Other Titles

Development of a Cervical Cancer Prevention Education Program for North Korean Refugee Women: Culturally Tailored Cervical Cancer Prevention Education [Title Slide]

Abstract

This mixed-method study developed and evaluated a culturally tailored cervical cancer prevention education program for North Korean females, reflecting their unique cultural and health needs. Guided by the Health Belief Model and the ADDIE instructional design, the four-session, 120-minute-per-week program aimed to enhance knowledge of cervical cancer and HPV, strengthen perceived benefits, reduce perceived barriers, and improve self-efficacy regarding preventive behaviors. Educational strategies included interactive lectures, audiovisual materials, cervical model demonstrations, culturally relevant role model sharing, and group discussions to promote engagement and understanding.

A non-equivalent control group pretest–posttest design was applied. The experimental group consisted of 28 females residing in G city, and the control group included 18 females from other regions (total N=46). Identical questionnaires were administered before and after the intervention. Quantitative data were analyzed using ANCOVA and paired t-tests, while qualitative data from focus group interviews were examined through thematic analysis.

Results demonstrated significant improvement in cervical cancer knowledge (F=10.922, p=.002) and overall health belief scores (F=5.579, p=.023) in the experimental group compared with the control. Although individual subscales such as perceived susceptibility, severity, benefits, barriers, self-efficacy, and preventive intention did not reach statistical significance, upward trends indicated positive educational influence. Qualitative findings corroborated these outcomes, revealing reduced fear of screening and vaccination and increased motivation to engage in preventive actions among participants.

This pilot study provides evidence that a culturally responsive education program can effectively improve knowledge and health beliefs among North Korean females, demonstrating its feasibility and potential scalability as an equitable health promotion strategy.

Notes

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References:

Allen, W. C. (2006). Overview and evolution of the ADDIE training system. Advances in Developing Human Resources, 8(4), 430–441.
https://doi.org/10.1177/1523422306288433

Makadzange, E. E., Peeters, A., Joore, M. A., & Kimman, M. L. (2022). The effectiveness of health education interventions on cervical cancer prevention in Africa: A systematic review. Preventive Medicine, 164, 107219.
https://doi.org/10.1016/j.ypmed.2022.107219

National Cancer Center Korea. (2023). Cervical cancer statistics. National Cancer Information Center.
https://www.cancer.go.kr/lay1/program/S1T211C223/cancer/view.do?cancer_seq=4877

Rosenstock, I. M. (1974). The Health Belief Model and preventive health behavior. Health Education Monographs, 2(4), 354–386.

Shorten, A., & Smith, J. (2017). Mixed methods research: Expanding the evidence base. Evidence-Based Nursing, 20(3), 74–75. https://doi.org/10.1136/eb-2017-102699

Description

This pilot study developed a culturally tailored cervical cancer prevention education program for North Korean females, reflecting their cultural health needs. The program improved cervical cancer knowledge and strengthened health beliefs, showing that culturally appropriate education can overcome fear and misinformation. These findings highlight its feasibility and importance as an approach to improve preventive health among vulnerable populations.

Acknowledgment: This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Ministry of Science and ICT, Korea government (No. RS-2022-00166717).

Author Details

Kyung-Hwa Choi, BSN, RN; Soo-Young Yu, PhD, MPH, RN

Sigma Membership

Non-member

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Mixed/Multi Method Research

Keywords:

Public and Community Health, Health Equity or Social Determinants of Health, Teaching and Learning Strategies, Cervix Neoplasms, Cervix Neoplasms--Prevention and Control, Immigrants, Women, North Korea

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-08-03

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Development of a Cervical Cancer Prevention Education Program for North Korean Female Defectors

Toronto, Ontario, Canada

This mixed-method study developed and evaluated a culturally tailored cervical cancer prevention education program for North Korean females, reflecting their unique cultural and health needs. Guided by the Health Belief Model and the ADDIE instructional design, the four-session, 120-minute-per-week program aimed to enhance knowledge of cervical cancer and HPV, strengthen perceived benefits, reduce perceived barriers, and improve self-efficacy regarding preventive behaviors. Educational strategies included interactive lectures, audiovisual materials, cervical model demonstrations, culturally relevant role model sharing, and group discussions to promote engagement and understanding.

A non-equivalent control group pretest–posttest design was applied. The experimental group consisted of 28 females residing in G city, and the control group included 18 females from other regions (total N=46). Identical questionnaires were administered before and after the intervention. Quantitative data were analyzed using ANCOVA and paired t-tests, while qualitative data from focus group interviews were examined through thematic analysis.

Results demonstrated significant improvement in cervical cancer knowledge (F=10.922, p=.002) and overall health belief scores (F=5.579, p=.023) in the experimental group compared with the control. Although individual subscales such as perceived susceptibility, severity, benefits, barriers, self-efficacy, and preventive intention did not reach statistical significance, upward trends indicated positive educational influence. Qualitative findings corroborated these outcomes, revealing reduced fear of screening and vaccination and increased motivation to engage in preventive actions among participants.

This pilot study provides evidence that a culturally responsive education program can effectively improve knowledge and health beliefs among North Korean females, demonstrating its feasibility and potential scalability as an equitable health promotion strategy.