Table 3. Characteristics of the social capital interventions and their impacts on cervical cancer screening.

Study (in alphabetical order)	Objective	Country, population size and description	Description of intervention	Social capital dimensions	Social capital functions	Impact and effectiveness
Khani Jeihooni et al., 2021	This non-equivalent quasi-experimental controlled study examined the effect of a Pap smear educational intervention targeting the beliefs, subjective norms and perceived behavioural control in Iranian women.	Iran 300 women (150 in the control group and 150 in the experimental group).	Health belief model and theory of planned behaviour were used to inform an educational program that was based on active learning to enhance the knowledge of cervical cancer, Pap smear tests, barriers to screening and individual and social factors related to Pap smear testing. The experimental group participated in eight 50-minute education sessions once per week that included a group discussion, brainstorming, question and answer and a film display to facilitate motivation and behavioural control in Pap smear testing. Spouses, physicians and healthcare staff were present during these sessions to play supporting roles. These groups helped to influence the subjective norms around cervical cancer screening. Control group participants received no education intervention.	Cognitive: · The health belief model, informing the educational intervention, depicts subjective norms as a result of many normative beliefs and perceptions; thus, people will often act based on their perception of what others would think they should do.	Linking, bridging and bonding: · The intervention included an educational session with spouses, physicians and health centre staff in attendance to play supporting roles and influence the subjective norms around screening behaviours.	· At 6-month post-intervention, a significantly greater portion of the experimental group received the Pap smear test (72%; n=108/150), compared to the control group (6%; n=9/150; p<0.05). · There was no significant difference in knowledge (p=0.09), perceived susceptibility to HPV and associated diseases (p=0.104) and severity of cervical cancer (p=0.135), barriers (p=0.121), benefits of cervical cancer screening (p=0.176), behavioural control (p=0.289), subjective norms (p=0.322), or intention scores (p=0.355) between control and experimental groups at baseline. · At 6-month post-intervention, there was a significant improvement in knowledge (p<0.05), understanding of perceived susceptibility to and severity of cervical cancer (p<0.05) and benefits of cervical cancer screening (p<0.05), behavioural control (p<0.05) and subjective norms (p<0.05) in the experimental group compared to the control group. Within the control group, there were no significant changes (p>0.05). · At 6-month post-intervention, there was a significant decrease in perceived barriers to cervical cancer screening (p<0.05), such as lack of time, in the experimental group. Within the control group, there were no significant changes (p>0.05).
Larkey et al., 2012	This two-group quasi-experimental design study examined the effect of using lay health educators to increase cancer screening behaviours in Latinas.	United States 1,006 women (604 women in social support group [SSG] and 402 women in individual [IND] group). Age: mean of 38.4 years old	The same intervention was delivered in two different formats: IND and SSG. The intervention included six 80-minute educational sessions that contained definitions for different cancers; dietary, tobacco and physical activity recommendations for each cancer (cervical, breast and colorectal); and screening information. The SSG intervention was designed to promote group interactions and involvement to encourage women to meet each other’s needs and have group goal setting.	Cognitive: · A Hispanic Advisory Board reviewed the intervention educational curriculum. They provided insight into how to organize groups and develop a sense of identity and commitment within a group.	Linking: · Lay health educators were considered “practical supports”, as individuals who can share health information with others. Bridging and bonding: · Lay health educators (or promotoras de salud) were language-matched and networked in their communities.	· No significant differences in cervical cancer screening between the SSG and IND groups (p=0.315). · No significant differences in maintenance of cervical cancer screening (p=0.971).
Ma et al., 2022	This one-group quasi-experimental design study evaluated the impact of a culturally tailored intervention for Chinese, Korean and Vietnamese women on HPV self-sampling test uptake.	United States 156 Asian-American women Age: mean of 44.66 years old	The intervention was informed by the health belief model and the community-based participatory research approach. The intervention contained four different components: group education workshops, written and illustrated instructions on the HPV self-sampling test, group discussion session and patient navigation and follow-up care.	Cognitive: · Focus groups informed the cultural components of the intervention. · Perceived social support was assessed using 11 survey questions to measure support from spouses, other family members, friends and physicians related to cervical cancer screening.	Bridging and bonding: · The intervention contained a group education component with bilingual health educators.	· 100% (n=156/156) of the participants completed the HPV self-sampling test, but only 92.5% (n=145/156) were adequate samples. · HPV-related knowledge, social support, self-efficacy and comfort increased significantly following the intervention (p<0.001).
McDonough et al., 2016	This one-group quasi-experimental design study evaluated the effectiveness of an educational intervention to improve Latina’s knowledge, attitudes, behaviours and intentions to get the Pap smear test.	United States 5,211 Latina women Age: mean of 39.07 years old	The intervention included an educational curriculum toolkit for promotores de salud (community health workers) to use in delivering cervical cancer screening education to Spanish-speaking Latina women. The toolkit contained bilingual materials of flip charts, key talking points, a charla (health education session) guide, educational brochures and a list of local resources for low-cost or free Pap smear testing.	Cognitive: · Promotores de salud offered social support, a sense of belonging and trust.	Linking: · Promotores de salud lived in the communities and provided health services and education as trusted members of the community. They acted as cultural brokers between the communities and the healthcare system. Bridging and bonding: · The intervention was delivered to a group of participants that identified as Latina and were part of a culturally similar group.	· Intentions to receive a Pap smear test increased significantly (z=−8.94; p<0.001). · Knowledge (p<0.001; 95% CI: −2.67, −2.53; r=0.73), positive attitudes (p<0.001; 95% CI: −0.15, −0.12; r=0.29) and self-efficacy (p<0.001; 95% CI: −0.18, −0.15; r=0.29) related to cervical cancer prevention and screening increased significantly.
Olubodun et al., 2022	This non-equivalent quasi-experimental controlled study examined the effects of a social marketing intervention on Pap smear knowledge, attitudes and behaviours among women living in urban slums.	Nigeria 400 women (200 in the intervention group and 200 in the control group). Age: 21–30 years, 44.1%; 31–40 years, 31.7%; 41–50 years, 18.1%; 51–60 years, 3.8%; 60–65 years, 2.2%	The intervention was informed by the health belief model and focus groups. The intervention group received six health education sessions on cervical cancer and Pap smears, which included education for participants’ husbands. As part of the social marketing intervention, community mobilization was implemented to recruit key community members such as religious clerics and community leaders to publicly show support for cervical cancer screening. The control group also received health education sessions on cervical cancer and free Pap smear tests following the study.	Structural and cognitive: · The development of the intervention was informed by perceived barriers related to religion, culture, spouses’ disapproval and feelings of embarrassment. · Religious leaders, traditional leaders and husbands helped promote the Pap smear services through speeches at health education sessions.	Bridging and bonding: · People were assigned to groups based on similar sociodemographic characteristics, beliefs, values and behaviours. · Sensitization and educational sessions were targeted toward husbands to reduce spouses’ disapproval.	· Cervical cancer screening uptake significantly increased in the intervention group (0% to 84.3%; p<0.001; 95% CI: 0.8–0.9), but not in the control group (p=1.000). · Change in knowledge was statistically significant in the intervention group (mean=0.0, SD=0.3 to mean=15.1, SD=3.7; p<0.001; 95% CI: 14.3–15.6), but not in the control group (p=0.096). · Attitude scores improved significantly in the intervention group (mean=27.2, SD=1.4 to mean=36.5, SD=4.8; p<0.001; 95% CI: 8.5–10.1), but not in the control group (p=0.068).

Abbreviations: CI, confidence interval; HPV, human papillomavirus; r, effect size; SD, standard deviation; z, z score