{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T04:03:59Z","timestamp":1773029039028,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Breast cancer persists as a significant contributor to global morbidity and mortality. Although early detection through systematic screening plays a pivotal role in improving outcomes, women with limited literacy frequently exhibit reduced participation, primarily due to insufficient awareness and heightened apprehension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The purpose of this research was to evaluate whether an educational programme using audiovisual tools could improve breast cancer screening practices and decrease fear in women with low literacy levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A randomised, double\u2010blind study was carried out involving 120 women between 40 and 69 years old. Participants were assigned by chance to one of two groups: the intervention group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200960) or the control group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200960). The intervention entailed a 12\u2010week structured programme, delivered once a week, which included the use of multimedia resources and breast models to provide training in breast self\u2010examination, clinical breast examination, and mammography techniques. Outcomes were measured pre\u2010 and post\u2010intervention using the Champion Breast Cancer Fear Scale and the Breast Cancer Screening Behaviour Questionnaire. Data were analysed using chi\u2010square tests, mixed\u2010model ANOVA, independent\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests, and repeated\u2010measures MANOVA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Post\u2010intervention, screening behaviours were markedly higher in the intervention versus control group\u2014 breast self\u2010examination BSE 91.7% versus 33.3% (\u03c7\u00b2(1)\u2009=\u200943.56,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), clinical breast examination 95.0% vs. 6.7% (\u03c7\u00b2(1)\u2009=\u200993.66,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and mammography 81.7% vs. 6.7% (\u03c7\u00b2(1)\u2009=\u200968.43,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Breast cancer\u2013related fear showed a significant time\u2009\u00d7\u2009group effect (mixed\u2010model ANOVA), F(1,114)\u2009=\u200970.35,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001, \u03b7p\u00b2\u2009=\u20090.38. Groups were equivalent at pre\u2010test (t(118)\u2009=\u20090.46,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.647). At post\u2010test, fear scores were substantially lower in the intervention group (M\u2009=\u200912.38, SD\u2009=\u20093.05) than control (M\u2009=\u200923.78, SD\u2009=\u200910.91), Welch's t(68.19)\u2009=\u2009\u22127.79,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001, Cohen's d\u2009=\u20091.42, indicating a large effect.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Audiovisual education with breast model simulations effectively enhances screening behaviours and reduces fear among low\u2010literacy populations. Implementing such programmes in rural areas can also support midwives and healthcare providers by improving patient engagement, facilitating education, and reducing barriers to early detection. These findings highlight the potential of audiovisual interventions as practical public health strategies to promote breast cancer awareness and screening in underserved communities.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      Clinical Trial ID: NCT06898229.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jep.70387","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T06:32:40Z","timestamp":1771482760000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Effect of Audiovisual Education on Breast Cancer Screening and Fear Among Illiterate Women: A Double\u2010Blind Randomised Controlled Trial"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3932-8017","authenticated-orcid":false,"given":"Sabriye 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