1 Department of Nursing and Midwifery, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran

2 Student Research Committee, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran


CONTEXT: Pap smear test is one of the most important actions in preventing cervical cancer. This
study aimed to perform a meta-analysis on all related literature about the effects of health belief
model (HBM)-based training on Pap smear screening test performance of Iranian women.
METHODS: The search was performed in Scopus, PubMed, and Web of Science. Eligibility criteria
were limited to English and Persian language articles with experimental or semi-experimental methods
until October 2019 that evaluated the effect of HBM-based training on Iranian women’s performance
of Pap smear test. We excluded studies that used both cervical and breast cancer screening together.
RESULTS: Twelve studies were performed on totally 1605 participants. This meta-analysis showed
that all of Health Belief Model (HBM) constructs improved significantly among HBM-based trained
women, perceived susceptibility (standard mean division [SMD] =0.785; P = 0.002; confidence interval
[CI] = 0.005 to 1.56; Heterogeneity; P = 0.013; I2 = 97%)., perceived severity (SMD = 1.14; P = 0.001;
CI = 0.66–1.62; heterogeneity; P < 0.001; I2 = 92%), perceived benefits (SMD = 1.25; P = 0.001;
CI = 0.545–0.135 heterogeneity; P = 0.003; I2 = 97%), perceived barrier (SMD = 0.20; P = 0.001;
CI = 0.44–1.24; heterogeneity; P < 0.001; I2 = 92%) and perceived self-efficacy (SMD = 0.638;
P < 0.001; CI =1.76–0.426; heterogeneity; P < 0.001; I2 = 97%).
CONCLUSION: Cervical screening education program based on the HBM can be effective on Iranian
women’s performance in their perceived susceptibility, perceived severity, perceived barrier, and
perceived self-efficacy about Pap smear test.


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