Targeting cervical cancer campaigns on teenage high schoolers in resource-limited economies: lessons from an intervention study of Nigerian senior secondary school girls

Background. Given the dearth of government-sponsored programmes, preventive lifestyles and practices are the realistic hopes for millions of women in developing countries against cervical cancer. Early interventions for teenage high school girls have been advocated recently, but evidence-base for sustainable activities at this demographic is lacking. This article reduces this gap by determining the impact of two cervical cancer education techniques. Method. This is a 6-month interventional cohort study of 432 female high school students in South-eastern Nigeria. Results. A total of 317 (73.4%) and 301 (69.7%) valid responses were received from the pre-intervention (16.8 +/- 1.5 years) and post-intervention (17.2 +/- 1.6 years) surveys, respectively. About 213 (70.8%) were fully engaged with the interventions. Logistic regression revealed that participants who were 'engaged' with the interventions, either through symposium attendance or by reading of the printed handouts, showed significant improvements across multiple cervical cancer parameters regarding knowledge on 'pap smears' (analysed with four items), 'HPV vaccine' (two items) and 'risk factors' (two items). Improvements in Knowledge of 'early symptoms' were not improved, with 'post-coital bleeding' [odds ratio (OR) = 0.95; P = 0.87] and 'being asymptomatic' (OR = 0.69; P = 0.32) remaining statistically similar between the engaged and the unengaged. If 'engagement' with either intervention was disregarded, a chi-square analysis identified no significant improvement in knowledge on any parameter. Conclusion. Ensuring 'engagement' with intervention campaigns is vital to achieving effective and sustainable cervical cancer knowledge. Engagement may be achieved by repeating the education activities across all the years/classes that make up high school in each developing country, along with formal examinations at each level.