A comparison of behavioural models explaining cervical cancer screening uptake

Area of Science:

• Public Health
• Health Behavior Theory
• Cancer Prevention

Background:

• Cervical cancer screening (CCS) is crucial for prevention, particularly in low- and middle-income countries.
• Psycho-social factors, often modifiable, significantly influence CCS uptake and are explained by behavioral models.
• This study compares the predictive power of three health behavior theories on CCS intention and behavior.

Purpose of the Study:

• To assess and compare the predictors of cervical cancer screening (CCS) intention and behavior.
• To evaluate the explanatory capacity of the Health Belief Model (HBM), Theory of Planned Behaviour (TPB), and Theory of Care-Seeking Behaviour (TCSB) for CCS.

Main Methods:

• A survey was conducted among 607 sexually active women in Karnataka, South India.
• Data collected included socio-demographics, health literacy, CCS knowledge, and constructs from HBM, TPB, and TCSB.
• Logistic regression analyses were used to compare the variance explained by each model for CCS intention and behavior.

Main Results:

• The Theory of Planned Behaviour (TPB) best explained CCS intention, followed by the Health Belief Model (HBM).
• Positive attitude towards screening and perceived benefits were the strongest predictors of screening intention.
• Fear, anxiety, embarrassment, and context-specific barriers also significantly influenced screening intention.

Conclusions:

• Health behavior models like TPB and HBM identify key socio-cognitive factors influencing women's intention for CCS.
• These models can inform targeted interventions to enhance CCS uptake by addressing attitudes, perceived benefits, emotions, and barriers.
• Interventions should focus on improving screening attitudes, highlighting benefits, managing emotions, and reducing practical barriers to screening.