Promoting Pap Smear Uptake in Dehloran Housewives: a randomized Control trial (RCT) Using the Extended Parallel Process Model

Abstract Background: Cervical cancer is one of the preventable and curable cancers among women, but due to low participation in screening programs, especially in less-privileged areas, it remains one of the major causes of mortality. The aim of this study was to determine the effectiveness of an educational intervention based on the Extended Parallel Process model (EPPM) on encouraging housewives in Dehloran to undergo Pap smear tests. Methods: The randomized control trial (RCT) conducted in 2024 among 120 housewives aged 30 to 59 years, and the participants were randomly allocated to two intervention and control groups (60 women in each group). The data collection tool was a researcher-made questionnaire based on EPPM constructs. The educational intervention consisted of four 60-minute group sessions that were designed using interactive and media methods. Data were collected in two stages: pre-test and two-month follow-up and analyzed using chi-square, independent t-test, and paired t-test in SPSS version 24. Results: After the intervention, the mean score of susceptibility, severity, threat appraisal, self-efficacy, response efficacy, and efficacy appraisal in the intervention group increased significantly (P<0.001). Also, the proportion of women in the danger control process in this group increased from 8.3% to 26.7% (P<0.001). Two months after training, 60% of the women in the intervention group had undergone a Pap smear test compared to 18.3% in the control group (P<0.001). Conclusions: The results showed that the educational intervention based on the EPPM can be used as an effective approach in promoting Pap smear screening behavior in housewives. Especially in less-privileged areas, we recommend using this model to design educational programs. Trial Registration:IRCT86081. Registered 09/24/2025. Available at: https://irct.behdasht.gov.ir/trial/86081