The effect of web-assisted education and reminders on health belief, level of knowledge and early diagnosis behaviors regarding prostate cancer screening q Cantürk Çapık a , Sebahat Gözüm b, * a Kafkas University, Kars School of Health, 36100 Kars, Turkey b Akdeniz University, Antalya School of Health, 07058 Antalya, Turkey Keywords: Prostate cancer Screening Early diagnosis Web Education Nursing interventions Health belief model abstract Purpose of the research: The aim of this study was to investigate the effect of web-assisted education and reminders on health belief, level of knowledge and early diagnosis behaviors regarding prostate cancer screening. Methods and sample: In this pretesteposttest longitudinal study, Turkish men over 40 years of age were given an interactive educational session on prostate cancer and prostate cancer screening, and were then given related web-assisted education and consultation for a period of 6 months. As well as the Internet, reminders such as desk calendar, booklets, e-mails and cell phone messages were used in the study. Changes in the screening behaviors, the health belief and knowledge level of patients were examined 3 and 6 months after the interventions. Key results: During the study, participants’ prostate examination rate increased from 9.3% to 19.1% and PSA measurement rate increased from 6.7% to 31.4%. The interventions raised the susceptibility perception on prostate cancer and prostate cancer screening while decreasing the barrier perception (p < 0.05). No change was observed in other health belief components and the level of knowledge. Conclusion: Web-assisted education and reminders provided positive changes in the barrier and susceptibility perceptions of individuals. Participation in the screening also increased. Ó 2011 Elsevier Ltd. All rights reserved. Introduction It has been reported in different regions in the world that prostate cancer is the second highest cause of cancer-related deaths among men. According to standardized age the rate of prevalence in 100,000 people are 24.6 in Australia, 92.1 in Ireland, and 97.9 in England. In America, the rate of prostate cancer patients, according to the standardized age, is 159.3/100 000 in Whites, and 239.8/ 100 000 in African Americans (Australian Institute of Health and Welfare [AIHW], 2007; Cancer Research UK; The Welsh Cancer Intelligence & Surveillance Unit [WCISU, 2009]). In 2005, preva- lence of prostate cancer in Turkey was 27.5 in 100 000 cases and this is the second highest cause of cancer-related deaths among men (Sa glik Bakanli gi, 2005). The earlier that prostate cancer is diagnosed, the lesser the probability of tumor cells settling in other areas of the body. Prostate examination and prostate specific antigen (PSA) level testing, measured by taking a blood sample, are two methods used in the early diagnosis of prostate cancer. At the end of these screening, a final diagnosis is established in suspicious cases by performing a needle biopsy (Carter and Partin, 2005). The health belief model is a useful conceptual framework that may be used for understanding and estimating health-related behaviors (Pierce et al., 2003). Several researchers have previously carried out interventions based on the health belief model for the early diagnosis of prostate cancer and have reported improvements in its various components (Cantor et al., 2002; Whaley, 2006; Ford et al., 2006; Oliver, 2007). The barrier perception, an important component of the health belief model in individuals’ participation in prostate cancer screening, may affect their participation in screening (Weinrich et al., 2000). It has been reported in the liter- ature that as well as barrier perception, motivation level, benefit perception, susceptibility perception, and seriousness perception may affect participation in prostate cancer screening (Tingen et al., 1998; Oliver, 2007). In a study conducted by Weller et al. (1998) on 3000 individuals, the authors stated that sensitivity perception was a highly important factor when directing individuals to having screening. Similarly, Kleier (2004) stated that the higher the q This study was presented as a conference paper at EONS 7 Spring Convention held in Hague, the Netherlands on 15e16 April 2010. The study was not financially supported by any institution or person. * Corresponding author. Tel.: þ90 242 3106103; fax: þ90 242 226 14 69. E-mail address: sgozum_25@hotmail.com (S. Gözüm). Contents lists available at ScienceDirect European Journal of Oncology Nursing journal homepage: www.elsevier.com/locate/ejon 1462-3889/$ e see front matter Ó 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.ejon.2011.03.007 European Journal of Oncology Nursing 16 (2012) 71e77