Improved Lung Cancer Prevention Knowledge Among Older Adults Through Structured Health Education

Ketut Sudiantara, Ni Wayan Prema Revina Sutami, I Wayan Mustika, Agus Sri Lestari, I Wayan Suardana, Suparji Suparji

Abstract


Background: Lung cancer remains a major global public health problem and is one of the leading causes of cancer-related mortality, particularly among the elderly who are more vulnerable due to age-related physiological decline and prolonged exposure to risk factors such as smoking and environmental pollutants. Despite ongoing preventive efforts, limited knowledge and awareness regarding lung cancer prevention among older adults continue to hinder effective control strategies. This study aimed to determine the effect of booklet-based health education on the level of knowledge regarding lung cancer prevention among the elderly. Methods:This study employed a quantitative pre-experimental design using a one-group pretest–posttest approach. The study was conducted in the working area of UPTD Puskesmas I East Denpasar, Bali, Indonesia. The sample consisted of 103 elderly individuals selected through purposive sampling. Primary data were collected using a structured questionnaire measuring knowledge levels, while secondary data included respondent characteristics. Data were analyzed using descriptive statistics and the Wilcoxon signed-rank test. Results:The results showed that prior to the intervention, the majority of respondents had poor knowledge (59.2%), which decreased to 9.7% after the intervention. Conversely, the proportion of respondents with good knowledge increased from 11.7% to 47.6%. The mean knowledge score also increased from 49.26 to 74.39, with a statistically significant difference (p = 0.001).Conclusions:In conclusion, booklet-based health education was associated with a significant improvement in knowledge regarding lung cancer prevention among the elderly. This intervention can be considered a practical and effective strategy for enhancing health literacy in community settings.

References


Yoo J, Lee Y, Park Y, Lee J, Choi JY, Lee H, Lim JU. Update in Association between Lung Cancer and Air Pollution. Tuberc Respir Dis (Seoul). 2025 Apr;88(2):228-236. https://doi.org/10.4046/trd.2024.0092.

Berg C, Schiller J, Boffetta P ...Air Pollution and Lung Cancer: A Review by International Association for the Study of Lung Cancer Early Detection and Screening CommitteeJournal of Thoracic Oncology, 2023; 18, 1277-1289. https://doi.org/10.1016/j.jtho.2023.05.024

Zhang, Y., Wang, W., Dai, K. et al. Global lung cancer burden attributable to air fine particulate matter and tobacco smoke exposure: spatiotemporal patterns, sociodemographic characteristics, and transnational inequalities from 1990 to 2021. BMC Public Health 25, 1260 (2025). https://doi.org/10.1186/s12889-025-22450-8

Asmara OD, Tenda ED, Singh G, Pitoyo CW, Rumende CM, Rajabto W, et al. Lung cancer in Indonesia. J Thorac Oncol. 2023;18(9):1134–1145. https://doi.org/10.1016/j.jtho.2023.06.010.

AbdulRaheem Y. Unveiling the Significance and Challenges of Integrating Prevention Levels in Healthcare Practice. J Prim Care Community Health. 2023 Jan-Dec;14:21501319231186500. https://doi.org/10.1177/21501319231186500.

Litvinjenko S, Magwood O, Wu S et al. Burden of tuberculosis among vulnerable populations worldwide: an overview of systematic reviews,The Lancet Infectious Diseases, 2023; 23, 1395-1407. https://doi.org/10.1016/

Pîslaru AI, Albișteanu SM, Ilie AC, Ștefaniu R, Mârza A, Moscaliuc Ș, Nicoară M, Turcu AM, Grigoraș G, Alexa ID. Lung Cancer: New Directions in Senior Patients Assessment. Geriatrics (Basel). 2024 Aug 1;9(4):101. https://doi.org/10.3390/geriatrics9040101.

Romadlona, N.A., BaharuddinNur, R.J., Utomo, B. (2025). Population Ageing in Indonesia. In: Fong, B.Y.F. (eds) The Handbook of Public Health in the Asia-Pacific. Handbooks in Asian Studies. Springer, Singapore. https://doi.org/10.1007/978-981-97-1788-0_49-1

Ferreira R, Baixinho CL, Ferreira ÓR, Nunes AC, Mestre T, Sousa L. Health Promotion and Disease Prevention in the Elderly: The Perspective of Nursing Students. J Pers Med. 2022 Feb 18;12(2):306. https://doi.org/10.3390/jpm12020306.

Chiu, C.-J.; Hu, J.-C.; Lo, Y.-H.; Chang, E.-Y. Health Promotion and Disease Prevention Interventions for the Elderly: A Scoping Review from 2015–2019. Int. J. Environ. Res. Public Health 2020, 17, 5335. https://doi.org/10.3390/ijerph17155335

Hasanbasri M, Maula AW, Wiratama BS, Espressivo A, Marthias T. Analyzing Primary Healthcare Governance in Indonesia: Perspectives of Community Health Workers. Cureus. 2024 Mar 13;16(3):e56099. https://doi.org/10.7759/cureus.56099.

Koulouvari AD, Margariti A, Sakellari E, Barbouni A, Lagiou A. Applications of Behavioral Change Theories and Models in Health Promotion Interventions: A Rapid Review. Behav Sci (Basel). 2025 Apr 25;15(5):580. https://doi.org/10.3390/bs15050580.

Sá GGM, Silva FL, Santos AMRD, Nolêto JDS, Gouveia MTO, Nogueira LT. Technologies that promote health education for the community elderly: integrative review. Rev Lat Am Enfermagem. 2019 Oct 14;27:e3186. https://doi.org/10.1590/1518-8345.3171.3186.

Nicole Knox, Meera Agar, Gemma McErlean, Shalini K Vinod, Louise Hickman, Exploring the unmet needs of older people living with lung cancer: a qualitative study, Age and Ageing, Volume 55, Issue 2, February 2026, afag023, https://doi.org/10.1093/ageing/afag023

Yasin, J.A., Tamimi, M.-A.A., Qtaishat, F.A., Al-Din, T.J., Obeidat, D.M., Alkuttob, L.A., Alhamaideh, L.H., Al-Habahbeh, F.O., Jabri, M.E., Al-Ani, A., Odat, R.M., Zuriekat, M. and Alfuqaha, O.A. (2024), Lung Cancer Screening Health Belief Model: Psychometric Properties of the Arabic Version and Factors Influencing Screening and Prevention Among Jordanians. Psycho-Oncology, 33: e70019. https://doi.org/10.1002/pon.70019

Cooke S, Nelson D, Arslan Argin A, Laparidou D, Young R, Waller J, et al. Identifying and exploring patient engagement interventions for people diagnosed with lung cancer: A rapid systematic review. Lung Cancer. 2025;202:108484. https://doi.org/10.1016/j.lungcan.2025.108484.

Gu X, Jiang L, Dou Y, Cai P, Chu JH, Huang YL. Effectiveness of an educational intervention based on the common-sense model of self-regulation for lung cancer patients after thoracoscopic surgery. Sci Rep. 2025 Dec 29;15(1):44833. https://doi.org/10.1038/s41598-025-29106-y.

Widagdo W, Mutarobin, Mumpuni, Susmadi. The effect of education using booklet media on knowledge of fall prevention in the elderly. Int J Clin Sci Med Res. 2024;4(3):103–109. https://doi.org/10.55677/IJCSMR/V4I3-06/2024.

Harrison V, Jones K, Hyde CAC. Using eHealth to support quality of life and well-being in patients with lung cancer: systematic review. JMIR Cancer. 2025;11:e70510. https://doi.org/10.2196/70510.

Shankar A, Dubey A, Saini D, Singh M, Prasad CP, Roy S, Bharati SJ, Rinki M, Singh N, Seth T, Khanna M, Sethi N, Kumar S, Sirohi B, Mohan A, Guleria R, Rath GK. Environmental and occupational determinants of lung cancer. Transl Lung Cancer Res. 2019 May;8(Suppl 1):S31-S49. https://doi.org/10.21037/tlcr.2019.03.05.

Feng M, Wang F, Bao M and Zhu L (2025) Environmental risk factors, protective factors and lifestyles for lung cancer: an umbrella review. Front. Public Health 13:1623840. https://doi.org/10.3389/fpubh.2025.1623840


Refbacks

  • There are currently no refbacks.




____________________________________________________________________________________________________________________________________________

Health Dynamics || Open Access Journal || Online version only || Publisher: Knowledge Dynamics || ISSN: 3006-5518 (online) || Contact: healthdynamics.journal@gmail.com; +8801814901991; +6282136364408