Effects of Education via WhatsApp vs Compact Disk on Health Literacy and Behavior of Middle-Aged Women about Screening Methods of Breast Cancer

The aim of this study was to compare the effect of delivering education via WhatsApp vs a compact disc on health literacy and behavior of middle-aged women about breast cancer.

This was a randomized controlled trial in which 154 middle-aged (40-59 years) women were recruited and randomly assigned into two groups of education (WhatsApp and compact disc [CD]). The CD training group was given a CD containing information, videos, and images about breast cancer screening methods. Women in the WhatsApp group received the same information on a daily basis for two weeks. The participants completed the Health Literacy Questionnaire (BCHL) before the intervention and after three months. The independent t test, the chi-square test, and the Wilcoxon test were used for analyzing the data.

The total score of health literacy was improved significantly in both groups after the intervention (from 79.1 ± 18.6 at baseline to 94.7 ± 11.9 in the CD group, and from 75.6 ± 17.7 to 85.5 ± 17 in the WhatsApp group; P < 0.0001). The improvement was observed in all domains of breast cancer health literacy including accessibility, reading, understanding, assessment, and decision making. Although using breast self-examination improved significantly in the two groups, there was little improvement in using clinical breast examination and mammography.

The results of this study showed that education could significantly improve the health literacy as well as the behavior of middle-aged women about breast cancer, but the comparison of the effects of the two methods showed a greater effect for education via CD.