Predictors of Iranian women's intention to first papanicolaou test practice: An application of protection motivation theory

Protection motivation theory in predicting cervical cancer screening participation: A longitudinal study in rural Chinese women

OBJECTIVE

To examine factors longitudinally associated with cervical cancer screening uptake among rural Chinese women, guided by protection motivation theory (PMT).

METHODS

A large sample of women (n = 2408, aged 35-65 years old) was randomly selected from a rural county in China in 2015 and followed up for 2 years. Data for demographic factors, knowledge of cervical cancer screening, screening outcome, and six PMT constructs measured at the baseline in 2015 were used to predict cervical cancer screening participation at the follow-up in 2017 using structural equation model method.

RESULTS

Among the 2408 women at the baseline, 1879 (78.03%) participated in the screening services at the follow-up. In addition to significant direct effect of age, social status and baseline screening outcome, and three (perceived severity, fear arousal and response efficacy) of the six PMT subconstructs, four variables (age, social status, knowledge of cervical cancer screening, and baseline screening outcome) at the baseline were indirectly associated with screening participation, mediated by the three significant PMT subconstructs.

CONCLUSIONS

Findings of this study indicate that the rate of participating in cervical cancer screening for rural women needs to be further improved. In addition to the commonly reported influential factors, PMT subconstructs play important roles in encouraging rural women in China to participate in cervical cancer screening. These longitudinal findings provided data much needed for future research to develop evidence-based intervention programs to enhance cervical cancer screening among rural women in China.

Factors Affecting Breast Self-examination Behavior Among Female Healthcare Workers in Iran: The Role of Social Support Theory

OBJECTIVES

In women, breast cancer is the most common cancer and the leading cause of cancer death. Screening tests are the basis for early diagnosis. In Iranian women, the mortality rate of breast cancer is high due to insufficient screening examinations and delayed visits for care. Therefore, this study aimed to determine the factors affecting breast self-examinations among Iranian women employed in medical careers.

METHODS

This cross-sectional study included 501 women working in the medical professions at Hamadan University of Medical Sciences in western Iran in 2018. The subjects were selected by stratified random sampling. Data were collected using a researcher-developed, self-report questionnaire that contained demographic information and questions based on protection motivation theory and social support theory. Descriptive data analysis was conducted using SPSS version 23 and model fitting with PLS version 2.

RESULTS

The mean age of the participants was 37.1±8.3 years, and most of the women (80.4%) were married. Most women had a bachelor's degree (67.5%). The findings of this study showed that the coping appraisal construct was a predictor of protection motivation (β=0.380, p<0.05), and protection motivation (β=0.604, p<0.05) was a predictor of breast self-examination behavior. Additionally, social support theory (β=0.202, p<0.05) had a significant positive effect on breast self-examination behavior.

CONCLUSIONS

The frequency of practicing self-examinations among women employees in the medical sector was low; considering the influence of social support as a factor promoting screening, it is necessary to pay attention to influential people in women's lives when designing educational interventions.

An Application of the Protection Motivation Theory to Predict Breast Self-Examination Behavior among Female Healthcare Workers

OBJECTIVE

Breast cancer is the most prevalent cancer among women and has the highest mortality rate among the women around the world. Early diagnosis of this cancer increases the survival of the patients. The aim of this study was to determine the predictor factors for breast self-examination (BSE) based on the Protection Motivation Theory (PMT) among female healthcare workers in Hamadan University of Medical Sciences.

MATERIALS AND METHODS

This analytical-descriptive study was conducted on 501 employed women in age range of 20-61 years old in Hamadan University of Medical Sciences in west of Iran during 2018. Participants in the study were random stratified sampling selected. Data collection tools were demographic information and the constructs of PMT. The data were analyzed by descriptive statistics and the logistic regression tests.

RESULTS

The results showed that only 9% of participants performed BSE regularly and monthly. The most important reason for lack of BSE was its triviality. Linear regression analysis showed that the structure of perceived threat appraisal is the predictor of the intention to perform BSE (R2=0.027). Moreover, the logistic regression analysis showed that the protection motivation construct was a strong predictor for BSE (R2=0.25).

CONCLUSION

The frequency of practice of BSE in female healthcare workers is low. Therefore, it is imperative to periodically emphasize the importance of early breast cancer diagnosis for them and the design of educational programs based on the PMT can increase the regular of BSE behavior.

Cognitive predictors of cervical cancer screening's stages of change among sample of Iranian women health volunteers: A path analysis

Introduction

The uptake of Pap smear among Iranian women is low, resulting in a high rate of casualties from cervical cancer in Iran. The present study used the Health Belief Model (HBM) and the Stages of Change theory as theoretical frameworks for understanding the predictors of the behaviour of Iranian Women Health Volunteers (WHVs) with respect to cervical cancer screening.

Methods

Data from the 1,253 WHVs were analyzed using path analysis to assess the effects of cognitive factors (including knowledge, perceived susceptibility to cervical cancer, perceived severity of cervical cancer, Pap smear benefits, Pap smear barriers, and Pap smear self-efficacy) on the stages of change for Pap-smear behaviour.

Results

The majority of the respondents (71.5%) reported that they had not taken previous Pap smear tests; only 3% had received a regular Pap test. The perceived benefits to cervical cancer screening, the perceived barriers to cervical cancer screening, and the perceived self-efficacy to perform cervical cancer screening emerged as the predictors of cervical cancer screening’s stages of change; perceived threat to cervical cancer, however, did not.

Discussion

Uptake of regular cervical screening for Iranian WHVs was very low. Different interventions, such as media campaigns and educational interventions could provide an opportunity to improve women's knowledge on cervical cancer and Pap test benefits, address any misconceptions or fears about the procedure of the Pap test, and finally increase the cervical screening uptake by Iranian women.