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Effect of Breast Self-Examination Demonstrations on Breast Self-Examination Skills among Female University Students in Nigeria

Abstract

Breast health is an important component of women's health, and breast self-examination may help women become familiar with the normal appearance and feel of their breasts and recognize changes that warrant professional assessment. Female university students in Nigeria may have limited practical knowledge of breast self-examination despite the importance of breast-health awareness among young women. Conventional health information may improve awareness but may not adequately develop the practical skills required to perform breast self-examination correctly. Breast self-examination demonstrations provide an opportunity to translate breast-health information into practical skills through guided instruction, visual examples, and supervised practice. Against this background, this study investigates the effect of breast self-examination demonstrations on breast self-examination skills among female university students in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and Health Literacy Theory. The Health Belief Model explains how students' perceptions of breast-health risks, perceived susceptibility, perceived severity, perceived benefits of breast self-examination, perceived barriers, self-efficacy, and cues to action may influence their willingness and ability to perform breast self-examination. Social Cognitive Theory emphasizes observational learning, behavioural modelling, guided practice, self-efficacy, reinforcement, and social support in the development of practical breast-health skills. Health Literacy Theory emphasizes students' ability to obtain, understand, evaluate, and apply reliable breast-health information when performing self-care practices and deciding when professional assessment is required. Collectively, these theoretical perspectives provide a suitable framework for explaining how breast self-examination demonstrations may influence breast self-examination skills among female university students in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise female undergraduate and postgraduate students aged 18 years and above enrolled in selected public and private universities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, universities, faculties or departments, academic levels, and eligible students. Breast self-examination demonstrations will be assessed using indicators such as exposure to demonstration sessions, frequency and duration of demonstrations, use of visual teaching materials, explanation of breast anatomy and normal breast changes, demonstration of appropriate examination procedures, inspection of the breasts for visible changes, systematic palpation techniques, examination of the breast tissue and surrounding areas, appropriate positioning, use of finger pads, coverage of the breast area, recognition of potential warning signs, and opportunities for supervised practice and feedback. Breast self-examination skills will be assessed using indicators such as ability to correctly prepare for examination, appropriate positioning, systematic inspection, systematic palpation, adequate coverage of breast tissue, use of appropriate pressure and technique, recognition of abnormal or concerning changes, correct sequence of examination steps, ability to demonstrate the procedure independently, and appropriate decision-making regarding when to seek professional breast assessment. Data will be collected using structured questionnaires, breast-health knowledge assessment tools, standardized breast self-examination skill checklists, objective practical assessments using appropriate breast models where available, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize students' demographic and academic characteristics, previous exposure to breast-health education, sources of breast-health information, knowledge levels, and practical skills. Inferential statistical techniques, including chi-square tests, paired and independent t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of breast self-examination demonstrations on breast self-examination skills. Where a quasi-experimental design is adopted, skill scores before and after the demonstration intervention may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that breast self-examination demonstrations have a significant positive effect on breast self-examination skills among female university students in Nigeria. Students exposed to structured, practical, evidence-based, and appropriately supervised demonstrations are expected to demonstrate greater competence in performing breast self-examination than students who receive information without comparable practical training. Demonstrations may improve students' ability to follow a systematic examination procedure, identify normal breast characteristics, recognize potentially concerning changes, and understand the importance of seeking professional assessment when an unusual change is detected. Guided practice and feedback may also improve self-efficacy and reduce uncertainty about how the procedure should be performed. However, embarrassment, cultural perceptions, fear of discovering an abnormality, misconceptions about breast cancer, limited access to appropriate teaching resources, and inconsistent practice may reduce the effectiveness of demonstrations alone. The study therefore expects practical, accessible, culturally sensitive, and sustained breast self-examination demonstrations, supported by appropriate breast-health education and referral services, to contribute significantly to improved breast self-examination skills among female university students in Nigeria. The study is expected to contribute to the literature on breast self-examination, breast-health education, women's health, breast cancer awareness, practical health education, university student health, preventive healthcare, health promotion, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Education, universities, university health centres, healthcare professionals, nurses, public health practitioners, breast-health organizations, student health services, development partners, and policymakers regarding strategies for strengthening breast-health education among young women. The study will also provide evidence-based recommendations for integrating practical breast-health demonstrations into university health programmes, strengthening breast self-examination instruction, improving access to appropriate teaching models and materials, increasing awareness of breast changes requiring professional assessment, strengthening referral pathways, and developing sustainable breast-health education programmes that promote practical breast-health skills among female university students across Nigeria.

Keywords: Breast self-examination demonstrations, breast self-examination skills, female university students, breast health, breast cancer awareness, women's health, practical health education, health promotion, preventive healthcare, Nigeria, public health.