Effectiveness of a health belief model-based self-examination of the vulva education program on women’s vulvar health awareness, health literacy, health beliefs, and self-examination practice: a randomized controlled trial

To evaluate the effects of a Health Belief Model-based vulvar self-examination education program on women’s health beliefs, vulvar health awareness, knowledge-based health literacy, and self-reported self-examination practices. A two-arm randomized controlled trial was conducted at six family health centres in Ankara, Türkiye, between August and October 2025. Of 206 randomized women, 203 were analysed (intervention: n = 100; control: n = 103). The intervention group received a 45-minute Health Belief Model-based education session combining theoretical instruction and anatomical model practice, while controls received routine counselling and educational materials. Outcomes were assessed at baseline and one month. Health beliefs (primary outcome domain) were evaluated using five Champion Health Belief Model Scale subscales; secondary outcomes included vulvar health awareness, knowledge-based health literacy, and self-reported self-examination. Data were analysed using mixed-design repeated-measures ANOVA, group comparison tests, and McNemar’s test. Müdahale grubunda vulva sağlığı farkındalığı puanı 11,54 ± 3,10’dan 16,63 ± 2,65’e, bilgi temelli vulva sağlığı okuryazarlığı puanı ise 12,70 ± 3,74’ten 19,21 ± 3,16’ya yükselmiştir. Her iki sonuç için grup × zaman etkileşimi anlamlı bulunmuştur (sırasıyla F(1,201) = 181,348; η²ₚ=0,474 ve F(1,201) = 176,696; η²ₚ=0,468; her ikisi için p < 0,001). Self-Examination of the Vulva uyguladığını bildiren kadınların oranı müdahale grubunda %11,0’den %73,0’e yükselirken ( p < 0,001), kontrol grubunda anlamlı değişim gözlenmemiştir ( p = 1,000). Sağlık inançlarının alt boyutlarında algılanan yararlar (F(1,201) = 9,007; p = 0,003; η²ₚ=0,043) ve öz etkililik/güven (F(1,201) = 58,943; p < 0,001; η²ₚ=0,227) açısından anlamlı grup × zaman etkileşimleri saptanmıştır. Algılanan duyarlılık ( p = 0,721), ciddiyet ( p = 0,530) ve engeller ( p = 0,387) açısından ise anlamlı grup × zaman etkileşimi bulunmamıştır. In the intervention group, vulvar health awareness scores increased from 11.54 ± 3.10 to 16.63 ± 2.65, and knowledge-based vulvar health literacy scores from 12.70 ± 3.74 to 19.21 ± 3.16, with significant group × time interactions (F(1,201) = 181.348, η²ₚ=0.474; F(1,201) = 176.696, η²ₚ=0.468; both p < 0.001). Self-reported vulvar self-examination increased from 11.0% to 73.0% ( p < 0.001), with no significant change in controls ( p = 1.000). Significant group × time interactions were observed for perceived benefits ( p = 0.003) and self-efficacy ( p < 0.001), but not perceived susceptibility ( p = 0.721), seriousness ( p = 0.530), or barriers ( p = 0.387). ClinicalTrials.gov, NCT07621315 retrospectively registered on May 18, 2026.