Retention of fellows to the faculty at a research-intensive academic medical center: a mixed-methods study.

Cervical cancer remains one of the leading causes of preventable mortality among women worldwide, with more than 85% of new cases and deaths occurring annually in low- and middle-income countries (LMICs) [, ]. Despite the availability of effective screening methods, including Papanicolaou (Pap) smear, visual inspection with acetic acid (VIA), and human papillomavirus (HPV) DNA testing, screening uptake remains unacceptably low in rural and underserved populations. Barriers such as geographic inaccessibility, limited health literacy, sociocultural stigma, and mistrust of healthcare systems continue to hinder early detection and timely treatment [–]. Structured health education interventions have been developed to address these informational and psychosocial barriers [–]. Their dual objectives are to improve knowledge and to modify perceptions of risk, benefits, and self-efficacy, which are key determinants of screening behavior. Evidence suggests that interventions grounded in behavioral theories such as the Health Belief Model (HBM) or Social Cognitive Theory (SCT) are generally more effective than non-theoretical approaches. Furthermore, delivery mode matters: face-to-face, interactive, and community-based formats typically achieve greater impact than passive, digital, or print-based interventions [–]. Nevertheless, despite an expanding body of research, inconsistencies persist regarding the optimal components of such educational interventions, particularly in relation to their theoretical foundation and delivery strategies [–]. Previous reviews have often lacked stratified analyses to clarify these factors, and many meta-analyses have overlooked structurally disadvantaged populations, the very groups bearing the highest disease burden [–]. To address these gaps, we conducted a systematic review and meta-analysis to quantify the effectiveness of structured, theory-based health education interventions in increasing cervical cancer screening uptake among women in rural and underserved communities. Subgroup analyses examined whether intervention modality and geographic region moderated the observed effects, and sensitivity analyses were performed to assess the robustness and potential sources of heterogeneity. This review was designed to inform the future development of equitable, evidence-based educational strategies for cervical cancer prevention in high-burden settings.