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Knowledge, attitude, practice, and self-efficacy in pap smear adherence intent: a cross-sectional study
Leila Ahadi1, Fatemeh Zarei2, Anoshirvan Kazemnejad3
1Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran Jalal AleAhmad Nasr, P.O. Box: 14115-111, Tehran, Iran.
Scientific Reports
|July 18, 2026
Summary
Self-efficacy and prior practice significantly boost Pap smear testing (PST) adherence among Iranian women. Health programs should focus on building confidence and addressing socioeconomic barriers for better cervical cancer prevention.
Area of Science:
- Public Health
- Gynecologic Oncology
- Health Behavior Research
Background:
- Cervical cancer screening is crucial for early detection and prevention.
- Knowledge, Attitude, Practice, and Self-efficacy (KAPSE) are known determinants of health behaviors.
- Limited evidence exists on the combined impact of KAPSE on Pap smear testing (PST) adherence.
Purpose of the Study:
- To investigate the combined influence of KAPSE on PST adherence intent in women aged 30-59.
- To identify key demographic and KAPSE factors predicting PST adherence.
Main Methods:
- Cross-sectional study involving 985 women in Saveh, Iran, using two-stage sampling.
- Validated questionnaires assessed KAPSE and PST adherence intent.
- Statistical analyses included Mann-Whitney U, Kruskal-Wallis, Spearman correlation, and linear regression.
Main Results:
- Self-efficacy showed the strongest positive correlation with PST adherence (r=0.597, p<0.001).
- A composite KAPSE score significantly predicted adherence; a one-unit increase in KAPSE correlated with a 7.2-unit increase in PST adherence (B=7.20, p<0.001).
- Education level and prior screening history were the strongest demographic predictors (p<0.001).
Conclusions:
- Self-efficacy and prior practice are critical drivers of cervical cancer screening adherence.
- Health promotion should enhance women's confidence and address socioeconomic barriers.
- Culturally tailored interventions strengthening KAPSE synergy can improve cervical cancer prevention in Iran.
