ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Health Education and Promotion
This article is part of the Research TopicDigital Health Innovations for Patient-Centered CareView all 36 articles
An Integrated PBL–KAP–AI Spiral Health Education Model for Breast Cancer Patients: Mechanism and Quasi-Experimental Evaluation
Provisionally accepted
- 1Zhejiang Zhoushan Tourism and Health College, Zhoushan, China
- 2Second Affiliated Hospital of Harbin Medical University, Harbin, China
- 3Nanchang Institute of Technology, Nanchang, China
- 4Women's Hospital School of Medicine Zhejiang University, Hangzhou, China
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Background:Breast cancer is the most common malignancy among women worldwide, with notable disparities in incidence and mortality. Traditional health education improves knowledge and some behaviors but often fails to sustain long-term change due to its static and unidirectional nature. To overcome these limitations, we developed a spiral health education model integrating Problem-Based Learning, the Knowledge– Attitude–Practice framework, and Artificial Intelligence (PBL–KAP–AI). Objective:To evaluate the impact of the PBL–KAP–AI model on health behaviors, health beliefs, and quality of life in breast cancer patients, and to examine underlying mediating and moderating mechanisms. Methods :A randomized controlled trial enrolled 488 breast cancer patients (intervention=244; control=244) from January to March 2024. The intervention group received PBL–KAP–AI education, while controls received routine health education. Outcomes included health behaviors (HPLP-II), health beliefs (HBM scale), and quality of life (SF-36). Analyses employed t-tests, RM-ANOVA, and Bootstrap-based mediation and moderated mediation models. Results:The intervention group achieved significantly greater improvements in health behaviors (123.01±9.90 vs. 98.12±7.96), health beliefs (128.69±15.89 vs. 107.65±16.24), and quality of life (80.58±7.28 vs. 71.37±10.21; all p<0.001). Mediation analysis showed satisfaction influenced quality of life through health behaviors, while moderated mediation revealed behavior levels shaped the pathway to health beliefs.
Keywords: breast cancer, Health Education, Problem-Based Learning, KAP, artificial intelligence
Received: 18 Aug 2025; Accepted: 24 Oct 2025.
Copyright: © 2025 Li, Lu, Tian, Zhou and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yang Lu, 105359258@qq.com
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