Using the health belief model to assess beliefs and behaviors regarding cervical cancer screening among Saudi women: a cross-sectional observational study

Knowledge of Cervical Cancer Among Women of Childbearing Age: A Qualitative Study of a Local Council in South-Eastern Nigeria

The study investigated the knowledge of cervical cancer among women of childbearing age in a local council of a southeastern Nigerian state, aiming at improving attitudes toward screening uptake and early detection. The health belief model served as a guide for the study's qualitative exploratory research design. Using a combination of purposive and availability sampling strategies, a sample of 20 women participants with varying ages (23-36 years) were selected from 10 villages. The findings revealed that participants have limited knowledge of cervical cancer, with misconceptions and cultural beliefs influencing their understanding. The findings identified factors contributing to the lack of knowledge, including limited access to information and resources, fear, social disapproval, and financial constraints resulting from poverty. The findings also revealed that lack of knowledge has detrimental effects on women's mental, psychological, and social lives, including their relationships with friends and family. In addition, education, awareness campaigns, collaboration with medical personnel, and community engagements were effective strategies to enhance knowledge and awareness of cervical cancer programs among women. The study revealed that the findings imply social work. However, the study recommended that future investigations should consider a larger, more diverse sample to validate these findings and explore strategies to improve knowledge and awareness of cervical cancer among women in Nigeria.

The effect of the music-supported education program on the awareness and health beliefs of Roma women about cervical cancer and screening

BACKGROUND

Roma women, who have low education, are one of the risk groups for cervical cancer as it has proven that they marry and give birth at an early age and have limited access to preventive health services.

AIM

This study aims to reveal the effect of a music-supported education program based on the Health Belief Model on the awareness and health beliefs of Roma women about cervical cancer and screening.

METHODS

This study was conducted between June 2021- January 2022 with 40 Roma women in the experimental group and 40 in the control group. Data were collected using the Personal Information Form and the Health Belief Model Scale for Cervical Cancer and Pap Smear Test. The experimental group received a four-week training and a two-week music-supported training.

RESULTS

It was revealed that 27.5% of the Roma women in the experimental group had the pap smear test after the intervention, and there was a significant difference in the mean scores of the awareness of cervical cancer and screening and the factors of the Health Belief Model Scale for Cervical Cancer and Pap Smear Test compared to the pre-intervention. It was found that the intervention had a significant effect at the level of 77.9% in reducing the perceived barriers to the pap smear test (p < 0.001).

CONCLUSION

It was found that the music-supported education program based on the Health Belief Model positively affected the awareness and health beliefs of Roma women about cervical cancer and screening.

TRIAL REGISTRATION

The study was registered with the U.S.National of Medicine Clinical Trials Registry (NCT04756440 -15.08.2020).

Assessment of Health Beliefs and Motivations for Cervical Cancer Screening

Background and Aim: This study evaluated Turkish women's health beliefs and motivations for participating in cervical cancer screening using the Health Belief Model Scale for Cervical Cancer and Pap Smear Test (HBMS-CCPST). Although the HPV vaccine has proven effective, Turkey has not integrated it into the national health program, but it provides free HPV-DNA screenings for women at family health centers (FHCs). This study evaluated Turkish women's health beliefs and motivations for participating in cervical cancer screening using the Health Belief Model Scale for Cervical Cancer and Pap Smear Test (HBMS-CCPST) with the aim of understanding and enhancing screening uptake. Methods: This cross-sectional study was conducted at the family health centers in the Kartal and Pendik districts of Istanbul and involved women aged 30-65 years. The participants were randomly selected from the FHCs' 2023 lists. Data were collected through face-to-face interviews, using a structured questionnaire based on the HBMS-CCPST. Results: A randomly selected sample of 422 women from 8003 registered FHCs was approached to participate; 354 agreed, 25 declined, and 43 were excluded because they did not meet the inclusion criteria. The mean age was 44.58 years (range: 30-64), and 51% had previously undergone a smear test. Correlations were found between age and the total HBMS-CCPST score (r = -0.207, p = 0.001), perceived benefits (r = -0.106, p = 0.046), health motivation (r = -0.195, p = 0.001), and perceived barriers (r = 0.132, p = 0.013). Social security status influenced the HBMS-CCPST scores (p = 0.019), health motivation (p = 0.011), and perceived barriers (p = 0.002). Employment status affected the total score (p = 0.001), health motivation (p = 0.001), and perceived barriers (p = 0.001), with employed women showing higher health motivation and lower perceived barriers. Alcohol use and physical activity levels affected the total score (p = 0.001 and p = 0.007, respectively) and health motivation (p = 0.011 and p = 0.001, respectively). STD risk perception affected the HBMS-CCPST scores (p = 0.001, p = 0.001) and perceived barriers (p = 0.001 and p = 0.001, respectively). Conclusions: Sociodemographic factors and daily habits significantly influenced the participants' health beliefs and motivations for cervical cancer screening.

Using a social marketing approach to increase the pap-smear test uptake: randomized controlled trial among women residing in urban region

BACKGROUND

Social marketing intervention is a strategy to improve intention and behavior in this field. Therefore, this study was conducted with the aim of determining the impact of social marketing intervention on Pap-smear test uptake.

METHODS

The study conducted between June 5th 2023 and August 6th 2023. This study is registered in IRCT (code: IRCT20221126056609N1 & Registration date: 2023-04-27) The population studied were married women aged 18 to 65 living in Qazvin City. Comprehensive health service centers of Qazvin city were clustered for sampling and samples were randomly taken from each cluster and randomly divided into two control and intervention groups. Demographic, social, and economic information was collected before the intervention for both intervention and control groups. The intervention was based on four marketing mixes (product, price, place, and promotion). After three months, the pap smear test uptake was examined in both intervention and control groups. The data were analyzed by performing paired t-tests, chi-square, and odds ratio estimation in SPSS and Stata software.

RESULTS

The findings showed that there was a significant difference in Pap smear test uptake between the intervention and control groups after the intervention. So the participant who intervened had about 12 times more chance of a test uptake and this chance in the follow-up period was 5 times more than the control group.

CONCLUSION

The findings of the present study showed that the intervention based on social marketing increases awareness, perceived risk, and the demand for Pap smear tests among women. By influencing women's intention and behavior, they can be led to participate in screening. For this purpose, a multifaceted intervention should be designed based on the barriers and facilitators of test's demand.

TRIAL REGISTRATION

This study is registered in IRCT (code: IRCT20221126056609N1 & Registration date: 2023-04-27).

Smoking behaviors among Middle Eastern college women in the United States

Objective: to examine factors associated with cigarette and hookah smoking among Middle Eastern (ME) Arab college women. Participants: 406 adult women of ME Arabic background, currently enrolled in or recently graduated from a US college. Methods: a cross-sectional design, using an anonymous online survey of demographic characteristics, sociocultural factors, and access to health care factors. Data analysis included regression model to identify predictors of smoking behaviors. Results: Smoking rates were 21% and 19% for cigarette and hookah smoking. Cigarette smoking was higher with having liberal attitudes toward sexuality and lower among those having a healthcare provider. Hookah smoking was higher among students who are Muslim, involved in student organizations, have higher acculturation-heritage levels, and have more liberal attitudes toward women. Hookah smoking was lower among students born in the US, attending college part-time, and having higher religiosity levels. Conclusions: The study findings have several implications for interventions to address smoking behaviors among ME Arab college women through community organizations and within college campuses.

Unlocking prevention: the role of health literacy in cervical cancer screening: community nursing perspective

INTRODUCTION

Cervical cancer presents a significant global public health challenge, particularly affecting low- and middle-income countries like Egypt. Despite the availability of effective screening methods such as Pap smears and HPV testing, the incidence of cervical cancer remains high in Egypt. Health literacy, which refers to the ability to access, understand, and utilize basic health information and services to make informed decisions, is crucial in influencing individuals' health behaviors, including their participation in cancer screening programs.

OBJECTIVES

To examine the correlation between health literacy levels and cervical cancer screening behaviors among women.

METHODS

This study employed a multi-site cross-sectional research design from September 2023 to January 2024. The research was conducted at four primary health care (PHC) facilities in the Damanhur district of Egypt. Three hundred fifty women participated in the study, completing a comprehensive questionnaire that included a Woman's Social and Health Form, a Cervical Cancer Knowledge Scale, a Cervical Cancer Screening Behaviors Scale, and a Health Literacy Scale (HLS-SF12).

RESULTS

The study revealed significant relationships between the importance of health literacy (HL) in understanding cervical cancer (CC) knowledge and screening behaviors among Egyptian women. A positive correlation was found between Knowledge and HL (r = 0.507, p < 0.001). Conversely, perceived barriers negatively correlated with knowledge and HL (r = -0.172, p < 0.05; r = -0.277, p < 0.01). The regression analysis revealed that higher levels of HL were significantly associated with greater knowledge about CC (B = 0.148, p < 0.001). Conversely, knowledge about CC was also found to be a strong predictor of higher HL levels (B = 1.205, p < 0.001). These results highlight the bidirectional relationship between HL and knowledge, where improvements in one can enhance the other.

CONCLUSION

Addressing misconceptions and increasing knowledge about the importance of regular screenings, mainly through accessible and culturally appropriate channels, could lead to an improved uptake of cervical cancer screening services. Overall, this study lays a foundation for future research to continue exploring ways to improve cervical cancer prevention and control efforts among women.

CLINICAL TRIAL NUMBER

Not applicable.

Awareness and acceptance of human papillomavirus vaccine in the Middle East: A systematic review, meta-analysis, and meta-regression of 159 studies

Cervical cancer, closely linked to human papillomavirus (HPV) infection, is a major global health concern. Our study aims to fill the gap in understanding HPV vaccine awareness and acceptance in the Middle East, where national immunization programs are often lacking and cultural perceptions hinder acceptance. This systematic review and meta-analysis adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive literature search across several databases was conducted on 5 September 2023. We included quantitative studies on HPV vaccine awareness and acceptance in Middle Eastern countries. Data extraction and quality assessment were conducted independently by multiple reviewers to ensure accuracy. Statistical analyses, including subgroup analyses, were performed using R to calculate pooled estimates, assess heterogeneity, and publication bias. We reviewed 159 articles from 15 Middle Eastern countries, focusing on 93,730 participants, predominantly female and healthcare workers. HPV vaccine awareness was found to be 41.7% (95% CI 37.4%-46.1%), with higher awareness among healthcare workers. The pooled acceptance rate was 45.6% (95% CI 41.3%-50.1%), with similar rates between healthcare and non-healthcare workers. Our study highlights the critical need for increased HPV vaccine awareness and acceptance in the Middle East, emphasizing the importance of integrating the vaccine into national immunization programs and addressing cultural and religious factors to improve public health outcomes.

Integrated cervical cancer screening uptake and associated factors among women attending primary care services at public health centres in Addis Ababa, Ethiopia: a multicentre cross-sectional study

Background

Cervical cancer (CC) is a major health problem in Ethiopia. Integrated healthcare approaches have been suggested as a way to increase access to and utilisation of screening services. Limited data exists on integrated CC screening (CCS) uptake at the primary care facilities where most women access healthcare. This study aimed to determine integrated CCS uptake and associated factors among women attending primary care services at health centres (HCs) in Addis Ababa, Ethiopia.

Methods

A multicentred cross-sectional study design was conducted among 1366 women attending primary care services at HCs in Addis Ababa. A systematic random sampling method was used to reach the study participants. Sexually active women aged 30-49 years attending primary care services in HCs were included in the study. A multivariable logistic regression model, with Stata/MP V.17.0 software, was used to identify the factors associated with integrated CCS service utilisation at a p value<0.05. Findings were presented using adjusted OR (AORs) with 95% CI.

Result

Only 15.6% (95% CI: 13.7 to 17.6) of women used the CCS that was integrated into the primary care services that they initially sought. Being single (AOR: 4.10; 95% CI: 2.19 to 7.68), divorced (AOR: 2.33; 95% CI: 1.04 to 5.21), attending college and above (AOR: 5.86; 95% CI: 2.32 to 14.79), being in the richest wealth index (AOR: 2.76; 95% CI: 1.46 to 5.22), husband's sexual behaviour (AOR: 6.8; 95% CI: 4.09 to 11.21), having a favourable attitude towards CCS (AOR: 2.24; 95% CI: 1.52 to 3.29) and visiting postnatal clinic (AOR: 8.06; 95% CI: 2.33 to 27.8) were associated with utilisation of CCS services, while preference of a specific gender of healthcare provider (HCP) (AOR: 0.04; 95% CI: 0.02 to 0.13) was associated with non-utilisation of CCS.

Conclusion

The study found low integrated CCS uptake among women in Addis Ababa, influenced by factors like marital status, education, wealth, husband's sexual behaviour, attitude towards CCS, postnatal clinic visits and preferred gender of HCPs. Taking these factors into consideration by stakeholders could promote CCS utilisation.

Cervical cancer screening uptake in Arab countries: a systematic review with meta-analysis

BACKGROUND

Cervical cancer, though one of the most common cancers affecting women globally, holds immense potential for prevention through screening. Therefore, we conducted this meta-analysis to assess the rate of cervical cancer screening in Arab countries and identify barriers among those who did not participate.

METHODS

A comprehensive search was conducted from January 1st to June 1st,2024, including all observational studies that reported cervical cancer screening uptake in any Arab country. A meta-analysis was performed using a random-effects model to estimate the pooled prevalence, and sensitivity analyses were conducted to test the robustness of the findings. The study followed PRISMA guidelines.

RESULTS

This meta-analysis, covering 55 studies and 204,940 Arab women, found an overall cervical cancer screening uptake rate of 18.2% (95% CI: 13.9-23.6), with sensitivity analysis confirming the reliability of this estimate. Country disparities were evident, with Bahrain having the highest uptake at 44.1%, while Somalia had the lowest at 8.9%. Among women who underwent screening, the majority were ever-married (94.7%) and held positive attitudes towards screening (91.0%). Barriers to screening were common among women who did not participate, with the most frequent reasons being a lack of information (25.1%), the misconception of feeling healthy (24.5%), fear of the procedure (19.3%), and feelings of embarrassment (13.2%). Additionally, women who were screened had lower perceived barrier scores (SMD = -0.466) and higher perceived benefits scores (SMD = 0.379) than those who were not (p < 0.05).

CONCLUSION

This meta-analysis reveals a low overall cervical cancer screening uptake (18.2%) among Arab women. Key barriers such as lack of information, fear, the misconception of feeling healthy, and embarrassment hinder uptake. This alarmingly low rate underscores the urgent need for targeted interventions to address these barriers and promote awareness of early detection's life-saving potential.

Knowledge and awareness toward human papillomavirus vaccination among Saudi female nursing students

Introduction

Human Papillomavirus is a sexually transmitted agent, causing cervical cancer. In Saudi Arabia, cervical cancer is ranked as the ninth most common carcinoma in women. HPV vaccine is an effective prevention method against HPV high-risk types such as HPV 18 and 16. Research on HPV vaccine knowledge and awareness is limited due to the lack of extensive data reportage on HPV and cervical cancer cases among Saudi women.

Aim

This study was aimed to determine the knowledge and awareness of human papillomavirus vaccination among Saudi nursing female students.

Methods

This study was cross-sectional and included (n = 114) participants. The study used an online survey, which included demographical variables and the HPV knowledge scale. The data were collected from October 10, 2023, until January 3, 2024. Descriptive data, Mann-Whitney Z-tests and nonparametric tests were used to analyze the study's findings.

Results

The study participants' mean age was 20.8 years (SD 1.6). Most students (72%) did not receive the HPV vaccine. The overall mean HPV knowledge was 10.0 (SD 7.08). The HPV knowledge subscales showed poor levels of knowledge of HPV infection, screening, and vaccines: 5.15 (SD 3.87), 1.39 (SD 1.34), and 2.06 (SD 1.87), respectively.

Discussion

In conclusion, Saudi Arabia having a predominantly youthful population, it is crucial to implement educational programs that improve the understanding and awareness of HPV infection among nursing students and other health professionals. There is a necessity to establish impactful awareness campaigns and integrate interventional research to inform health professionals and the public about the disease and dispel misunderstandings and cultural beliefs about HPV and HPV vaccines to prevent cervical cancers among young females.

Low uptake of Pap test as a cervical cancer screen among Saudi women: Findings from a national survey

OBJECTIVE

The present study aimed to assess the current knowledge and uptake of Papanicolaou (Pap) tests for cervical screening among Saudi women, including barriers to undergoing the test and the availability of related services.

METHODS

A cross-sectional study was conducted using a health questionnaire administered through the Absher portal between April 1, 2019, and March 31, 2020. The questionnaire consisted of five questions and took less than 5 min to complete. Descriptive and inferential statistics were employed to analyze demographic variables, and chi-square tests were used to examine the association between these variables and Pap test uptake.

RESULTS

The questionnaire included 8194 Saudi women, with the majority from Makkah (24.40%), Riyadh (21.92%), and Eastern (14.44%) regions. Only 22.52% of respondents had ever received a Pap test, and among them, 17.48% did so based on their physician's recommendation. Private clinics accounted for 10.73% of Pap test locations, while public clinics accounted for 8.97%. The primary reasons for not undergoing the test were lack of knowledge regarding its importance (40.24%) and lack of information from physicians (16.96%). Knowledge of the Pap test as a cervical screening method was significantly associated with marital status, Saudi region, and age group.

CONCLUSIONS

This study revealed low awareness of the Pap test for cervical screening among Saudi women, particularly in younger age groups. Targeted educational initiatives are essential to increase awareness and emphasize the significance of regular screenings, especially among younger individuals, to enhance early detection and reduce the burden of cervical cancer in Saudi Arabia.

Cervical cancer screening practice and associated factors among female health care professionals in Ethiopia 2024: a systematic review and meta-analysis

BACKGROUND

Cervical cancer, ranking as the fourth most common gynecological cancer worldwide, claimed an estimated 570,000 lives and resulted in 311,000 new cases in 2018. This disease disproportionately affects those living in poverty and is more prevalent in countries with weak healthcare systems. Low and middle-income nations, particularly in Sub-Saharan Africa, face higher incidence and mortality rates due to limited access to vaccines, screening, and treatment. The world health organization recommends regular screening for women from age 25, setting a 90-70-90 target for low- and middle-income countries by 2030. Despite limited previous knowledge, the study aims to assess the pooled prevalence of cervical cancer screening practices and associated factors among female healthcare professionals in Ethiopia in 2024.

OBJECTIVE

The study aimed to synthesize the existing literature on cervical cancer screening practice and associated factors among female health workers in Ethiopia.

METHODS

Studies were searched through the search engine of Google Scholar, PubMed, and Cochrane Library. Searching was made using Keywords/ MeSH terms Cervical cancer; utilization; Preventive practice. Heterogeneity was assessed using the Cochran Q test and I2 statistics. A random-effects model with a 95% confidence interval was used for the pooled prevalence and odds ratio estimations.

RESULT

Seven studies were included in this systematic review and meta-analysis. The overall pooled prevalence of cervical cancer screening practice among female health workers in Ethiopia was 18%. Work place(OR = 2.858;95% CI: 0.412, 5.305),knowledge(OR = 3.457; 95% CI: 2.314, 4.601), work experience(OR = 5.421; 95% CI:4.178,6.664),being diagnosed(OR = 10.787; 95% CI: 06.197,15.377) and ever cared of cervical cancer patient (OR = 2.93; 95% CI: 2.004, 3.856) were the pooled associated factors that are significantly associated with cervical cancer screening practice among female health care worker.

CONCLUSION

The implementation of preventive measures for cervical cancer screening was found to be suboptimal. Our findings underscore the importance of enhancing awareness among this demographic, which is crucial in mobilizing local communities. It is imperative to provide continuous education to female health workers regarding cervical cancer. The Ministry of Health should collaborate with various organizations to ensure the accessibility of cost-effective screening services in all healthcare facilities.

Barriers and Enablers of Cervical Cancer Screening Among Saudi Women

BACKGROUND

Cervical cancer is a significant global health issue, with low screening uptake rates in many regions, including Saudi Arabia. This study sought to understand the barriers and enablers of cervical cancer screening among Saudi women, particularly in Makkah, Saudi Arabia.

OBJECTIVES

To identify barriers and enablers influencing cervical cancer screening uptake among Saudi women.

METHODS

This cross-sectional study was conducted in Makkah, Saudi Arabia, among 418 Saudi women aged 21-65. A questionnaire collected data on demographics, reproductive health, service utilization, and attitudes toward cervical cancer screening. Statistical tests such as the chi-square test and Mann-Whitney test were used for inferential analyses to determine significance, with a p-value of less than 0.05 considered significant.

RESULTS

 The study identified significant factors influencing cervical cancer screening uptake, including age, marital status, and household monthly income (p<0.001, p<0.001, and p=0.018, respectively). Health conditions such as hypertension, dyslipidemia, and miscarriage history also showed significant associations with screening uptake (p<0.001, p=0.009, and p<0.001, respectively). Additionally, the availability of screening services and encouragement from healthcare providers were linked to higher screening rates (p<0.001 and p=0.006, respectively). However, perceived benefits, barriers, susceptibility, and seriousness were not significantly associated with screening uptake (p>0.05).

CONCLUSIONS

The study identified several demographic and healthcare service utilization factors influencing cervical cancer screening uptake among Saudi women. These findings can be instrumental in informing public health measures, awareness campaigns, and healthcare policies aimed at increasing cervical cancer screening rates in Saudi Arabia.

The edutainment program on knowledge, perception, and uptake of cervical cancer screening among Muslim women in Southern Thailand: a quasi experimental study

INTRODUCTION

Cervical cancer is a significant global health concern and is the third most common cancer in women. Owing to their religious beliefs, Muslim women in Thailand are less likely to be screened for cervical cancer.

OBJECTIVE

This study aimed to explore how a Health Belief Model (HBM) (HBM = Health Belief Model)-Based Edutainment Program affects the knowledge, perception, and uptake of cervical cancer screening among Muslim women in Thailand.

METHODS

A quasi-experimental study was conducted in two rural districts of Southern Thailand with 83 Muslim women (intervention = 42, control = 41). The assessment was conducted through face-to-face interviews at baseline, post-intervention, and at 3-month follow-up. The intervention included four sessions involving video clips, folk songs, and short films. Data analysis was performed using repeated-measures ANOVA (ANOVA = Analysis of Variance) at a significance level of 0.05.

RESULTS

There were significant differences in the mean score of knowledge and perception between the intervention and control groups post-intervention and at 3-month follow-up (p < 0.001). The mean scores of knowledge and perception in the intervention group significantly increased post-intervention and at 3-month follow-up (p < 0.001). The uptake of cervical cancer screening tests in the intervention group was approximately twice as high as that in the control group (90.47% vs. 51.21%).

CONCLUSION

The findings revealed that the Edutainment Program could improve the knowledge, perception, and uptake of cervical cancer screening among Muslim women in Thailand. In future studies, the intervention suggests testing different population groups to improve access to primary care for everyone.

Experiences Relating to Sexual Well-Being Among Muslim Gynecological Cancer Survivors: A Systematic Review of Qualitative Studies

Background

Gynecological cancers are one of the most important threats to women's health worldwide. The objective of this review is to synthesize and present the best available evidence on the experiences relating to sexual well-being among Muslim women with gynecological cancer.

Methods

The databases searched included Web of Science, Scopus, SID, Google Scholar, ProQuest, MEDLINE, and CINAHL from the inception of the database until August 2021. The review was guided by the JBI methodology used for qualitative systematic reviews. Findings were collated using the meta-aggregation method through JBI SUMARI.

Results

Eight studies involving Muslim women cancer survivors were included in the review. Meta-synthesis of the eight included studies generated 59 findings, which were organized into 14 categories and combined into four synthesized findings.

Conclusions

Gynecological cancer and its treatment results in numerous challenges with sexual well-being among Muslim women cancer survivors. Providing information about sexual activity following gynecological cancer, better communication from health care professionals, and support from the husband is essential to overcome the struggle with intimacy and femininity experienced by the women, thus improving the sexual quality of life of Muslim gynecological cancer survivors.

Prevalence and Predictive Factors of Cervical Cancer Screening in Saudi Arabia: A Nationwide Study

BACKGROUND

Cervical cancer, despite being preventable, is one of the most prevalent cancers among females globally and in Saudi Arabia. The literature demonstrated that, unlike global trends, cervical cancer incidence in Saudi Arabia is increasing. In addition to that, a high proportion of it is discovered in advanced stages. This state of late discovery was attributed to the absence of efficient preventive and screening programs. Observing the scale of the preventable morbidities and mortalities that can be caused by cervical cancer and the efforts and costs that are positioned to fight cervical cancer across the globe and the current ambiguity in the cervical cancer screening prevalence in Saudi Arabia brings the realization of the importance of conducting a study that properly explores the status of cervical cancer screening in Saudi Arabia.

AIM

This study aims to measure the prevalence and the predictive factors for cervical cancer screening among adult women who were previously sexually active in Saudi Arabia, as well as explore the participants' knowledge and attitude toward cervical cancer and human papillomavirus (HPV) vaccines.

METHODS

This study was a nationwide cross-sectional study conducted in Saudi Arabia between September 2023 and November 2023 on adult Saudi females between the ages of 21 and 65 years who were previously sexually active and did not undergo a hysterectomy. Data were collected through a convenience sampling technique where a self-administered survey was established and disseminated to the targeted population all over the country with the assistance of data collectors. Cervical cancer screening prevalence and screening predictive factors were measured. Factors associated with cervical cancer screening and knowledge of cervical cancer were tested using a chi-square test, an independent t-test, and an ANOVA test. Multivariate logistic regression was also used to determine predictors of cervical cancer screening.

RESULTS

The study included 2,337 participants. The prevalence of cervical cancer screening among Saudi females was observed to be 22.1%. The most commonly reported reason for not undergoing cervical cancer screening was that it was never recommended by a physician, as reported by 42.4%. Only 7.6% reported taking the HPV vaccine. The majority of the participants (84.1%) had a low knowledge level about cervical cancer. The multivariate logistic regression model revealed that the following factors were observed to be significantly predictive of undergoing cervical cancer screening: being 46-59 years of age (74% increase rate), having an income greater than 20,000 Saudi Riyals (SRs) (158% increase rate), having a history of gynecological problems (152% increase rate), knowing someone who underwent cervical cancer screening (393% increase rate), and receiving a recommendation from a healthcare practitioner to undergo cervical cancer screening (1300% increase rate).

CONCLUSION

There are clearly low rates of cervical cancer screening and even lower rates of uptake for the HPV vaccine, which are the prevention measures for cervical cancer. National initiatives and programs that promote HPV vaccine uptake and regular cervical cancer screening are highly recommended to minimize the morbidity and mortality of cervical cancer.

Moroccan Women's Attitudes Regarding Pap Smear Test and Adherence to Cervical Cancer Screening

In Morocco, cervical cancer is the second most common cancer affecting women after breast cancer. Encouraging more women to practice cervical cancer screening remains a major public health concern. There is a lack of data on awareness and of data concerning the determinants of the acceptability of Pap smear test in Morocco. To fill this gap, our study aims to assess the level of awareness of cervical cancer and human papillomavirus (HPV) infection among Moroccan women and to understand the determinants of the acceptability of Pap smear test. We conducted a cross-sectional study including 857 women in the following three Moroccan regions: Casablanca-settat, Marrakech-Safi, and Tanger-Tetouan-Al Hoceima, by using a structured interviewer-administered questionnaire between November 2019 and February 2020. Out of the total sample, 83.9% of participants were aware of cervical cancer, 87.2% of participants were unaware of HPV, and 51.8% of participants were aware of Pap smear test. The rate of women who had ever had a Pap smear test in our population was only 19.36%. Moreover, our study revealed that more than 78% of participants were willing to undergo Pap smear test regularly in the future. The study revealed parity, age, educational level, risk perception, and the belief that early screening improves the chances of successful treatment, as determinants of acceptability of Pap smear test. Our results have shown that there is an urgent need to implement a strategy to sensitize women on the prevention of cervical cancer. Furthermore, the results of this study should be taken into account in the development of strategic and action plans for the prevention of cervical cancer.

Beliefs and Utilization of Cervical Cancer Screening by Female Health Care Workers in Saudi Arabia Using the Health Belief Model: A Nationwide Study

Purpose

Epidemiologically, cervical cancer is the fourth most commonly diagnosed cancer among females globally and the third most commonly diagnosed gynecological cancer in Saudi Arabia. Screening is an important measure to prevent it. The current study aimed to assess, epidemiologically, female healthcare workers' (HCWs) utilization of cervical cancer screening services and its association with their beliefs about cervical cancer and the screening test, as well as their personal characteristics.

Methods

This cross-sectional study included female HCWs in Saudi Arabia. A predesigned, self-administered survey was used to collect data, and it included questions about sociodemographic and reproductive characteristics, self-utilization of cervical cancer screening services, and the Health Belief Model (HBM) scale. Regression analyses were conducted to identify predictors of cervical cancer screening service utilization.

Results

A total of 1857 females participated. The cervical cancer screening test uptake was 24.6% of ever-married females. However, 45% of the participants were willing to have the test. The odds of utilizing a screening were significantly higher among older participants, those with a higher level of education, and those with a higher number of pregnancies. Furthermore, HCWs with a history of HPV infection, cervical cancer in the family, hormonal contraception, or immunocompromised diseases were more likely to have the screening. An increase in the mean scores of the perceived benefits and motives subscales of HBM was associated with an increase in the uptake of screening. However, an increase in perceived barrier scores was significantly associated with a lower likelihood of cervical cancer screening uptake.

Conclusion

Low cervical screening uptake and slightly higher intentions to have the test exist among HCWs. Certain personal factors and health beliefs significantly affect the utilization of the screening test. Approaches that target perceived benefits, health motivation, and perceived barriers to improve the screening rates of cervical cancer among HCWs are recommended.

Knowledge, Perception, and Acceptance of HPV Vaccination and Screening for Cervical Cancer among Saudi Females: A Cross-Sectional Study

Cervical cancer (CC) ranks as the eighth most prevalent malignancy in Saudi Arabian women of all ages. This cross-sectional study intends to assess women's knowledge, perceptions, and acceptance concerning HPV vaccination and CC screening in Saudi Arabia as well as the contributing variables to women's screening and vaccine acceptability. Data were collected between 1 April 2023 and 30 May 2023 through online questionnaires. Out of 421 responses, 70% of the studied sample had fair knowledge, and 30% had good knowledge related to cervical cancer screening and vaccine. Only 1.9% of the participants had a positive perception, while 41% of the participants had a negative perception toward cervical cancer screening and vaccine. A total of 38% of the participants were fearful of the side effects of the vaccine, while 22.2% doubted the effectiveness of the vaccine. Acceptance was much better correlated with perception (Rho = 0.47) than with knowledge (Rho = 0.177). However, this correlation remains weak. We conclude that Saudi women still have a poor understanding or impression of cervical cancer and prevention methods. Fear of the vaccination's negative effects and skepticism about the effectiveness of the vaccine/screening have recently been the most often-mentioned hurdles to vaccine uptake.

Knowledge, attitudes, and practice of the Pap smear test in female college students attending a global university in the United States

BACKGROUND

According to the World Health Organization, every minute, one woman is diagnosed with cervical cancer, and every 2 minutes, one woman dies of cervical cancer globally (World Health Organization, 2022). The biggest tragedy is 99% of cervical cancer is caused by a preventable sexually transmitted infection known as human papilloma virus (World Health Organization, 2022).

LOCAL PROBLEM

Many US universities indicate approximately 30% of their admissions are international students. The lack of Pap smear screening in this population has not been clearly identified by college health care providers.

METHODS

Fifty-one participants from a university located in the northeastern United States completed an online survey between September and October 2018. The survey was designed to identify disparities between United States residents and internationally admitted female students in their knowledge, attitudes, and practice of the Pap smear test.

INTERVENTIONS

One hundred percent of US students had heard of the Pap smear test as compared with 72.7% of international students ( p = .008); 86.8% of US students considered a Pap smear as opposed to 45.5% of international students ( p = .002), and 65.8% of US students previously had a Pap smear test as opposed to 18.8% of international students ( p = .007).

RESULTS

Results revealed statistically significant differences between US and internationally admitted female college students in knowledge, attitudes, and practice of the Pap smear test.

CONCLUSIONS

This project helps to bring awareness to college health clinicians the need for cervical cancer education and Pap smear screening for our college age international female population.

Malaysian Women's Viewpoint on HPV Screening and Vaccination: A Study on Barriers

Cervical cancer is the second most common cancer in low-income countries and the third most common cancer in Malaysia among women aged 15 to 44. This is a huge concern because of the high mortality rate compared to other countries. Cervical cancer is caused by a common sexually transmitted human papillomavirus (HPV). Of cervical cancer cases, 80% are attributed to serotypes 16 and 18; therefore, early detection of premalignant lesions and infections from these viruses is important. Diagnosis can be carried out by polymerase chain reaction (PCR)-based HPV DNA analysis and Pap smear, which act as a viable preventive strategy. (1) Background: This study determined the adoption of the human papillomavirus (HPV) vaccine and the willingness to get vaccinated in Malaysian women. (2) Methods: An online survey was conducted with women from across Malaysia to gather their views on the barriers that prevent them from accessing HPV services. Sentiment analysis was performed to detect and classify the comments into three groups (positive, neutral, and negative). (3) Results: A total of 449 opinions were received, and the findings revealed that 41.3% were not afraid to be diagnosed early, and were prepared to accept positive or negative screening results. In addition, 18.6% of those surveyed indicated that they feared a Pap smear and were very concerned that they would not get good results. Of the respondents, 36% believed in vaccination and preferred to know more about it; 43.24% claimed that their family members were very supportive towards screening and vaccination; and 21.3% felt embarrassed and were afraid to undergo the screening procedure, as they had no prior experience and were unsure of how the procedure was conducted. In addition, 40.5% indicated that they had no concerns about HPV testing and related procedures, as this information is widely available. Only a few respondents (8.1%) talked about the time constraints and busy work schedules that prevented them from going to medical appointments. The survey also revealed that women are prevented from participating in cervical cancer screening and vaccination programs due to a lack of knowledge, shyness, personal rumors, privacy issues, financial issues, a lack of access to medical services, and ignorance and beliefs about rumors spreading online. (4) Conclusion: Results indicate that awareness of HPV and related prevention measures among women is vague and that negative perceptions continue to exist. It is strongly advised to develop a well-designed and knowledge-based application on the efficacy of screening and vaccination among Malaysian women.

Understanding of Cervical Screening Adoption among Female University Students Based on the Precaution Adoption Process Model and Health-Belief Model

This study aimed to identify the decisional stages for cervical screening and corresponding cognitive factors in female university students. A cross-sectional study was conducted among Korean female university students aged 20-29 years through an online survey. The main outcome was the decisional stage of cervical screening adoption using the precaution adoption process model. The stages were classified into pre-adoption (the unawareness, unengaged, and undecided stages), adoption (the decided to act and acting stages), and refusal (the decided not to act stage). The cognitive factors in each stage were analyzed using the key concepts of the health-belief model. Cervical screening was defined as a clinical Papanicolaou (Pap) smear performed by a physician in a clinic. The final analysis included 1024 students. Approximately 89.0%, 1.0%, and 10.2% were classified as the pre-adoption, refusal, and adoption stages, respectively. Compared to the pre-adoption stage group, the adoption stage group was more likely to be older and have higher self-efficacy and knowledge. Most participants belonged to the pre-adoption stage-those unaware of cervical screening. Furthermore, most had a low level of knowledge and perception of cervical cancer and its screening. Therefore, our study highlighted the need for education to increase awareness and knowledge of cervical screening in this population.

CircRNA8924-Transfected Bone Marrow Mesenchymal Stem Cells (BMSCs) Affects the Biological Behaviors of Hela Cells

This study investigated the effect of BMSCs transfected with CircRNA8924 on biological behaviors of Hela cells. The transfected BMSCs was then co-cultured with Hela cells and divided into CircRNA8924 mimic group, CircRNA8924 inhibitor group, and CircRNA8924 NC group followed by analysis of cell proliferation, apoptosis, migrated and invaded capacity as well as CirRNA8924 and CBX8 expression. CircRNA8924 mimic group showed highest CircRNA8924 expression followed by NC group and Inhibitor group. CircRNA8924 Inhibitor group presented significantly reduced cell proliferation and cells at S stage, decreased cell migrated and invaded capacity and elevated cell apoptotic activity (P < 0.05) compared to other two groups. In addition, significantly downregulated CircRNA8924 and CBX8 was also found in CircRNA8924 Inhibitor group (P < 0.05). In conclusion, BMSCs transfected with CircRNA8924 could down-regulate CBX8 and CircRNA8924 so as to exert regulatory action on the biological behaviors of Hela cells, indicating that CBX8 might be a therapeutic target for treating cervical cancer.

Improving intervention design to promote cervical cancer screening among hard-to-reach women: assessing beliefs and predicting individual attendance probabilities in Bogotá, Colombia

Background

Despite being a preventable disease, cervical cancer continues to be a public health concern, affecting mainly lower and middle-income countries. Therefore, in Bogotá a home-visit based program was instituted to increase screening uptake. However, around 40% of the visited women fail to attend their Pap smear test appointments. Using this program as a case study, this paper presents a methodology that combines machine learning methods, using routinely collected administrative data, with Champion’s Health Belief Model to assess women’s beliefs about cervical cancer screening. The aim is to improve the cost-effectiveness of behavioural interventions aiming to increase attendance for screening. The results presented here relate specifically to the case study, but the methodology is generic and can be applied in all low-income settings.

Methods

This is a cross-sectional study using two different datasets from the same population and a sequential modelling approach. To assess beliefs, we used a 37-item questionnaire to measure the constructs of the CHBM towards cervical cancer screening. Data were collected through a face-to-face survey (N = 1699). We examined instrument reliability using Cronbach’s coefficient and performed a principal component analysis to assess construct validity. Then, Kruskal–Wallis and Dunn tests were conducted to analyse differences on the HBM scores, among patients with different poverty levels. Next, we used data retrieved from administrative health records (N = 23,370) to fit a LASSO regression model to predict individual no-show probabilities. Finally, we used the results of the CHBM in the LASSO model to improve its accuracy.

Results

Nine components were identified accounting for 57.7% of the variability of our data. Lower income patients were found to have a lower Health motivation score (p-value < 0.001), a higher Severity score (p-value < 0.001) and a higher Barriers score (p-value < 0.001). Additionally, patients between 25 and 30 years old and with higher poverty levels are less likely to attend their appointments (O.R 0.93 (CI: 0.83–0.98) and 0.74 (CI: 0.66–0.85), respectively). We also found a relationship between the CHBM scores and the patient attendance probability. Average AUROC score for our prediction model is 0.9.

Conclusion

In the case of Bogotá, our results highlight the need to develop education campaigns to address misconceptions about the disease mortality and treatment (aiming at decreasing perceived severity), particularly among younger patients living in extreme poverty. Additionally, it is important to conduct an economic evaluation of screening options to strengthen the cervical cancer screening program (to reduce perceived barriers). More widely, our prediction approach has the potential to improve the cost-effectiveness of behavioural interventions to increase attendance for screening in developing countries where funding is limited.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12905-022-01800-3.

Ensuring a successful transition from Pap to HPV-based primary cervical cancer screening in Canada by investigating the psychosocial correlates of women’s intentions: Protocol for an observational study (Preprint)

Background

Objective

Methods

Results

Conclusions

International Registered Report Identifier (IRRID)

Cervical Cancer Screening Uptake and Predictors Among Women in Jeddah, Saudi Arabia

INTRODUCTION

Cervical cancer is one of the most common cancers among females, contributing to significant mortality and morbidity worldwide. These numbers have significantly decreased since the implementation of cervical cancer screening. Despite that, screening in many countries, including Saudi Arabia, remains suboptimal.

METHODS

A cross-sectional study was conducted between May to November 2021 among 385 women aged 21-65 years who live in Jeddah, Saudi Arabia. The data were collected using a four-part online survey: demographic characteristics, cervical cancer screening status, predictors of undergoing cervical cancer screening, and barriers to screening.

RESULTS

Among the 385 women who completed the survey, only around one-third (33.4%) had a Pap smear at some point in their lives. The factors that were found to be significantly associated with the screening status (having a Pap test) in the univariate analysis are increasing age, education level, monthly income, perceived risk of getting cervical cancer, source of information about Pap test, having a family doctor, recommendation by the family doctor to have a Pap test, undergoing a gynecological examination, visiting a gynecologist in the past, history of previous gynecological complaint, and history of abortion. In the multivariable analysis, only four factors were found to be significantly associated with the screening status: age, monthly income, undergoing a gynecological examination in the past, and the recommendation by the family doctor, which by far had the largest effect.

CONCLUSION

Cervical cancer screening rate is relatively low in the city of Jeddah. The recommendation of a Pap test by the family doctor had the largest impact on screening status. These results support the important role of family physicians in promoting screening tests for preventive healthcare. The results also suggest the need for education programs to promote cervical cancer screening among women in Saudi Arabia.

A predictive model of genital warts preventive behaviors among women in the south of Iran: application of health belief model

BACKGROUND

Genital wart (GW) is known as an infectious disease. Besides the infection, it is associated with a higher risk of cervical neoplasia and cancer in the infected population. The present research aimed to explore the predictors of GW preventive behaviors based on the health belief model (HBM).

METHODS

The present analytical and cross-sectional research was conducted in 2019 among 720 women between 15 and 49 years of age in Bandar Abbas in the south of Iran. The sample was selected in a multi-stratified clustering method. The participants responded to a reliable and valid researcher-made questionnaire which explored demographic information, knowledge-related items and the model constructs. A multivariate linear regression analysis was run to determine the predictors of adopting GW preventive behaviors. A path analysis was also run to test the direct and indirect effects of the model constructs on the dependent variable.

RESULTS

The mean and standard deviation of participants' age was 30.43 ± 8.697 years. As Pearson's correlation coefficients showed, knowledge (r = 0.197, p < 0.001), perceived susceptibility (r = 0.434, p < 0.001), severity (r = 0.463, p < 0.001) and self-efficacy (r = 0.434, p < 0.001) were significantly correlated with the adoption of GWs preventive behaviors. Multiple linear regression analysis showed that self-efficacy (B = - 0.010, p < 0.001), perceived susceptibility (B = 0.070, p < 0.001) and severity (B = 0.078, p < 0.001) were the predictors of GW preventive behaviors. Path analysis showed that perceived susceptibility, severity and self-efficacy directly affected healthy behaviors while perceived benefits and barriers indirectly affected the preventive behaviors.

CONCLUSIONS

The present findings help to promote knowledge of the predictors of GW preventive behaviors. HBM can be a useful theoretical framework to evaluate the preventive behavior of the disease and help to reduce the rate of sexually-transmitted infections including GW.

The Effect of Peer-Led Navigation Approach as a Form of Task Shifting in Promoting Cervical Cancer Screening Knowledge, Intention, and Practices Among Urban Women in Tanzania: A Randomized Controlled Trial

BACKGROUND

Even though the government's priorities in preventing cervical cancer are implemented in urban areas, the screening rate remains unsatisfactory at 6%, compared to 70% recommended by the world health organization. The ongoing public health education has not resulted in sufficient screening rates. The study aims to assess peer-led navigation (PLNav) in promoting cervical cancer screening knowledge, intention, and practices among urban women in Tanzania. Since PLNav is the form of task shifting, it involves delegating cervical-cancer-related tasks from healthcare professionals to community health workers (CHWs).

METHODS

It is a community-based randomized controlled trial conducted in Dar es Salaam in Tanzania March-Sept 2020. The PLNav involved the CHWs delivering health education, counselling and navigation assistance to community women (COMW). The CHWs help women who have never undergone cervical cancer screening (CCS) and those who have undergone CCS but with a precancerous cervical lesion to overcome screening barriers. The data related to PLNav were analyzed by descriptive statistics, an independent-samples t-test, repeated measures ANOVA and linear regression.

RESULTS

The repeated measures ANOVA across time showed that PLNav intervention on mean knowledge score changes was statistically significant in the intervention group compared with the control group's usual care, [F (1, 43) = 56.9, P < .001]. At the six-month follow-up, 32 (72.7%) out of 44 participants from the intervention group had screened for cervical cancer, and only one participant (2.3%) from the control group screened. The PLNav intervention on CCS uptake changes was statistically significant in the intervention group compared with usual care in the control group [F (1, 43) = 100.4, P < .001]. The effect of time on CCS uptake in the intervention and control groups was statistically significant [F (1.64, 70.62) = 73.4, P < .001].

CONCLUSION

Peer-led navigation (PLNav) was effective in promoting cervical cancer screening knowledge, intention, and uptake.

Privacy, Self-Esteem, Anxiety in Women Having Pelvic Examination

This study aims to determine the privacy perception, self-esteem and anxiety levels of women undergoing pelvic examination and influencing factors. This web-based cross-sectional study was conducted with 415 women who underwent pelvic examination. The data were collected using a Personal Information Form, the Body Privacy Scale for Gynecology and Obstetrics, the Rosenberg Self-Esteem Scale and the State Anxiety Inventory. It was found that self-esteem (R² = .055, p < .0001) and state anxiety (R² = .037, p: .004) were significantly related to body privacy perceptions. The results of the study showed that making a statement to the women before the examination positively affected their perception of privacy. It is recommended for health professionals to be trained on the importance of privacy and communication during pelvic examination to increase their awareness on the topic.

Cervical cancer screening "see and treat approach": real-life uptake after invitation and associated factors at health facilities in Gondar, Northwest Ethiopia

BACKGROUND

Although cervical cancer is a preventable disease, screening coverage in Ethiopia is far below the target. There is limited evidence on uptake among the general population in Ethiopia. Thus, this study was conducted to assess uptake and associated factors with the cervical cancer screening "see and treat approach" among eligible women in public health facilities in Gondar town, Northwest Ethiopia.

METHOD

A facility-based, cross-sectional study was conducted. The total sample size was 493. A consecutive sampling method was applied. Participants were informed about and invited to cervical cancer screening using visual inspection with acetic acid. Crude and adjusted odds ratios were calculated to determine statistical association with socio-demographic variables. Multivariable logistic regression was used to determine factors of cervical cancer screening uptake.

RESULT

Out of 464 women advised for screening, 76 (16.4, 95% CI [13, 19.8%]) attended the screening. Primary education and above (AOR = 5.3, 95% CI [2.20, 13.0]), knowledge about the disease (AOR = 8.4, 95% CI [3.33, 21.21]), perceived susceptibility (AOR = 6.5, 95% CI [2.72, 15.51]), fewer perceived barriers (AOR = 6.4, 95% CI [2.30, 17.80]), cues to action (AOR = 4.6, 95% CI [1.86, 11.32]), perceived self-efficacy (AOR = 5, 95% CI [2.14, 11.73]), and previous recommendation for screening (AOR = 2.7, 95% CI [1.15, 6.51]) were significantly associated with screening uptake.

CONCLUSION

The actual uptake of screening offered in this study was high relative to only 3% national screening coverage. There is a need to implement active invitation for screening with special focus on less-educated women. Repeated invitation may facilitate future screening uptake.

Factors associated with the intention to undergo Pap smear testing in the rural areas of Indonesia: a health belief model

Purposes

This study aimed to understand the influence of health beliefs, demographic factors, and health characteristics on the intention to undergo Pap smear testing among women in rural areas of Indonesia.

Methods

A descriptive cross-sectional study was conducted and 687 married women participated in the study. A convenience sampling was applied to recruit the participants from community health centres in a rural region in Indonesia. Self-reported data using the Health Beliefs Model Scale for Cervical Cancer and Pap Smear Test was collected to assess the health beliefs. Independent t-tests, simple logistic regressions, and a hierarchical logistic regression with 3 steps were run. Statistical significance for analysis was set at p < 0.05.

Results

The mean age of the participants was 42 years (SD = 8.4). Among the participants, 81% of the women had never undergone a Pap smear test, and 61% (n = 422) of the women reported a high intention of receiving a Pap smear test. Income and education Health beliefs regarding Pap smear testing were different between women who had low and high intentions to undergo Pap smear testing. Health beliefs, such as perceived benefits, severity, barriers to Pap smear testing, and health motivation for a Pap smear test were associated with the intention to undergo Pap smear testing among rural Indonesian women. Overall, the hierarchical multiple regression with 3 steps containing demographic, health characteristics, and health belief variables accounted for 31% variance of the intention to undergo Pap smear test among the Indonesian rural women.

Conclusions

Low screening rates of cervical cancer and high intentions to do the screening exist among rural Indonesian women. Health beliefs significantly affect the rural women’s intention of Pap smear testing in Indonesia.

Cervical cancer is a leading cancer among women and a significant cause of mortality for females around the world, including Indonesia. Globally, the screening rate for cervical cancer among women in rural areas remains low. In Indonesia, the incidence and the mortality from cervical cancer remain high compared to other female cancers. The Indonesian government has offered a free Pap smear screening to women since 2014, but the screening rate is still low, around 28%.

A total of 687 married women were included in the study. Approximately 80% of Indonesian women living in rural areas have never undergone a Pap smear test, and 60% of women reported a high intention of receiving a Pap smear test. Education, income, previous experience of Pap smear testing, a friend with a history of cervical cancer, perceived severity, perceived benefits, perceived barriers, and health motivations were significantly associated with the intention of Pap smear testing. Low screening rates of cervical cancer and high intentions toward the cervical cancer screening exist among rural Indonesian women. Health beliefs significantly affect the women’s intention of Pap smear testing.

Understanding the Health Behavior Decision-Making Process with Situational Theory of Problem Solving in Online Health Communities: The Effects of Health Beliefs, Message Credibility, and Communication Behaviors on Health Behavioral Intention

Online health communities (OHCs) offer users the opportunity to share and seek health information through these platforms, which in turn influence users' health decisions. Understanding what factors influence people's health decision-making process is essential for not only the design of the OHC, but also for commercial health business who are promoting their products to patients. Previous studies explored the health decision-making process from many factors, but lacked a comprehensive model with a theoretical model. The aim of this paper is to propose a research model from the situational theory of problem solving in relation to forecasting health behaviors in OHCs. An online questionnaire was developed to collect data from 321 members of online health communities (HPV Tieba and HPV vaccina Tieba) who have not received an HPV vaccination. The partial least squares structural equation modeling (PLS-SEM) method was employed for the data analysis. Findings showed that information selection and acquisition is able to forecast HPV vaccination intentions, perceived seriousness and perceived susceptibility can directly impact HPV vaccination intention and have an indirect impact by information selection and acquisition, and perceived message credibility indirectly affected HPV vaccination intention via information selection. The current paper supports health motivations analysis in OHCs, with potential to assist users' health-related decision-making.

A Social Marketing Intervention to Improve Treatment Adherence in Patients with Type 1 Diabetes

This research explores if a social marketing intervention model based on social representations theory and the health belief model can generate changes regarding treatment adherence and improve patient self-efficacy. As a pilot, a test-retest field quasi-experiment was designed to evaluate the intervention model with type 1 diabetes (T1DM) patients of families with 8- to 17-year-old children. The intervention model was designed to clarify misconceptions, increase awareness of the benefits of following doctors' treatments and improve patients' self-efficacy. In-depth interviews were carried out to gain a richer understanding of the intervention's effect. The pilot intervention generated a favourable change in shared misconceptions, individual health beliefs, glycaemic control and declared treatment adherence. This paper contributes to the social marketing literature and public health by providing early support for the theoretical assumptions regarding the role of shared misconceptions in physiological and behavioural outcomes for patients with T1DM. Contrary to previous studies, instead of only focusing on individual beliefs, this study incorporates shared beliefs between patients and caregivers, generating more comprehensive behavioural change.

The Effectiveness of Educational Interventions on Breast Cancer Screening Uptake, Knowledge, and Beliefs among Women: A Systematic Review

There have been various systematic reviews on the significance of educational interventions as necessary components to encourage breast cancer screening (BCS) and reduce the burden of breast cancer (BC). However, only a few studies have attempted to examine these educational interventions comprehensively. This review paper aimed to systematically evaluate the effectiveness of various educational interventions in improving BCS uptake, knowledge, and beliefs among women in different parts of the world. Following the PRISMA guidelines, a comprehensive literature search on four electronic databases, specifically PubMed, Scopus, Web of Science, and ScienceDirect, was performed in May 2019. A total of 22 interventional studies were reviewed. Theory- and language-based multiple intervention strategies, which were mainly performed in community and healthcare settings, were the commonly shared characteristics of the educational interventions. Most of these studies on the effectiveness of interventions showed favorable outcomes in terms of the BCS uptake, knowledge, and beliefs among women. Educational interventions potentially increase BCS among women. The interpretation of the reported findings should be treated with caution due to the heterogeneity of the studies in terms of the characteristics of the participants, research designs, intervention strategies, and outcome measures.

Health beliefs and practices regarding cervical cancer screening among women in Nepal: A descriptive cross-sectional study

The health beliefs and practices regarding cervical cancer screening among women in the mountainous and Terai region of Nepal were investigated and examined for the differences. A descriptive cross-sectional study was conducted with a purposive sample of 216 in mountainous and 294 in Terai. The interview tools were a socio-demographic scale, a Nepalese Health Belief Model Scale for Cervical Cancer followed by the Screening Test. Chi-square test, binary logistic regression, Mann-Whitney U, and Kruskal-Wallis were used to analyze the data. The results showed that the screening rate was low for both regions with a significant difference in the benefit of screening and health motivation. Being older and having a positive family history of cervical cancer were shown to be predictors screening practice. Women from both groups preferred female doctors for screening. Culturally appropriate educational interventions focused on the benefits and obstacles of screening is needed to improve the beliefs of cervical cancer and screening and increase the screening rate. Nurses need to be aware of health beliefs regarding cervical cancer during cervical screening and education.

Epidemiology of cancer in Saudi Arabia thru 2010-2019: a systematic review with constrained meta-analysis

Background

Cancer is emerging as a major global health-care system challenge with a growing burden worldwide. Due to the inconsistent cancer registry system in Saudi Arabia, the epidemiology of cancer is still dispersed in the country. Consequently, this review aimed to assemble the epidemiological metrics of cancer in Saudi Arabia in light of the available published data during the period from (2010–2019).

Methods

Published literature from Saudi Arabia relating to cancer incidence, prevalence, risk factors, and other epidemiological metrics were accessed through electronic search in Medline/PubMed, Cochrane, Scopus, Web of Knowledge, Google Scholar, and public database that meet the inclusion criteria. Relevant keywords were used during the electronic search about different types of cancers in Saudi Arabia. No filters were used during the electronic searches. Data were pooled and odds ratios (ORs) and 95% confidence interval (95%CI) were calculated. A random-effects meta-analysis was performed to assess the well-determined risk factors associated with different types of cancers.

Results

The most common cancers in Saudi Arabia are breast, colorectal, prostate, brain, lymphoma, kidney and thyroid outnumbering respectively. Their prevalence rates and OR (95%CI) as follow: breast cancer 53% and 0.93 (0.84–1.00); colon-rectal cancer (CRC) 50.9% and 1.2 (0.81–1.77); prostate cancer 42.6% and 3.2 (0.88–31.11); brain/Central Nervous System cancer 9.6% and 2.3 (0.01–4.2); Hodgkin and non-Hodgkin's lymphoma 9.2% and 3.02 (1.48–6.17); kidney cancer 4.6% and 2.05 (1.61–2.61), and thyroid cancer 12.9% and 6.77 (2.34–19.53).

Conclusion

Within the diverse cancers reported from Saudi Arabia, the epidemiology of some cancers magnitude 3-fold in the latest years. This increase might be attributed to the changing in the Saudi population lifestyle (adopting western model), lack of cancer awareness, lack of screening & early detection programs, social barriers toward cancer investigations. Obesity, genetics, sedentary lifestyle, tobacco use, viral infection, and iodine & Vit-D deficiency represent the apparent cancer risk factors in Saudi Arabia.

Human papillomavirus and its vaccination: Knowledge and attitudes among female university students in Saudi Arabia

Context:

College students worldwide have low levels of knowledge on human papillomavirus (HPV)-related diseases, highlighting the lack of awareness about HPV infection. To date, no study has examined the level of knowledge of cervical cancer and the HPV vaccine in the northern region of Saudi Arabia.

Aim:

This study aimed to assess the level of knowledge of cervical cancer and its risk factors, as well as HPV vaccine acceptance among female students in Saudi Arabia enrolled in health colleges.

Methods:

A descriptive cross-sectional survey was conducted using a valid and reliable self-administered questionnaire. The questionnaire was completed by 966 female students enrolled at the University of Hail, northern region of Saudi Arabia, with a response rate of 83.5%. The main outcome measure was the identification of the knowledge gap pertaining to HPV infection and its prophylactic vaccine.

Results:

The findings highlighted a lack of knowledge about cervical cancer, Pap smears, and HPV vaccine among most female university students. The knowledge score positively correlated to the duration of education. Students enrolled in applied medical science and medical colleges showed significantly higher knowledge scores, as did students in their senior academic years. Vaccine uptake barriers included concerns about its side effects and a lack of information.

Conclusions:

Our findings can be used to formulate effective future awareness programs in the northern region of Saudi Arabia. A larger number of educational programs are required to enlighten Saudi women about cervical cancer and its prophylactic vaccine, including the benefits of screening programs and prevention strategies.

The yield of pap smears and its characteristics in a community based setting in Saudi Arabia

OBJECTIVES

To assess the yield of Papanicolaou tests (pap smears), including the characteristics of abnormal pap smears. Methods: In this record-based cross-sectional study, we reviewed pap smears of patients seen at the Family Medicine clinics, King Faisal Specialist Hospital and Research Center from January 2002 to January 2017. All women between the ages of 21 and 65 were included. Study-specific case report form was developed to capture patient demographics, pap smear histopathology (Bethesda III System), human papilloma virus polymerase chain reaction (HPV PCR), and the parity status. Results: A total of 3346 patients were included; 2.2% had abnormal pap smear. Most frequent abnormalities were atypical squamous cells of undetermined significance (2%), followed by glandular cell abnormalities (0.8%). Human papilloma virus infection was detected in 6.5% and all other infections were identified in 9.2% of all screened Pap smears. Conclusion: Pap smears remain an effective tool for cervical cancer screening. Low yields of pap smears compared to other developed countries could be attributed to lower risk factors for cervical cancer in Saudi Arabia. Routine screening especially among high risk women is strongly recommended.

Adaptation and validation of the Arabic version of self-efficacy scale for mammography. A report on psychometric properties

Objectives:

To culturally adapt and validate a mammography-specific self-efficacy (MSSE) scale into Arabic for the Saudi Arabian context.

Methods:

A methodological study aimed at tool translation and adaptation conducted in primary healthcare centers in As Madinah, Saudi Arabia between March 2016 and May 2016. The MSSE scale was translated and adapted into Arabic using standard procedures. Content and face validity were investigated. Confirmatory factor analysis and reliability analysis were used to determine the scale’s psychometric properties.

Results:

The scale showed a good internal consistency (Cronbach’s alpha=0.88). The confirmatory factor analysis supported the scale’s single-factor structure and the goodness-of-fit indices confirmed the model’s good fit (comparative fit index=0.961, Tucker-Lewis index=0.943, root-mean-square error of approximation=0.076, and standardized root-mean-square residual=0.045). Women who had a mammogram in the last 2 years scored significantly higher on the scale (39±6.2) than women who had never received a mammogram (35.88±7.2; p=0.009).

Conclusion:

The study confirmed that the scale’s Arabic version has good psychometric properties, using reliability analysis, confirmatory factor analysis, and extreme groups validation. The scale is likely to be useful for evaluating interventional studies aimed at improving mammography screening participation rates.

The effect of web-based education on Pap smear behaviours of teachers

OBJECTIVE

Web-based education would be useful for gaining health-related behaviours. The aim of the study was to determine the effect of web-based education on Pap smear behaviours of teachers.

METHODS

The study was an experimental-control groups with a longitudinal type. The sample consisted of 1,290 teachers (experimental: 678, control: 612). The educational videos about cervical cancer and Pap smear test were sent to the experimental group via the web. Three months later, the teachers in both groups were contacted by telephone and asked whether they have a Pap smear test or not, reasons for not having it and test results. A qualitative interview was conducted with 20 teachers in the experimental group to evaluate the web-based education.

RESULTS

At the beginning of the study, 25.9% of the teachers in both groups had a Pap smear test. After three months, having a Pap smear test was found to be statistically significantly higher in the experimental group (31.6%) than the control group (23.2%). According to the result of pathology, in the control group cervical cancer (n = 1), in the experimental group CIN1 (n = 1) and HPV53 (n = 1) were diagnosed.

CONCLUSION

The web-based education was found to be effective in Pap smear behaviours of teachers.

Cervical cancer screening service utilization and associated factors among age-eligible women in Jimma town using health belief model, South West Ethiopia

BACKGROUND

Cervical cancer is the second most common gynecologic cancer affecting the lives of women. It causes hundreds of thousands of death among women annually worldwide. When a woman is screened for cervical cancer at least once in her life between the ages of 30 and 40, the risk of getting cervical cancer can be decreased by 25-36%. Despite this advantage, the coverage of cervical cancer screening is limited in low and middle-income countries including Ethiopia.

OBJECTIVE

To assess cervical cancer screening service utilization and associated factors among age-eligible women in Jimma town, South West Ethiopia, 2017.

METHODS

Community based cross-sectional study was used. Seven hundred thirty-seven women were selected using systematic random sampling. Data were collected using a structured interview administered questionnaire. Data were collected on socio-demographic, reproductive factors, knowledge of cervical cancer as well as constructs of Health belief model and practice related variables. Logistic regression analysis was performed, and variables with a p-value of less than 0.05 in the multivariable analysis were taken as statistically significant predictors of cervical cancer screening service utilization.

RESULTS

Of the 737 women, only 15.5% were screened for cervical cancer. The independent predictors of cervical cancer screening utilization were: being government employee [AOR = 3.00, 95% CI: 1.49-6.01], knowing someone who has ever screened [AOR = 3.61, 95% CI: 2.07-6.29], having history of gynecologic examination for any reason (having previous examination that expose women genitalia for physician like examination during child birth, abortion procedure and examination for STI) [AOR =2.84, 95% CI: 1.48-5.45], not preferring gender of physician for gynecological examination [AOR = 3.57, 95% CI: 1.98-6.45], getting advice from health care providers [AOR = 4.45, 95% CI: 2.57-7.70], having good knowledge of cervical cancer screening [AOR = 3.46, 95% CI: 1.47-8.21] and having perceived susceptible for cervical cancer [AOR = 3.03, 95% CI: 1.64-5.56].

CONCLUSIONS

The utilization of cervical cancer screening services was low in Jimma town. Strengthening the screening service is important through raising the awareness of the community towards cervical cancer and screening services.

Knowledge, attitudes and practices of young people in Zimbabwe on cervical cancer and HPV, current screening methods and vaccination

BACKGROUND

The rise in cervical cancer trends in the past two decades has coincided with the human immunodeficiency virus (HIV) epidemic especially in the sub-Saharan African region. Young people (15 to 24 years old) are associated with many risk factors such as multiple sexual partners, early sexual debut, and high HIV incidences, which increase the chances of developing cervical cancer. The National Cancer Prevention and Control Strategy for Zimbabwe (2014-2018) highlights that no cancer communication strategy focusing on risk factors as primary cancer prevention. Therefore, the study aims to determine the knowledge, attitude and practices of young people in Zimbabwe on cervical cancer, screening, human papillomavirus (HPV) and vaccination.

METHODS

A cross-sectional survey assessing young people's knowledge, attitude and practices concerning cervical cancer was conducted in five provinces in Zimbabwe. A total of 751 young people were recruited through a three-stage cluster design from high schools and universities. Knowledge, attitudes and practices were assessed using questions based and adapted from the concepts of the Health Belief Model (HBM) and the Cervical Cancer Measuring tool kit-United Kingdom (UK).

RESULTS

Most young people, 87.47% (656/750) claimed to know what the disease called cervical cancer is, with a mean score of 89.98% [95% CI 73.71.11-96.64] between high school and 86.72% [95% CI 83.48-89.40] among university students. There was no significant difference in mean scores between high school and university students (p = 0.676). A risk factor knowledge proficiency score of ≥13 out of 26 was achieved in only 13% of the high school respondents and 14% of the university respondents with a broad range of misconceptions about cervical cancer risk factors in both females and males. There was not much difference on comprehensive knowledge of cervical cancer and its risk factors between female and male students, with the difference in knowledge scores among high school (p = 0.900) and university (p = 0.324) students not statistically significant. In contrast, 43% of respondents heard of cervical cancer screening and prevention, and 47% knew about HPV transmission and prevention. Parents' educational level, province and smoking, were some of the factors associated with knowledge of and attitude towards cervical among high school and university students.

CONCLUSION

This study revealed that young people in Zimbabwe have an idea about cervical cancer and the seriousness thereof, but they lack adequate knowledge of risk factors. Cervical cancer education and awareness emphasising causes, risk factors and care-seeking behaviours should be commissioned and strengthen at the community, provincial and national level. Developing a standard cervical cancer primary prevention tool that can be integrated into schools can be a step towards addressing health inequity.

Group Versus Individual Culturally Tailored and Theory-Based Education to Promote Cervical Cancer Screening Among the Underserved Hispanics: A Cluster Randomized Trial

Purpose:

To determine whether group education is as effective as individual education in improving cervical cancer screening uptake along the US–Mexico border.

Design:

Cluster randomized controlled study.

Setting:

El Paso and Hudspeth Counties, Texas.

Participants:

Three hundred women aged 21 to 65 years, uninsured, due for a Pap test, no prior history of cervical cancer or hysterectomy.

Intervention:

Theory-based, culturally appropriate program comprised of outreach, educational session, navigation services, and no-cost cervical cancer testing.

Measures:

Baseline, immediate postintervention, and 4-month follow-up surveys measured knowledge and theoretical constructs from the Health Belief Model, Theory of Reasoned Action, and the Social Cognitive Theory.

Analysis:

Relative risk regression analyses to assess the effects of educational delivery mode on the uptake of screening. Mixed effect models to analyze changes in psychosocial variables.

Results:

One hundred and fifty women assigned to each educational group; 99% Hispanic. Of all, 85.7% completed the follow-up survey. Differences in screening rate at follow-up were analyzed by education type. Overall screening rate at follow-up was 73.2%, no significant difference by education type (individual: 77.6%, group: 68.9% P = .124). Significant increases among group education at follow-up for knowledge, perceived susceptibility, perceived seriousness, and subjective norms and significant decrease for perceived benefits.

Conclusion:

This study provides evidence to support the effectiveness of group education to promote cervical cancer screening among vulnerable Hispanic women and offers an additional method to address cervical cancer disparities.