/10.1007/S13187-020-01915-X.

Holden CE, Wheelwright S, Harle A, Wagland R. The role of health literacy in cancer care: A mixed studies systematic review. PLoS One 2021;16. https://doi.org/10.1371/JOURNAL.PONE.0259815.

Ramaswamy M, Lee J, Wickliffe J, Allison M, Emerson A, Kelly PJ. Impact of a brief intervention on cervical health literacy: A waitlist control study with jailed women. Prev Med Rep 2017;6:314–21. https://doi.org/10.1016/J.PMEDR.2017.04.003.

Ramaswamy M, Kelly PJ. “The Vagina is a very tricky little thing down there”: Cervical health literacy among incarcerated women. J Health Care Poor Underserved 2015;26:1265–85. https://doi.org/10.1353/hpu.2015.0130.

Nair US, Jordan JS, Funk D, Gavin K, Tibbetts E, Collins BN. Integrating health education and physical activity programming for cardiovascular health promotion among female inmates: A proof of concept study. Contemp Clin Trials 2016;48:65–9. https://doi.org/10.1016/J.CCT.2016.03.007.

Lamberton C, Vaughn MS. Correctional Medical Care for Female Prisoners: Legal Issues Surrounding Inadequate Treatment of Chronic and/or Preexisting Health Conditions. Prison J 2022;102:493–514. https://doi.org/10.1177/00328855221109824.

Dinkel S, Schmidt K. Health education needs of incarcerated women. Journal of Nursing Scholarship 2014;46:229–34. https://doi.org/10.1111/JNU.12079.

Coughlin SS, Vernon M, Hatzigeorgiou C, George V. Health Literacy, Social Determinants of Health, and Disease Prevention and Control. J Environ Health Sci 2020;6. https://doi.org//pmc/articles/PMC7889072/.

Santana S, Brach C, Harris L, Ochiai E, Blakey C, Bevington F, et al. Updating Health Literacy for Healthy People 2030: Defining Its Importance for a New Decade in Public Health. Journal of Public Health Management and Practice 2021;27:S258–64. https://doi.org/10.1097/PHH.0000000000001324.

Yunitasari E, Matos F, Zulkarnain H, Kumalasari DI, Kusumaningrum T, Putri TE, et al. Pregnant woman awareness of obstetric danger signs in developing country: systematic review. BMC Pregnancy Childbirth 2023;23:1–24. https://doi.org/10.1186/S12884-023-05674-7/TABLES/5.

Brousseau EC, Ahn S, Matteson KA. Cervical Cancer Screening Access, Outcomes, and Prevalence of Dysplasia in Correctional Facilities: A Systematic Review. J Womens Health 2019;28:1661. https://doi.org/10.1089/JWH.2018.7440.

Zulkarnain NIM, Vanoh D. Association between Self-Esteem and Dietary Changes among Cancer Patients: A Cross-Sectional Study. Malaysian Journal of Medicine and Health Sciences 2024;20:84–91. https://doi.org/10.47836/mjmhs.20.1.12.

Yi M, Li T, Niu M, Luo S, Chu Q, Wu K. Epidemiological trends of women’s cancers from 1990 to 2019 at the global, regional, and national levels: a population-based study. Biomark Res 2021;9. https://doi.org/10.1186/S40364-021-00310-Y.

Escobar N, Plugge E. Prevalence of human papillomavirus infection, cervical intraepithelial neoplasia and cervical cancer in imprisoned women worldwide: a systematic review and meta-analysis. J Epidemiol Community Health (1978) 2019;74:95–102. https://doi.org/10.1136/JECH-2019-212557.

Alnbaheen MS, Ikbal AMA, Salem Bekhit MM, Bhattacharjee B, Dey N, Sahu RK, et al. Exploring Interplay of Polyunsaturated Fatty Acids: A Promising Approach for Treatment of Breast Cancer. J Biol Regul Homeost Agents 2024;38:5769–92. https://doi.org/10.23812/j.biol.regul.homeost.agents.20243809.463.

Rukmana S, Rokhanawati D, Kurniati N. Awareness Women of childbearing age On Early Detection Cervical cancer: A Scoping Review. International Journal of Health Science and Technology 2021;3. https://doi.org/10.31101/IJHST.V3I2.1966.

Gondhowiardjo S, Christina N, Ganapati NPD, Hawariy S, Radityamurti F, Jayalie VF, et al. Five-Year Cancer Epidemiology at the National Referral Hospital: Hospital-Based Cancer Registry Data in Indonesia. JCO Glob Oncol 2021:190–203. https://doi.org/10.1200/GO.20.00155.

Suryanegara W, Gultom FL. Relationship of Knowledge in Women Age 25-50 Years in RW 05 Cibubur, East Jakarta on BSE Knowledge as Early Detection of Breast Cancer. Journal of Drug Delivery and Therapeutics 2022;12:110–7. https://doi.org/10.22270/JDDT.V12I1-S.5218.

Crosby D, Bhatia S, Brindle KM, Coussens LM, Dive C, Emberton M, et al. Early detection of cancer. Science (1979) 2022;375. https://doi.org/10.1126/SCIENCE.AAY9040.

Maharani C, Herlambang H, Enis RN, Fitri AD, Kusdiyah E, Harahap H, et al. PEMERIKSAAN IVA UNTUK DETEKSI DINI LESI PRA-KANKER DI MASA PANDEMI COVID-19 PADA MASYARAKAT MENDALO INDAH, JAMBI. Medical Dedication (Medic) Jurnal Pengabdian Kepada Masyarakat FKIK UNJA 2021;4:165–9. https://doi.org/10.22437/MEDICALDEDICATION.V4I1.13475.

Wu Q, Tan J, Chen S, Wang J, Liao X, Jiang L. Incidence and influencing factors related to social isolation among HIV/AIDS patients: Protocol for a systematic review and metaanalysis. PLoS One 2024;19. https://doi.org/10.1371/journal.pone.0307656.

Willingham ML, Cassel KD, Sy A, Taafaki M, Diaz TP, Mummert AG, et al. Abstract PR011: Exploring factors influencing preventive cancer screenings for Native Hawaiian and Pacific Islander adults in Hawaiʻi. Cancer Epidemiology, Biomarkers & Prevention 2023;32:PR011–PR011. https://doi.org/10.1158/1538-7755.DISP23-PR011.

Puteh SEW, Abdullah YR, Aizuddin AN. Catastrophic Health Expenditure Among Cancer Patients In National Cancer Institute (NCI), Malaysia And Its Influencing Factors. Malaysian Journal of Medicine and Health Sciences 2024;20:21–9. https://doi.org/10.47836/mjmhs.20.1.4.

Galán-Casado D, del Mar García-Vita M, Raya-Miranda R, Añaños FT. Prison and Stigma. A Study from a Socio-educational and Gender Perspective. Generos 2024;13:22–42. https://doi.org/10.17583/generos.12508.

Munakampe MN, Haaland MESH, Zulu JM, Michelo C. From science to sustainable systems: Evidence based-decision making for adolescent fertility in Zambia. Health Policy Open 2021;2:100046. https://doi.org/10.1016/J.HPOPEN.2021.100046.

Sriyono S, Nursalam N, Hamzah H. Family resilience, coping and disaster preparedness in the coastline area: One and a half years post-earthquake in Lombok. Systematic Reviews in Pharmacy 2020;11:1085–9. https://doi.org/10.31838/srp.2020.6.154.

Chukwudi Cosmos Maha, Tolulope Olagoke Kolawole, Samira Abdul. Revolutionizing community health literacy: The power of digital health tools in rural areas of the US and Africa. GSC Advanced Research and Reviews 2024;19:286–96. https://doi.org/10.30574/gscarr.2024.19.2.0189.

Joy A, Carey L, Neilson C, Lockwood K, Harding K. Online learning for allied health knowledge translation: A systematic review. Health Education in Practice: Journal of Research for Professional Learning 2024;7. https://doi.org/10.33966/hepj.7.1.17698.

Elliot DL, Goldberg L, MacKinnon DP, Ranby KW, Kuehl KS, Moe EL. Empiric validation of a process for behavior change. Transl Behav Med 2016;6:449–56. https://doi.org/10.1007/s13142-015-0343-y.

Hewson T, Minchin M, Lee K, Liu S, Wong E, Edge C, et al. Interventions for the detection, monitoring, and management of chronic non-communicable diseases in the prison population: an international systematic review. BMC Public Health 2024;24. https://doi.org/10.1186/S12889-024-17715-7.

Laili NR, Zulkarnain H, Yasmara D, Sriyono. Promoting spiritual nursing care in an intensive care unit: A systematic review. Indian J Public Health Res Dev 2019;10:2773–7. https://doi.org/10.5958/0976-5506.2019.02291.5.

Melnikow J, Henderson JT, Burda BU, Senger CA, Durbin S, Weyrich MS. Screening for cervical cancer with high-risk human papillomavirus testing updated evidence report and systematic review for the us preventive services task force. JAMA - Journal of the American Medical Association 2018;320:687–705. https://doi.org/10.1001/jama.2018.10400.

Ramaswamy M, Simmons R, Kelly PJ. The Development of a Brief Jail-Based Cervical Health Promotion Intervention. Health Promot Pract 2015;16:432–42. https://doi.org/10.1177/1524839914541658.

Keinki C, Zowalla R, Wiesner M, Koester MJ, Huebner J. Understandability of Patient Information Booklets for Patients with Cancer. J Cancer Educ 2018;33:517–27. https://doi.org/10.1007/S13187-016-1121-3.

Hartiningsih SN. Pengaruh pendidikan kesehatan dengan media audiovisual dan media booklet terhadap perilaku caregiver dalam mencegah tuberkulosis pada anggota keluarga. Health Sciences and Pharmacy Journal 2018;2:97. https://doi.org/10.32504/HSPJ.V2I3.43.