Journal of Health Literacy

Journal of Health Literacy

An Exploratory Investigation of Media Literacy Preferences Based on Profiling of Clients Attending Comprehensive Health Service Centers within the Framework of the Social Marketing P7 Model to Enhance Participation in Breast Cancer Screening

Articles in Press

Document Type : Original Article

Authors
Khatereh Berahmoghadam 1
Shaghayegh Vahdat 2
Somayeh Hesam 2
1 PhD student in Health Services Management, Islamic Azad University, South Tehran Branch, Tehran, Iran.
2 Associate Professor, Islamic Azad University, South Tehran Branch, Tehran, Iran.
10.22038/jhl.2026.95272.1957
Abstract
Background and Objective: Breast cancer is the most common malignancy among women, and screening plays a vital role in reducing its mortality. This study aimed to conduct an exploratory investigation of media preferences among identified profiles based on the factors of the social marketing P7 model in women presenting for breast cancer screening.

Material and Methods: A cross-sectional exploratory-descriptive study was conducted on 393 women (aged 30–69 years) attending comprehensive health service centers for breast cancer screening at Iran University of Medical Sciences (Tehran), Mashhad University of Medical Sciences, and Abadan University of Medical Sciences. The data collection tool was a researcher-developed questionnaire whose factor structure was validated using Confirmatory Factor Analysis (CFA). Data analysis included the k-Means method to identify attitudinal-behavioral profiles of clients, and the Chi-square test with Cramer’s V to examine the relationship between clusters and their media preferences. The optimal number of clusters was determined using the elbow method, sample size balance, and interpretability.

Results: Three distinct clusters were identified and labeled: “Pragmatic Critics” (23.7%), “Structural Critics” (41.2%), and “Satisfied Aware” (35.1%). Examination of 7Ps construct scores revealed that “Structural Critics” had the lowest score on the “product/service” construct (2.55) and the highest on “personnel” (4.18), while “Pragmatic Critics” had the lowest scores on “process” (2.86) and “personnel” (2.98), and “Satisfied Aware” achieved the highest scores on “personnel” (4.14) and “product/service” (3.89).
Differences in media preferences between clusters were not statistically significant (P>0.05). In the overall sample, “telephone contact” (65.8%) was the most effective follow-up method, “pamphlets and brochures” (36.9%) the most suitable communication strategy, “physicians and healthcare center caregivers” (63.9%) the most appropriate awareness channel, and “pharmacies” (51.7%) the preferred message delivery location.

Conclusion: The “media co-preference” pattern observed in this study indicated that despite profound attitudinal differences, the overall sample preferred similar communication channels. Accordingly, a “channel-content separation” strategy appears more efficient than channel personalization. It is recommended that common and traditional communication channels (telephone contact, brochures, clinics, and pharmacies) be maintained as the core infrastructure, while message content is customized for each profile. Definitive confirmation of this strategy requires future interventional research.
Keywords
Health Literacy
Breast Cancer Screening
Social Marketing
Media Co-preference
Cluster Analysis

Acknowledgments: The authors sincerely thank the health team members at the comprehensive health service centers of Iran, Mashhad, and Abadan Universities of Medical Sciences who cooperated in completing and collecting the questionnaires. We also express our gratitude to all the women who, through their participation and honest responses to the questionnaires, made valuable contributions to this research. We are also very grateful for the support and consultations of Dr. Hamidreza Kamyar in preparing and editing the article.


Availability of Data and Materials: The supporting materials and data for this study are available from the corresponding author upon reasonable request.


Conflict of Interest: The authors declare that they have no conflicts of interest in conducting this research.


Consent for Publication: Not applicable.


Ethical Approval and consent to participate: This research was conducted in full compliance with ethical principles in medical research based on the Declaration of Helsinki and national guidelines. The official research ethics code [IR.IAU.VARAMIN.REC.1404.068] was obtained from the Islamic Azad University, Varamin Branch ethics committee. Informed consent was obtained from all participants prior to enrollment, and they were assured that their information would remain confidential and used solely for research purposes. The authors declare that they have no conflicts of interest in conducting this research.


Funding: This study was conducted without specific financial support.


Authors’ Contributions: Dr. Shaghayegh Vahdat served as the corresponding author; Khatereh Berahmoghadam was the study designer, statistical analyst, and writer of the final manuscript; Dr. Shaghayegh Vahdat and Dr. Somayeh Hesam performed critical revision of the manuscript and supervised the research process. All authors have read and approved the final version of the manuscript.

 

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

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Journal of Health Literacy

Articles in Press, Accepted Manuscript
Available Online from 23 August 2026