Picture-Based Pocket Book to Improve Early Detection of Cervical Cancer among Women of Reproductive Age

Hesty Widyasih, Sumarah


School of Health Sciences, Ministry of Health, Yogyakarta




Background: Health education materials are not always appropriately written for those with low health literacy. The materials that do take low health literacy into account are limited. The Mayer’s cognitive theory of multimedia learning (CTML) insisted three principles: (1) People process information through auditory and visual channels; (2) Each channel has a limited account of memory, and (3) Learning consists of actively filtering and sorting information. Given these principles, multimedia, which may be defined as “the combination of text and pictures”, should help improve an individual’s capacity to learn. This study aimed to determine the effectiveness of picture-based pocket book in enhancing health literacy in early detection of cervical cancer among women of reproductive age.

Subjects and Method: This was a randomized controlled trial (RCT) conducted in Yogyakarta. A sample of 120 women of reproductive age were selected at random and then assigned randomly into two groups: (1) 60 women in the experimental group received picture-based pocket book health education; (2) 60 women in the control group did not receive picture-based pocket book health education. The dependent variable was health literacy in early detection of cervical cancer. The independent variable was picture-based pocket book health education. The health literacy was measured by a questionnaire. The mean difference in health literacy after intervention between the experimental and control groups was tested by independent t-test.

Results: The mean health literacy in the experimental group (Mean= 74.3; SD= 5.7) was higher than that in the control group (Mean= 46.7; SD= 5.3), and it was statis­tically significant (p= 0.023).

Conclusion: The picture-based pocket book health education is effective to improve health literacy in early detection of cervical cancer among women of reproductive age.


Keywords: picture-based pocket book, health literacy, early detection, cervical cancer, women of reproductive age

Correspondence: Hesty Widyasih. School of Health Polytechnics. Ministry of Health, Yogyakarta, Gamping, Sleman, Yogyakarta 55293. Email: hesti.widyasih@poltekkesjogja.ac.id. Mobile: 08156860937.

DOI: https://doi.org/10.26911/ICPHpromotion.FP.08.2021.21

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