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A parallel cluster-randomized controlled trial with 114 participants from four Hyderabad colleges evaluated multimedia sessions, survivor testimonials, pamphlets, breast models, gamified quizzes, and reminders against delayed control access. Outcomes were measured at baseline and 1- and 3-month follow-ups using validated Urdu questionnaires and analyzed with descriptive statistics, bivariate tests, and GEE in SPSS 29. Breast self-examination practice and knowledge improved significantly, alongside perceived susceptibility, severity, benefits, barriers, self-efficacy, and cues to action.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/from-awareness-to-action-health-belief-model-based-educational-intervention-to-improve-breast-self-examination-practice-among-college-teachers-in-pakistan-crct/356295/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/from-awareness-to-action-health-belief-model-based-educational-intervention-to-improve-breast-self-examination-practice-among-college-teachers-in-pakistan-crct/356295.png","ImageObject",300,407,{"name":92,"@type":93},"Olivia Brown","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-02","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What problem does the intervention address?","Question",{"text":112,"@type":113},"The study addresses limited breast cancer awareness and underuse of preventive screening practices, focusing on improving breast self-examination (BSE) knowledge, beliefs, and practices among female college teachers.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the study designed and conducted?",{"text":117,"@type":113},"A parallel cluster-randomized controlled trial was conducted with 114 female teachers from four colleges in Hyderabad, Pakistan, using colleges as the unit of randomization and collecting data at baseline, 1 month, and 3 months.",{"name":119,"@type":110,"acceptedAnswer":120},"Which intervention components were used?",{"text":121,"@type":113},"The intervention group received multimedia presentations, survivor testimonials, pamphlets, breast models, gamified quizzes, and reminders; the control group received the session after study completion.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},356295,1790178584,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},16904993612988,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","OPEN ACCESS  \nCitation: Mahar B, Osman MB, Fauzi FA (2026) From awareness to action: Health Belief Modelbased educational intervention to improve breast self-examination practice among college teachers in Pakistan (CRCT) . PLoS One 21(1): e0341804. [https://doi.org/10.1371/journal](https://doi.org/10.1371/journal). pone.0341804  \nEditor: Ruobing Li, Stony Brook University, UNITED STATES OF AMERICA  \nReceived: September 28, 2025  \nAccepted: January 13, 2026  \nPublished: January 29, 2026  \nCopyright: © 2026 Mahar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.  \nData availability statement: Data available online with DOI: [https://doi.org/10.6084/](https://doi.org/10.6084/)[ ](https://doi.org/10.6084/)[m9.figshare.30102124](m9.figshare.30102124.)[.](m9.figshare.30102124.)  \nFunding: The author(s) received no specific funding for this work.  \nRESEARCH ARTICLE  \nFrom awareness to action: Health Belief Model-based educational intervention to improve breast self-examination practice among college teachers in Pakistan (CRCT)  \nBenazir Mahar, Malina Binti Osman*, Fatimah Ahmad Fauzi  \nDepartment of Community Health, Faculty of Medicine and Health Sciences, University Putra Malaysia, Selangor, Malaysia  \n* [malinaosman@upm.edu.my](malinaosman@upm.edu.my)  \nAbstract  \nBackground  \nBreast cancer (BC) is the most common malignancy among women globally, with Pakistan showing similar trends. Teachers, especially female college teachers, are influential in health promotion. This study assessed the effectiveness of a Health Belief Model (HBM)-based educational intervention in improving breast selfexamination (BSE) knowledge, beliefs, and practices.  \nMethodology  \nA parallel cluster-randomized controlled trial was conducted among 114 female teachers from four colleges in Hyderabad, Pakistan, with colleges as the unit of randomization. The intervention group received multimedia presentations, survivor testimonials, pamphlets, breast models, gamified quizzes, and reminders, while the control group was offered the session after study completion. Data was collected at baseline, 1-month, and 3-month follow-ups using validated Urdu questionnaires. Analyses included descriptive statistics, bivariate tests, and Generalized Estimating Equations (GEE), using the Statistical Package for the Social Sciences (SPSS) version 29. A p-value \u003C 0.05 was considered statistically significant.  \nResults  \nBaseline characteristics were comparable across groups. Following the intervention, BSE practice improved significantly in the intervention group. At 1 month, participants were 5.7 times more likely to practice BSE (Adjusted Odds Ratio (AOR) = 5.724, p \u003C 0.001), rising to 26.5 times at 3 months (AOR = 26.500, p \u003C 0.001) . Knowledge scores also increased significantly (p \u003C 0.001) . Significant between-group differences  \nPLOS One | [https://doi.org/10.1371/journal.pone.0341804](https://doi.org/10.1371/journal.pone.0341804) January 29, 2026 1 / 25  \nCompeting interests: The authors have declared that no competing interests exist.  \nwere observed in perceived susceptibility, severity, benefits, barriers, self-efficacy, and cues to action (all p ≤0.001) .  \nConclusion  \nHBM-based intervention effectively enhanced BSE knowledge, beliefs, and practices while reducing barriers. Findings emphasize the value of structured educational interventions in promoting preventive health behaviors among female educators.  \nIntroduction  \nBreast cancer poses an escalating global health burden, particularly in low-resource settings such as Pakistan, where it ranks as the most prevalent malignancy among women. According to the annual cancer report by the International Cancer Registry, breast cancer accounted for 51% of all female cancer cases recorded in 2022 in Pakistan [ 1] . Similarly, in P","cbCaiiSin4CRf9Js","https://ap.wps.com/l/cbCaiiSin4CRf9Js","pdf",1275845,25,"English","# Abstract\n## Background\n## Methodology\n## Results\n## Conclusion\n# Introduction","[{\"question\":\"What problem does the intervention address?\",\"answer\":\"The study addresses limited breast cancer awareness and underuse of preventive screening practices, focusing on improving breast self-examination (BSE) knowledge, beliefs, and practices among female college teachers.\"},{\"question\":\"How was the study designed and conducted?\",\"answer\":\"A parallel cluster-randomized controlled trial was conducted with 114 female teachers from four colleges in Hyderabad, Pakistan, using colleges as the unit of randomization and collecting data at baseline, 1 month, and 3 months.\"},{\"question\":\"Which intervention components were used?\",\"answer\":\"The intervention group received multimedia presentations, survivor testimonials, pamphlets, breast models, gamified quizzes, and reminders; the control group received the session after study completion.\"}]","From Awareness to Action - Health Belief Model-Based Educational Intervention to Improve Breast Self-Examination Practice Among College Teachers in Pakistan (CRCT) | PDF",1790124478,63]