Abstract / Summary
Although breast cancer is rare during adolescence, early breast health awareness and preventive skills may support long-term health behavior. This study evaluated a school-based intervention integrating Orem’s Self-Care Theory and Social Cognitive Theory (SCT). A quasi-experimental pre-test–post-test control group study involved 159 adolescent girls from two Indonesian secondary schools. Schools were allocated to an intervention group ( n = 80), which received three 90-minute sessions combining self-care framing, modeling, guided practice, feedback, and educational materials, or a control group ( n = 79), which received a leaflet and a 45-minute lecture. Knowledge, attitude, BSE practice, and self-efficacy were assessed at baseline and six months later using validated instruments. Within-group changes and between-group differences in change scores were analyzed using distribution-appropriate tests. Between-group comparisons of change scores showed significantly greater improvements in the intervention group than in the control group across all outcomes (all p < 0.001). Within the intervention group, the mean increases in total scores were 6.73 points for knowledge (95% CI 6.17 to 7.28), 8.35 points for attitude (95% CI 7.48 to 9.22), 37.86 points for BSE practice (95% CI 35.14 to 40.58), and 3.60 points for self-efficacy (95% CI 2.79 to 4.41). The largest improvement occurred in BSE practice, indicating substantial gains in psychomotor competence. The theory-integrated intervention was associated with improvements in knowledge, attitudes, BSE practice, and self-efficacy. Combining self-care principles with modeling, guided practice, and feedback may bridge the gap between knowledge and preventive action in resource-limited schools.