The effect of motivational interviewing on the change of breast cancer screening behaviors among rural Iranian women

•People may be unwilling to display screening behaviors when feeling well.•Education alone raises women’s awareness of breast cancer.•people do not change unhealthy behaviors quickly and decisively.•Motivational interviewing is based on assumption that change in behavior occurs continuously.•Motivational interviewing can improve breast cancer screening uptake among rural women. The study aimed to determine the effect of motivational interviewing on the change of breast cancer screening behaviors among rural Iranian women. This Randomized controlled trial (RCT) was performed on 120 Iranian rural women selected through cluster random sampling method. Out of all 20 rural health centers of Abish Ahmad District, in the northwest of Iran, about one third (six clusters) were randomly selected; out of which three were randomly assigned to the control group and three to the intervention group. A list of women aged 40–69 years in the selective health centers was prepared and 60 participants were selected for each group through the convenience sampling method based on the inclusion and exclusion criteria. Then, six group sessions (two educational and four motivational interviewing sessions) were held for the intervention group. The data were collected using demographic and obstetric questionnaire, paper-based health records, and the stages of change checklist and analyzed in SPSS 24. The groups were compared through the chi square test, homogeneity test, and the sequential logistic regression with generalized estimating equations. Two months after the intervention, a significant difference was found between the two groups in terms of the stages of change for clinical breast examination and mammography by taking into account the pre-intervention stages (p = 0.001). MI-based counseling increased the Iranian rural women’s motivation for displaying breast cancer screening behaviors. The application of MI for enhancing cancer screening programs among Iranian women is suggested.