English abstract
Abstract: Background and Aim: Women in Oman and low- and middle-income countries (LMICs) are
usually diagnosed with BC at a younger age and more advanced stage, with poor five-year survival.
This study aims to evaluate the effectiveness of breast cancer (BC) related educational programs
among female Omani adolescents. Materials and Methods: Six female-only public schools were
randomly selected from three governorates of Oman and assigned to the control or interventional
group. An Arabic version of the Breast Cancer Awareness Measure questionnaire was used to evaluate
students attending grades 10 and 11 at baseline (T0) and after 4 weeks (T1). After T0, the intervention
group participated in a one-hour BC education program involving group discussions, a slideshow
presentation, leaflets, and online access to program materials and videos. Non-parametric tests were
used to compare scores between intervention and control groups and within each group across time
(T0 vs. T1). Results: A total of 1106 students participated, of which 547 (49.5%) and 559 (50.5%)
were allocated to the control and intervention groups, respectively. Recognition of BC risk factors
(Z = 18.67; p < 0.001) and symptoms (Z = 20.01; p < 0.001) increased significantly in the intervention
group between T0 and T1 and compared to the control group at T1 (U = 27.27; p < 0.001, and U = 25.75;
p < 0.001, respectively). Anticipated time to seeking medical help (Z = 18.67; p < 0.001) and barriers to
help-seeking (Z = 7.91; p < 0.001) decreased significantly between T0 and T1 in the intervention group
and compared to the control group at T1 (U = 15.78; p < 0.001, and U = 3.44; p = 0.001, respectively).
Conclusion: The program increased knowledge of BC risk factors and symptoms and promoted
early medical help-seeking among Omani female adolescents. Healthcare strategic planners and
policy-makers in Oman and low- and middle-income countries should consider incorporating cancer
education programs in the national school curriculum to minimize delays in BC diagnosis and
improve the survival rate.
