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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 practice significantly drive Pap smear test (PST) adherence among Iranian women. Health programs should enhance confidence and address socioeconomic factors to improve cervical cancer screening.
Area of Science:
- Oncology
- Public Health
- Behavioral Science
Background:
- Cervical cancer screening adherence is crucial for early detection and prevention.
- Limited evidence exists on the combined impact of knowledge, attitude, practice, and self-efficacy (KAPSE) on Pap smear testing (PST) adherence.
- Understanding these determinants is vital for effective health promotion strategies.
Purpose of the Study:
- To investigate the combined influence of KAPSE on PST adherence intent in women aged 30-59 in Saveh, Iran.
- To identify key demographic and psychosocial factors associated with screening adherence.
- To inform the development of targeted interventions for cervical cancer prevention.
Main Methods:
- Cross-sectional study involving 985 women 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 was associated with a 7.2-unit increase in 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 programs should focus on building women's confidence and addressing socioeconomic barriers.
- Culturally tailored interventions strengthening KAPSE synergy can improve cervical cancer prevention outcomes in Iran.
