A Digital Health Education Intervention to Improve Breast Self-Examination Knowledge among Adolescent Girls

Mestiana Br Karo; Jessica G.P. Zandroto; Lili Suryani Tumanggor

doi:10.34306/itsdi.v8i1.735

Authors

Mestiana Br Karo Institut Kesehatan Santa Elisabeth Medan https://orcid.org/0000-0002-3633-5692
Jessica G.P. Zandroto Institut Kesehatan Santa Elisabeth Medan
Lili Suryani Tumanggor Institut Kesehatan Santa Elisabeth Medan https://orcid.org/0009-0004-4966-5983

DOI:

https://doi.org/10.34306/itsdi.v8i1.735

Keywords:

Breast Self-Examination, Health Education, Breast Cancer, Adolescent Girls, Knowledge

Abstract

Breast cancer remains a major health concern among women, as delayed detection contributes to high morbidity and mortality. Breast Self-Examination (BSE) is a simple and accessible method for early detection, yet limited knowledge of BSE among adolescents remains a concern. This study aimed to assess changes in adolescent girls’ knowledge of breast cancer early detection following BSE health education at SMA Santo Thomas 1 Medan. A quantitative study using a pre-experimental one-group pre-test–post-test design was conducted. The participants consisted of 54 Grade XI female students who were selected through simple random sampling. Data were collected using a 13-item knowledge questionnaire administered before and after the intervention. The data were analyzed using the Wilcoxon signed-rank test at a significance level of p < 0.05. Prior to the intervention, most respondents demonstrated adequate knowledge (70.4%), while 20.4% had poor knowledge and 9.3% had good knowledge. After the intervention, the proportion of respondents with good knowledge increased to 87%, while 13% demonstrated adequate knowledge. The Wilcoxon analysis demonstrated a statistically significant difference in knowledge scores between the pre-test and post-test (p < 0.001). These findings indicate that BSE health education was associated with an improvement in adolescent girls’ knowledge and may inform school-based breast cancer health education programs.

Downloads

Download data is not yet available.

References

B. Mahar, M. B. Osman, F. A. Fauzi, and S. Aliyu, “The impact of educational interventions on breast self-examination practice, knowledge, and beliefs among women: A systematic review and meta-analysis,” Journal of Public Health Research, vol. 15, no. 1, p. 22799036261423725, 2026.

M. A. Aina, “The effectiveness of breast self-examination (bse) training on skill improvement among nursing mothers: a comparative study of intervention and control groups in osun state, nigeria,” Journal of Health, Wellness and Safety Research, 2026.

Ministry of Health of the Republic of Indonesia, “Prevent breast cancer with breast self-examination and clinical breast examination,” Oct. 2022, accessed August 28, 2026. [Online]. Available: https://www.kemkes.go.id/id/cegah-kanker-payudara-dengan-sadari-dan-sadanis

R. A. Sunarjo, T. Pujiati, D. Apriliasari, and M. Hardini, “Digital onboarding in agricultural platforms and its impact on agricultural productivity,” IAIC Transactions on Sustainable Digital Innovation (ITSDI), vol. 6, no. 2, pp. 205–214, 2025.

B. D. K. Patro et al., “Improved early detection accuracy for breast cancer using a deep learning frame-work in medical imaging,” Computers in Biology and Medicine, vol. 187, p. 109751, 2025.

L. W. Sishartami, K. M. Ariesaka, A. Weningtyas, H. T. Iftitahurroza, A. Ladika, F. Y. Bakhtiar, and F. Solikha, “Enhancing the well-being of high school students through comprehensive reproductive health education,” Journal of Community Service and Empowerment, vol. 6, no. 1, pp. 207–213, 2025.

Government of the Republic of Indonesia, “Law number 17 of 2023 concerning health,” Aug. 2023, accessed August 28, 2026. [Online]. Available: https://jdih.kemkes.go.id/documents/undang-undang-nomor-17-tahun-2023

C. A. Uzoechi, A. D. Parsa, I. Mahmud, I. Alasqah, and R. Kabir, “Menstruation among in-school adolescent girls and its literacy and practices in nigeria: A systematic review,” Medicina, vol. 59, no. 12, p. 2073, 2023.

T. Indrayana, H. Prasetyorini, A. Salim, I. M. Ali et al., “The influence of digital-based education on adolescent knowledge about bse,” Sustainable Applied Modification Evidence Community, vol. 2, no. 2, pp. 43–51, 2025.

B. Mahar, M. B. Osman, and F. A. Fauzi, “From awareness to action: Health belief model-based educational intervention to improve breast self-examination practice among college teachers in pakistan (crct),” Plos one, vol. 21, no. 1, p. e0341804, 2026.

N. D. Yuliasih, P. Sari, A. D. Bestari, N. Martini, and B. Sujatmiko, “Does health education through videos and e-leaflet have a good influence on improving students’ reproductive health knowledge, attitudes, and practices? an intervention study in jatinangor, indonesia,” Advances in medical education and practice, pp. 29–39, 2025.

G. Van Oirschot, C. Purcell, A. Keogh, C. M. Greene, and C. Doherty, “A feasibility randomised controlled trial of patient education videos assessing multimedia design effects on engagement and learning in adolescents with scoliosis,” BMC Medical Education, vol. 26, no. 1, p. 679, 2026.

E. Ernawati, Y. S. Baso, H. Hidayanty, S. Syarif, A. Aminuddin, and B. Bahar, “The effects of anemia education using web-based she smart to improve knowledge, attitudes, and practice in adolescent girls,” International Journal of Health and Medical Sciences, vol. 5, no. 1, pp. 44–49, 2022.

W. S. Gitarja, R. T. S. Haryati, and F. Antonio, “Technopreneurship adoption and innovation value in private wound care nursing practices,” Aptisi Transactions on Technopreneurship (ATT), vol. 8, no. 2, pp. 754–767, 2026.

J. Majeed, P. Sharma, P. Ajmera, and K. Dalal, “Menstrual hygiene practices and associated factors among indian adolescent girls: a meta-analysis,” Reproductive health, vol. 19, no. 1, p. 148, 2022.

J. Parajuli and P. Prangthip, “Adolescent nutrition and health: a critical period for nutritional intervention to prevent long term health consequences,” Current nutrition reports, vol. 14, no. 1, p. 116, 2025.

G. Mottis, P. Kandasamey, and D. Peleg-Raibstein, “The consequences of ultra-processed foods on brain development during prenatal, adolescent and adult stages,” Frontiers in public health, vol. 13, p. 1590083, 2025.

S. Shorey and C. M. S. Chua, “Perceptions, experiences, and needs of adolescents about school-based sexual health education: qualitative systematic review,” Archives of sexual behavior, vol. 52, no. 4, pp. 1665–1687, 2023.

H. Hassan, S. Zaki, and F. Nady, “Relation between female workers’ history and their knowledge about breast cancer, breast-self-examination and preventive: Effect of an educational program,” Journal of Community Medicine and Public Health Reports, vol. 6, no. 2, pp. 1–7, 2025.

E. I. Obeagu and G. U. Obeagu, “Breast cancer: A review of risk factors and diagnosis,” Medicine, vol. 103, no. 3, p. e36905, 2024.

E. S. Ariestiningsih, D. F. S. Has, B. A. Kurniawan, L. Y. Yuliati, H. P. Laurita, and M. N. Arifani, “Effectiveness of peer education based on social cognitive theory in preventing anemia among adolescent girls at the state senior high school 1 kebomas gresik,” AcTion: Aceh Nutrition Journal, vol. 10, no. 2, pp. 461–470, 2025.

S. Wibowo, I. A. Widjaya, J. Zanubiya, R. Evans, U. Rahardja et al., “Orange technology for humanistic innovation in higher education,” Jurnal MENTARI: Manajemen, Pendidikan dan Teknologi Informasi, vol. 4, no. 2, pp. 105–115, 2026.

R. Sarker, M. S. Islam, M. S. Moonajilin, M. Rahman, H. A. Gesesew, and P. R. Ward, “Knowledge of breast cancer and breast self-examination practices and its barriers among university female students in bangladesh: Findings from a cross-sectional study,” Plos one, vol. 17, no. 6, p. e0270417, 2022.

Y. J. Evers, F. Schneider, V. Widdershoven, C. J. Goense, C. M. Peters, S. G. Van Elsen, C. J. Hoebe, and N. H. Dukers-Muijrers, “Using a theoretical framework of intervention mapping to inform public health communication messages designed to increase vaccination uptake; the example of mpox in the netherlands,” BMC Public Health, vol. 23, no. 1, p. 2373, 2023.

Z. S. Shumie and Z. A. Mengie, “Menstrual hygiene management knowledge, practice and associated factors among school girls, northeast ethiopia,” Plos one, vol. 17, no. 7, p. e0271275, 2022.

I. Handayani, R. Agustina et al., “Starting a digital business: Being a millennial entrepreneur innovating,” Startupreneur Business Digital (SABDA Journal), vol. 1, no. 2, pp. 126–133, 2022.

K. Asmare, Y. Birhanu, and Z. Wako, “Knowledge, attitude, practice towards breast self-examination and associated factors among women in gondar town, northwest ethiopia, 2021: a community-based study,” BMC Women’s Health, vol. 22, no. 1, p. 174, 2022.

N. Kuru Alici, A. Arikan D¨onmez, O. Aktas¸, and Z. Zeytun, “The effect of simulation-based breast health education on breast cancer awareness and breast self-examination skills of afghan refugee women: a randomized controlled trial,” BMC Public Health, vol. 25, no. 1, p. 2048, 2025.

R. Sarker, M. S. Islam, M. S. Moonajilin, M. Rahman, H. A. Gesesew, and P. R. Ward, “Effectiveness of educational intervention on breast cancer knowledge and breast self-examination among female university students in bangladesh: a pre-post quasi-experimental study,” BMC cancer, vol. 22, no. 1, p. 199, 2022.

S¸ . Z. Altunkurek, E. Yes¸ilyurt, and S. Hassan Mohamed, “The effect of breast cancer and breast self-examination health education on awareness, beliefs, and practices of female students at the faculty of health sciences of a university in somalia,” The Breast Journal, vol. 2026, no. 1, p. 8854280, 2026.

M. Alshafie, J. Soqia, D. Alhomsi, M. B. Alameer, L. Yakoub-Agha, and M. Saifo, “Knowledge and practice of breast self-examination among breast cancer patients in damascus, syria,” BMC women’s health, vol. 24, no. 1, p. 73, 2024.

F. Sutisna, N. Lutfiani, E. Anderson, D. Danang, and M. O. Syaidina, “E-commerce and digital marketing strategies: Their impact on startupreneur performance using pls-sem,” IAIC Transactions on Sustainable Digital Innovation (ITSDI), vol. 6, no. 2, pp. 215–223, 2025.

K. Assfa Mossa, “Perceptions and knowledge of breast cancer and breast self-examination among young adult women in southwest ethiopia: Application of the health belief model,” Plos one, vol. 17, no. 9, p. e0274935, 2022.

K. S. Wondmu, M. T. Tessema, G. Degu, G. T. Mihiret, and M. T. Sinshaw, “Effect of breast cancer education based on the health belief model on knowledge, health belief, and breast self-examination among female students of debre markos university, northwest ethiopia, in 2021,” Frontiers in oncology, vol. 12, p. 1034183, 2022.

H. Hijrah, A. N. Usman, Y. Sanusi Baso, S. Syarif, M. Ahmad, and Z. Nulandari, “Influence of variables on breast self-examination: Potential barrier or enhancement of breast cancer prevention,” Breast Disease, vol. 43, no. 1, pp. 145–155, 2024.

A. S. Bist, B. Rawat, U. Rahardja, Q. Aini, and A. G. Prawiyogi, “An exhaustive analysis of stress on faculty members engaged in higher education,” IAIC Transactions on Sustainable Digital Innovation (ITSDI), vol. 3, no. 2, pp. 126–135, 2022.

N. M. Dhahir, M. M. Ahmed, and N. M. Younis, “The association between health beliefs and breast self-examination among healthcare providers: A cross-sectional study,” Journal of Education and Health Promotion, vol. 15, p. 82, 2026.

L. Conte, R. Lupo, A. Lezzi, S. Sciolti, I. Rubbi, M. Carvello, A. Calabr`o, S. Botti, A. Fanizzi, R. Massafra et al., “Breast cancer prevention practices and knowledge in italian and chinese women in italy: clinical checkups, free nhs screening adherence, and breast self-examination (bse),” Journal of cancer education, vol. 40, no. 1, pp. 30–43, 2025.

B. Mahar, M. B. Osman, and F. B. Ahmad Fauzi, “Effectiveness of theory-based breast self-examination intervention for breast cancer prevention among female college teachers in pakistan: A cluster randomized controlled trial study protocol,” PLoS One, vol. 20, no. 4, p. e0321634, 2025.

K. Damayanti, M. Effendi, and R. W. Daryono, “The effectiveness of the problem-based learning model on student learning achievement in islamic education learning,” IJORER: International Journal of Recent Educational Research, vol. 5, no. 5, pp. 1097–1108, 2024.