Effectiveness of community-based culturally tailored cervical cancer awareness interventions among women and decision-making men in low-resource settings: A pre-post design evaluation in rural Uganda and Bangladesh

Objective: Cervical cancer disproportionately affects women in low-resource settings (LRS), where screening uptake and awareness remains low. Male household decision-makers often influence women's health decisions but are infrequently targeted in awareness interventions. This study evaluated culturally tailored interventions to improve cervical cancer awareness among women and male household decision-makers in rural Uganda and Bangladesh. Methods: A quasi-experimental pre-post design using data from the PRevention and SCReening Innovation Project Toward Elimination of Cervical Cancer (PRESCRIP-TEC) surveyed women and male household decision-makers before (Uganda May 2022; Bangladesh April-June 2022) and after (December 2022-October 2023) a mass media with community health worker (CHW) outreach intervention. Multivariable logistic regression assessed changes in risk factor and symptom knowledge. Results: Among 3342 respondents (1453 pre-, 1889 post-intervention), women and decision-making men showed significantly improved awareness post-intervention: risk factor knowledge (women OR = 9.51, 95% CI: 7.52, 12.02; men OR = 11.72, 95% CI: 8.03, 17.10) and symptom knowledge (women OR = 6.24, 95% CI: 5.03, 7.74; men OR = 4.53, 95% CI: 3.31, 6.19), after adjustment for covariates. Conclusions: Culturally tailored interventions engaging male household decision-makers alongside women and integrating mass media with CHW-led outreach effectively improves cervical cancer awareness across socio-culturally diverse LRS and can inform policy and screening campaigns in LRS.