Educational interventions to improve participation of communities in cancer screening programs

Abstract

In Ain, France, a low-income, immigrant community with low literacy levels participated in a study by Balamou et al.[1] to evaluate the effects of an eight-week cancer educational intervention on the participants’ screening outcomes, cancer knowledge, and self-efficacy. The study highlighted the importance of targeted educational interventions for populations facing multiple socioeconomic and literacy-related barriers. Vulnerable populations, characterized by factors such as low education, low socioeconomic status, migration, and limited healthcare access, bear a disproportionate burden of cancer incidence and mortality. Additionally, these groups often engage in high-risk behaviors, including tobacco and alcohol use, obesity, physical inactivity, and inadequate consumption of fruits and vegetables, which further elevate their susceptibility to cancer.[2,3] The convergence of socioeconomic disadvantages and these risk factors amplify the vulnerability of these populations to cancer. The study by Balamou et al.[1] sheds light on a crucial topic, given the significant burden of cancer in India and other developing countries and the potential impact of educational interventions. In this editorial, we examine the role of cancer educational interventions in optimizing cancer screening activities, with a specific focus on India’s low literacy population, while referencing similar studies conducted globally to highlight best practices and potential strategies for implementation. Global impact of cancer Cancer is a significant global public health issue, representing the leading cause of death worldwide. In 2020 alone, it accounted for over 10 million deaths, comprising nearly one in six deaths.[4] India, with its vast population and diverse socioeconomic landscape, faces unique challenges in combating cancer. Low literacy rates prevalent among certain segments of the Indian population hinder effective cancer prevention and screening efforts. However, targeted cancer educational interventions present an opportunity to bridge this knowledge gap and empower individuals with the necessary information to make informed decisions. Low literacy rates in India India’s literacy rates have improved over the years, but a considerable portion of the population still faces literacy challenges. According to the National Statistical Office’s 2017–2018 report, the overall literacy rate in India was 77.7%.[5] However, this figure masks regional disparities, with some states reporting literacy rates as low as 66.4%.[6] This low literacy scenario poses a significant barrier to effective cancer prevention and screening initiatives. A study conducted by Tripathi et al.[7] examined the impact of low literacy on cancer knowledge and prevention behaviors in a rural Indian population. The study found that individuals with lower literacy levels had limited awareness of cancer symptoms, risk factors, and the importance of screening. This lack of knowledge contributed to delays in seeking medical care, leading to late-stage diagnoses and poorer treatment outcomes. Overcoming barriers in cancer educational interventions To overcome the challenges of low literacy, cancer educational interventions play a vital role in promoting awareness, dispelling myths, and fostering preventive behaviors. These interventions must be tailored to the specific needs and cultural context of the Indian population, ensuring they are accessible, relatable, and easy to comprehend. A systematic review by Christiansen et al.[8] examined the effectiveness of cancer educational interventions in low- and middle-income countries, including India. The review highlighted the importance of culturally appropriate communication channels, such as radio, television, and community outreach programs, in reaching individuals who may have limited access to written information. By utilizing vernacular languages, relatable stories, and visual aids, the interventions were successful in enhancing understanding and engagement among the low literacy population. Simplifying complex medical jargon and providing clear, concise information are imperative in cancer educational interventions.[9] A study by Mbanda et al.[10] demonstrated the effectiveness of visual aids, such as infographics and diagrams, in aiding comprehension among low literacy populations. These visual tools can help individuals with limited literacy skills grasp key concepts related to cancer symptoms, screening procedures, and treatment options. Furthermore, incorporating storytelling and real-life examples can help connect with the audience emotionally, facilitating better retention of information. Community participation and involvement are integral to the success of cancer educational interventions. A review by Sharma et al.[11] explored the role of community health workers in preventive care at the primary healthcare level. The study found that community health workers trained in culturally sensitive approaches were effective in disseminating information, addressing misconceptions, encouraging screening participation, and helping patients navigate within the healthcare system. This model can be adapted to the Indian context by partnering with local leaders, healthcare providers, and community-based organizations. Empowering community health workers or volunteers to conduct interactive sessions and provide ongoing support can ensure that the knowledge gained through the intervention translates into meaningful action.[12] Impact and sustainability The impact of cancer educational interventions goes beyond immediate awareness. By optimizing cancer screening activities, these interventions contribute to early detection, which is crucial for improving treatment outcomes and reducing cancer-related mortality.[13] A systematic review conducted by Housten et al.[14] on the impact of cancer educational interventions on screening participation among low literacy populations revealed a significant increase in screening rates following educational interventions, with some studies reporting up to a 30% rise in participation. These findings highlight the potential of targeted education programs in improving screening rates and ultimately reducing the burden of cancer. Sustainability is key to ensuring long-term benefits. Integrating cancer education into the existing healthcare infrastructure, such as primary care centers and community health programs, can help embed this knowledge into routine healthcare delivery. Regular training and capacity building of healthcare professionals will enhance their ability to provide accurate and accessible information. Leveraging technology and digital platforms can extend the reach of cancer educational interventions.[15] Mobile health applications, short message services (SMS)-based reminders, and telemedicine can provide continuous support and personalized guidance to individuals, even in remote areas. A study by Hombaiah et al.[16] demonstrated the effectiveness of a mobile health application in improving cervical cancer knowledge and screening adherence among low socioeconomic status populations in India through the involvement of social support groups. The application provided interactive voice responses with screening appointment reminders to women who were members of a social support group, resulting in increased screening rates and improved knowledge retention. Cancer educational interventions thus play a crucial role in optimizing cancer screening activities among the low literacy population. By tailoring communication channels, simplifying information, fostering community participation, and ensuring sustainability, these interventions have the potential to empower individuals and communities to take control of their health. Through increased awareness and early detection, we can significantly reduce the burden of cancer. To achieve this vision, it is essential to involve various stakeholders, including government agencies, healthcare providers, community leaders, and non-profit organizations. Collaborative efforts, informed by evidence-based practices and cultural sensitivity, can pave the way for a more comprehensive and effective cancer education framework. Investing in cancer educational interventions is an investment in the future of our population, especially those who are underserved and vulnerable. By prioritizing education, we can create a society that is better equipped to prevent, detect, and treat cancer, leading to improved health outcomes.