A Digital Educational Media Model for Breast Self-Examination (BSE) to Improve Knowledge and Early Detection Behavior of Breast Cancer Among Women of Reproductive Age

Abstract

Breast cancer remains the most commonly diagnosed cancer among women in Indonesia, and late-stage presentation continues to undermine treatment outcomes, making early detection through breast self-examination (BSE), locally known as SADARI, a critical public health priority. This study aimed to design a digital educational media model for BSE capable of improving knowledge and early detection behavior among women of reproductive age in a residential community setting. A formative, mixed-methods situational analysis was conducted among 20 married women aged 30–45 years, members of a neighborhood arisan (rotating social-savings) group in Perumahan NTI, Makassar City, using field observation, in-depth interviews, focus group discussion, and a structured questionnaire. Problem prioritization was determined using the Urgency-Seriousness-Growth (USG) method, and root causes were analyzed using a fishbone (Ishikawa) diagram. The results showed that although 95% of respondents owned and actively used a smartphone, 70% had never performed BSE, and correct knowledge of BSE's ideal timing (20%) and proper technique (15%) was particularly low. No visual educational media on BSE was found circulating in the community, and existing health information was delivered only orally and incidentally. Respondents expressed a clear preference for concise, visually engaging, shareable digital content distributed through existing WhatsApp arisan groups, using informal language and non-explicit illustrations. These findings indicate that the absence of appropriate educational media, rather than lack of technology access, is the principal barrier to BSE knowledge and practice in this population, and support the development of a shareable digital media model tailored to housewives' communication habits and preferences as a feasible strategy for improving breast cancer early detection behavior.