Educational Approaches and Retention of Breast-Health Learning Among School-Aged Adolescents: A Systematic Literature Review

Breast-health education can help school-aged adolescents recognise unusual breast changes and seek appropriate advice. Improvement immediately after teaching, though, does not indicate whether students retain what they have learned. This review examined the educational approaches used to teach breast health and whether changes in knowledge, attitudes or breast self-examination learning remained for at least four weeks. PubMed, ERIC, CINAHL Complete and Academic Search Ultimate were searched for English-language studies published between January 2015 and August 2026. Open Dissertations and the reference lists of relevant articles were searched for additional evidence. Eligible studies involved school-aged adolescents, evaluated a breast-health educational intervention and included an assessment conducted at least four weeks after education. Study selection followed PRISMA 2020, and methodological quality was assessed using the revised JBI critical appraisal tool for quasi-experimental studies. The searches identified 264 records. After duplicates and records outside the publication period were removed, 236 records were screened and 10 studies met the eligibility criteria. Follow-up periods ranged from four weeks to 12 months. Educational approaches included lectures, demonstrations, drama, printed materials, podcasts, online teaching, augmented reality and repeated activities. Most studies reported that knowledge remained higher than baseline, though some decline occurred between three and six months. Positive follow-up findings were frequently reported in programmes involving student participation, practical guidance or repeated learning activities. The evidence remains limited by differences in programme content, measurement tools and study quality. Several studies lacked comparison groups, relied on self-reported practice or involved a single school or location. Evidence from Malaysia and other ASEAN countries was particularly limited. School programmes may benefit from age-appropriate content, guided activities, refresher sessions and follow-up assessment. Further multi-school studies with longer follow-up and direct assessment of practical skills are needed.

adolescents, breast-health education, breast self-examination, learning retention, systematic literature review

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