Health belief model and practice of breast self-examination and breast cancer screening in Iranian women

Objective

The objective of this study is to determine the role of different health belief model components in practice of breast cancer screening among Iranian women.

Subjects and methods

A cross-sectional study of 500 women aged 18–65 years was conducted in an urban population under the coverage of a health therapeutic system in Babol, northern Iran in 2012. Demographic data and data regarding practice of breast self-examination (BSE), breast clinical examination (BCE), and mammography were collected by interview, and a standard health belief model questionnaire was used to assess women’s attitudes in six different domains based on a Likert scale that ranked from 1 to 5. The average score of each item for each domain was calculated. The Wilcoxon rank test and a multiple logistic regression model were used to estimate the odds ratio of each domain for performing breast cancer screening (BSE, BCE, and mammography).

Results

The mean age of the women was 31.2 (9.4) years. Overall, the average scores in domains of perceived benefit, self-efficacy, and health motivation were significantly higher among those who performed BSE and BCE, but not for mammography. For the domains of perception of susceptibility, seriousness, and barriers, no significant differences were observed. Higher scores on the scales of perceived benefits, perceived confidence/self-efficacy, and health motivation showed significant positive association with performing BSE [adjusted OR (95 % confidence interval [CI]) 1.73 (1.11, 2.72), 4.01 (2.39, 6.73), and 2.01 (1.30, 3.08), respectively] and BCE [adjusted OR (95 % CI) 1.65 (1.0, 2.95), 2.33 (1.39, 3.91), and 1.58 (1.0, 2.53), respectively], but not for performing mammography. For perceived susceptibility, perceived seriousness, and barriers, no significant association was observed.

Conclusions

Positive attitudes toward perceived benefits, perceived confidence/self-efficacy, and health motivation have a strong association with performing BSE and BCE. The impact of health belief model subscales on breast cancer screening may vary with respect to culture and values.     

Psychosocial Predictors of Breast Self-Examination among Female Students in Malaysia: A Study to Assess the Roles of Body Image,Self-efficacy and Perceived Barriers

Background: Early detection is a critical part of reducing the burden of breast cancer and breast selfexamination (BSE) has been found to be an especially important early detection strategy in low and middle income countries such as Malaysia. Although reports indicate that Malaysian women report an increase in BSE activity in recent years, additional research is needed to explore factors that may help to increase this behavior among Southeastern Asian women. Objective: This study is the first of its kind to explore how the predicting variables of self-efficacy, perceived barriers, and body image factors correlate with self-reports of past BSE, and intention to conduct future breast self-exams among female students in Malaysia. Materials and Methods: Through the analysis of data collected from a prior study of female students from nine Malaysian universities (n=842), this study found that self-efficacy, perceived barriers and specific body image sub-constructs (MBSRQ-Appearance Scales) were correlated with, and at times predicted, both the likelihood of past BSE and the intention to conduct breast self-exams in the future. Results: Self-efficacy (SE) positively predicted the likelihood of past self-exam behavior, and intention to conduct future breast self-exams. Perceived barriers (BR) negatively predicted past behavior and future intention of breast self-exams. The body image sub-constructs of appearance evaluation (AE) and overweight preoccupation (OWP) predicted the likelihood of past behavior but did not predict intention for future behavior. Appearance orientation (AO) had a somewhat opposite effect: AO did not correlate with or predict past behavior but did correlate with intention to conduct breast self-exams in the future. The body image sub-constructs of body area satisfaction (BASS) and self-classified weight (SCW) showed no correlation with the subjects' past breast self-exam behavior nor with their intention to conduct breast self-exams in the future. Conclusions: Findings from this study indicate that both self-efficacy and perceived barriers to BSE are significant psychosocial factors that influence BSE behavior. These results suggest that health promotion interventions that help enhance self-efficacy and reduce perceived barriers have the potential to increase the intentions of Malaysian women to perform breast self-exams, which can promote early detection of breast cancers. Future research should evaluate targeted communication interventions for addressing self-efficacy and perceived barriers to breast self-exams with at-risk Malaysian women. and further explore the relationship between BSE and body image.     

The Relationship Between Women's Health Beliefs and Their Participation in Screening Mammography.

Breast cancer is the most common type of cancer in women. Early diagnosis of this disease can reduce mortality significantly and will promote women's quality of life. Changes in the women's beliefs and attitudes are necessary to encourage them to undergo screening mammography. To make this change happen, understanding their health beliefs is important. This attempt is to determine the relationship between women's health belief of city of Kerman with their participation in mammography on the basis of health belief model in the year 2005-2006. This study was an experimental-control one in which the main independent variable was health blief including different dimensions such as perceived sensitivity, perceived intensity, perceived barriers, perceived benefits, "cues to actions" and self-efficacy. Participation in the mammography was taken as the dependent variable. Two samples consisting of 148 women who had and 148 women who had not underwent mammography were selected. Data were collected through questionnaires and were analyzed by SPSS=12 software. The result of this study showed that women's health belief in some dimensions of health belief model such as perceived benefits of mammography use, the presence of cues to action in mammography use is associated with having mammography. Moreover the total score of mammography group was more than the score of the group without the mammography. When the two groups were compared in terms of demographic data, experimental group showed significant statistical differences with regard to age, benign breast mass and family history of breast cancer. (P, 0001)Understanding the benefits and advantages of mammography and cues to action will increase women's adherence toward doing it. It is of great importance to better realize breast cancer screening behaviors and factors influencing it. It is also necessary to recognize the factors affecting health professionals' and particularly nurses' use of mammography.     

Validity and Reliability of Health Belief Model Questionnaire for Promoting Breast Self-examination and Screening Mammogram for Early Cancer Detection

Background: Early detection of breast cancer is essential in improving overall women’s health. The researchers sought to develop a comprehensive measure that combined the basic components of the health belief model (HBM) with a focus on breast self-examination (BSE) and screening mammogram amongst women.Methods: Questionnaire items were developed following a review of relevant literature of HBM on BSE and screening mammogram. The sampling frame for the study was Malaysian women aged 35 to 70 years old, living in Kuantan, Pahang and able to read or write in Bahasa Malaysia or English. As such, 103 women were randomly selected to participate in the study. Tests of validity using exploratory factor analysis (EFA) and reliability were subsequently performed to determine the psychometric properties of the questionnaire. Results: The EFA revealed nine factors (self-efficacy of mammogram, perceived barriers of BSE and mammogram, perceived susceptibility of breast cancer, perceived severity of breast cancer, cues to action for mammogram screening, perceived benefits of BSE, health motivation, perceived benefits of mammogram and self-efficacy of BSE) containing 54 items that jointly accounted for 74.2% of the observed variance. All nine factors have good internal consistency with Cronbach’s alpha ≥ 0.8. Fifty-four items remained in the final questionnaire after deleting 13 problematic items. The scale also showed good convergent and discriminant validity.Conclusion: The findings showed that the designed questionnaire was a valid and reliable instrument for the study involving women in Kuantan, Pahang. The instrument can help to assess women’s beliefs on BSE adoption and mammogram screening in health care practice and research.     

Effects of Education Based on the Health Belief Model on Screening Behavior in High Risk Women for Breast Cancer,Tehran, Iran

Background: Breast cancer is the most common malignancy in women. Early diagnosis allows efficienttreatment and increases survival, but the efficacy of breast self examination (BSE) is not sufficiently wellestablished. The American Cancer Society aims to give women the opportunity to recognize the utility,limitations and adverse effects of breast cancer screening through education models based on psychologicaltheories. With the Health Belief Model, people’s health perceptions and attitudes influence their practices, forexample with screening. Objective: The purpose of this randomized controlled clinical trial was to determine theeffect of education based on this model on breast cancer screening in high risk Iranian women. Materials andMethods: Participants were women with a family history of breast cancer (mother, sister, and daughter). Afterexplanation of the study objectives to participants, they were recruited on obtaining oral consent and each filledout the study questionnaire based on the Health Belief Model. Allocation was into two groups by computerizedrandomization, control and intervention, receiving education on breast cancer screening. Perceived susceptibilityto and seriousness of breast cancer, perceived usefulness of and barriers to BSE, clinical breast examination,and mammography, and self-efficacy in the ability to perform these, were assessed, with comparison of scoresfor BSE practice before and after education and doing mammography and clinical examination by a physicianin intervention and control group. Results: The mean age was 37.8±11.7 (range 19-60). The mean rank in theintervention group significantly differed before and after the education, but except for “ perceived threat “and“perceived usefulness of breast self examination”, we did not find any significant differences from the controlgroup. After educational sessions, breast self examination and clinical examination practice rates were elevated.Conclusion: Health education based on well known psychological theories for breast cancer screening should beextended to the entire populations in developing countries. In addition, we should pay attention to barriers towomen undergoing mammography, such as costs, shame and accessibility, and increase the target populationawareness and positive attitudes towards benefits of early breast cancer screening.     

Health Beliefs and Breast Cancer Screening Behaviors among Iranian Female Health Workers

Background: Breast cancer is a serious health problem. Early detection is crucial for optimal treatment andreducing mortality. Objective: The aim of this study was to evaluate health beliefs concerning performance ofbreast self- examination (BSE) and mammography in a sample of Iranian female health workers. Materialsand Methods: This cross-sectional study was performed among 441 female health care workers (physicians=88,nurses=163, midwives=38, officers=68, and others=84) in 3 different health centers in Yazd, Iran. Data werecollected using a self administered questionnaire which included demographic characteristics and thenPersianversion of the Champion’s Health Belief Model Scale (CHBMS). Results: The mean age of the participants was34.7±13.7. It was found that 41.9% of the workers performed BSE in the past and 14.9% of them regularly,but only 10.6% of them had undergone a mammogram. Perceived barriers to BSE (F=6.351, P=0.021) andmammography (F=5.214, p=0.022) were significantly higher in officers than physicians, nurses or midwives.Perceived barriers were lower among those who had performed BSE and mammography, but not significant(p=0.34 and p=0.56, respectively). Furthermore, perceived susceptibility and perceived benefits of the workerswho had BSE and mammography were significantly higher than who did not (p<0.05). Perceived seriousness wasnot a significant variable in BSE and mammography (p=0.71 and p=0.43, respectively). Conclusions: The healthbeliefs of health workers concerning the perceived susceptibility of breast cancer and the perceived benefits BSEand mammography significantly impact their screening practices.     

Factors Influencing Breast Cancer Screening Behavior among Iranian Women

Background: Early detection of breast cancer is of great importance to improve women’s health and to decreasethe cost related to cancer death. Therefore, recognition of variables related to breast cancer screening behaviorsis necessary. Objectives of this study were to identify the rates of breast self-examination (BSE) performance andmammography use in Iranian women, and to characterize the demographic and cognitive factors associated withtheir breast cancer screening behavior. Method: Data were collected from a convenience sample of 388 females,using an adapted version of Champion’s revised Health Belief Model Scale. Results: The results showed that7.5% of the participants performed BSE on a regular monthly basis, and among the women aged 40 and older,14.3% reported having had at least one mammography in their lifetime. Perceived self-efficacy and perceivedbarriers to BSE were significant predictors for BSE performance. For having mammography, health motivationwas the main predictor. Conclusion: Eliminating barriers and increasing perceived self-efficacy with an emphasisto make the women acquainted with BSE performance; as well as increasing health motivation of women andpersuading of physicians for clinical breast examination (CBE) performance with low cost and free access tom ammography, are important to promote BSE and mammography.     

Effects of Breast Self-Examination Consultation Based on the Health Belief Model on Knowledge and Performance of Iranian Women Aged Over 40 Years

Background Breast cancer is the most prevalent malignancy in women worldwide; lack of awareness of symptoms and delay on diagnosis of breast cancer are the main causes of mortality among women. This study was conducted with the purpose of assessing the effect of educational consulting for breast self-examination (BSE) based on the health belief model (HBM) on the knowledge and performance of women over 40 years attending health care centers in Hamadan, Iran. Materials and Methods In this quasi-experimental study, eligible women admitted to health centers in Hamadan city in 2015 were randomly assigned to intervention and control groups (n75 in each group). The intervention group received 4 weekly sessions of breast cancer screening consulting based on the HBM. Control group received only routine care. Knowledge, HBM constructs, and BSE practice were compared between the groups before, immediately after and three months after the consultation. Results Before the intervention, no significant differences were observed in knowledge, health belief and practice between two groups. However, after the intervention a significant difference was observed between two groups in mean scores of perceived benefits, perceived barriers, self-efficacy and the health motivations (<0.05). Significant differences were also observed in terms of knowledge and BSE practice (<.01). Conclusions The results indicate the importance of consultation on knowledge and beliefs to improve BSE performance and prevention of breast cancer in Iranian women.     

Breast cancer early detection, health beliefs, and cancer worries in randomly selected women with and without a family history of breast cancer

BACKGROUND: Early detection practices (EDP) consist of clinical breast examination (CBE) and mammography. Breast self-examination (BSE) is no longer generally recommended, but many women still perform it. AIMS: To compare EDP, health beliefs, and cancer worries in women with and without a family history of breast cancer in a population-based sample. METHODS: 489 women aged 21-60 were randomly sampled from the entire Jewish female population of Israel; 61 (12.5%) had a family history of breast cancer. Participants answered questionnaires by phone, including demographic details, EDP performance, health beliefs, and cancer worries. RESULTS: Rates of CBE were similar in women with and without a family history (p>0.05). For women over 40, rates of undergoing mammography screening were similar (p>0.05), but regular attendance was reported more by women with a family history (p<0.05). More women under 40 with a family history of breast cancer attended mammography (p<0.05), but only about 14% had ever undertaken mammography screening and 27% had ever undertaken CBE. More than 50% of the women had performed BSE, while significantly more women with a family history reported its over-performance (p<0.01). Women with a family history reported higher perceived susceptibility (p<0.01), higher cancer worries (p<0.05), and fewer barriers to mammography (p<0.05). According to logistic regression analysis, higher odds of EDP were significantly related to perceiving fewer barriers and having higher cancer worries. A positive family history was related to higher odds of women undergoing mammography. Perceived susceptibility was significantly related to higher odds of BSE only. Over-performance of BSE was significantly related to having a positive family history, higher susceptibility, and higher cancer worries. CONCLUSIONS: (1) A high rate of women did not undergo CBE or mammography screening. Women under 40 with a family history of breast cancer who have never undergone CBE or mammography merit special attention. (2) The change in guidelines on BSE necessitates further study of its over-performance in relation to cancer worries. (3) Interventions are needed to promote attendance for CBE and mammography in younger women with a positive family history.     

Evaluation of Breast Self-Examination (BSE) Application in First and Second Degree Relatives of Patients with Breast Cancer

Background: The aim of this study was to determine beliefs concerning breast self-examination in first- andsecond-degree relatives of patients with breast cancer and evaluate their breast self-examination (BSE) application.Materials and Methods: A survey study was conducted in an oncology polyclinic and general surgery clinic ofa hospital in Ankara, the capital of Turkey with a sample of 140 women. Results: It was determined that 60.7%of the participants had conducted BSE and 48.1% had undergone a clinical breast examination. Perceived selfefficacyof the women who performed BSE were significantly higher compared with women who did not practiceBSE (p<0.001) Furthermore, perceived barriers were lower among those who had performed BSE (p<0.001).Logistic regression analysis indicated that women who perceived higher self-efficacy (OR: 1.119, 95% CI: 1.056-1.185, p<0.001) and had regular CBE (OR: 8.250, 95% CI: 3.140-21.884, p<0.001) and educational status (OR:5.287, 95% CI: 1.480-18.880, p<0.01) were more likely to perform BSE. Conclusions: Findings from this studyindicated that perceived barriers, perceived self-efficacy, and educational status could be predictors of BSEbehavior among the first- and second-degree relatives of patients with breast cancer. Therefore, BSE trainingprograms that emphasize self-efficacy and address perceived barriers are recommended.     

Breast Cancer Screening Disparity among Korean American Immigrant Women in Midwest

Purpose: Using three breast cancer screening methods such as mammogram, Clinical Breast Examination (CBE), and Breast Self-Examination (BSE), this study investigated breast cancer screening rates and its associated factors in Korean American immigrant women. Method: Cross-sectional data were obtained from 168 Korean immigrant women aged 40 and older in Midwest. The Andersen’s Behavioral Model (1995) theoretically guided this study and logistic regression was used to examine factors associated with screening receipt and performance. Results: Study participants reported low screening rates, specifically mammography and CBE uptake. About 71% of the women had a mammography at least once in their lifetime, while about 36% indicating receipt of a mammogram in the last three years. About 59% of the women received a CBE at least once in their lifetime, while about 32% had CBE in the past three years. About 74% of study participants have performed BSE at least once in their life time, while about 69% have done it in the past three years. Knowledge of screening method was consistently correlated with participant’s three breast cancer screening uptake. Additional factors that were positively associated with screening included older age, low barriers to mammograms, and lower educational attainment. Conclusions: Overall, study participants reported low rates of breast cancer screening receipt and performance. It is required to promote screening uptake among Korean immigrant women, especially women with young age, a lower level of education, and lack of health accessibility. A community-based language-appropriate health education program should be developed to increase health care access.     

Factors Associated with Breast Cancer Mammographic Screening Behavior among Iranian Women

Breast cancer is one of the most common diseases of women, which can increase the survival of patients with its early diagnosis. Despite the existence of relatively sensitive methods of early detection of breast cancer, such as mammography, statistics show that a small number of women perform mammography according to the recommended clinical guidelines. Using the health belief model, this study aims to determine the factors affecting mammography among women teachers in Hamedan. Methods: This study was conducted on 458 female teachers aged 40 years and older of Hamadan city, in western part of Iran, during October to December of 2019. The participants were asked about the factors affecting mammography based on the health belief model. Questionnaires were completed by self-reported method and analyzed by SPSS software at 95% confidence interval. Results: The average age of the study participants was 46±4.1 years. Among the participants, about 41.5% had performed mammography at least once. In univariate analysis, the constructs of the health belief model generally predicts performing mammography between 35 and 49 percent. In multivariate analysis, age 46 to 50 years, having supplementary insurance, history of breast disease, perceived barriers with odds ratio of 3.4, 3.4, 10.6 and .89, respectively, were significantly related to mammography. Conclusions: Female teachers over 45 years of age with a history of breast disease, if they do not have financial or other barriers to do mammography, perform breast cancer screening.     

Knowledge,cultural, and attitudinal barriers to mammography screening among nonadherent immigrant Chinese women

BACKGROUND:

Chinese‐American women have much lower mammography screening rates than the general population. This study examined the collective impact of knowledge, cultural views, and health beliefs on intentions to obtain mammography among Chinese women who had not had a mammogram in the previous year.

METHODS:

Five hundred sixty‐six immigrant Chinese women from the Washington, District of Columbia and New York metropolitan areas completed baseline assessments for a longitudinal intervention study. Validated surveys were used to measure variables of interest. The outcomes were 1) past mammography use (ever vs never) and 2) future screening intention.

RESULTS:

Only 35% of the participants reported intentions to obtain mammograms, with approximately 19% of the never users reporting intentions (vs 44% ever users). Ever users had higher knowledge (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.03‐1.25), less Eastern cultural views (OR, 0.78; 95% CI, 0.70‐0.87), and perceived fewer barriers (OR, 0.78; 95% CI, 0.70‐0.87) than never users, controlling for covariates. Never users were more likely to be recent immigrants, have low income, have limited English ability, and lack regular sources of care than ever users (all P < .001). Multivariate models showed that ever users who were employed received physician recommendations, had less Eastern views, perceived higher susceptibility, and were more likely to have intentions. Among never users, being 40‐49 years of age and perceiving fewer barriers led to increased intention.

CONCLUSIONS:

Understanding cultural patterns and health beliefs in Chinese women is critical to changing their screening behaviors. Interventions that address their common beliefs and specific group barriers are optimal for promoting mammography adherence. Cancer 2009. © 2009 American Cancer Society.     

Knowledge,Barriers and Attitudes Towards Breast Cancer Mammography Screening in Jordan

Background: Breast cancer is the most common type of cancer in Jordan. Current efforts are focused onannual campaigns aimed at increasing awareness about breast cancer and encouraging women to conductmammogram screening. In the absence of regular systematic screening for breast cancer in Jordan, there is aneed to evaluate current mammography screening uptake and its predictors, assess women’s knowledge andattitudes towards breast cancer and screening mammograms and to identify barriers to this preventive service.Materials and Methods: This cross-sectional study was conducted in six governorates in Jordan through faceto-face interviews on a random sample of women aged 40 to 69 years. Results: A total of 507 participants withmean age of 46.8±7.8 years were interviewed. There was low participation rate in early detection of breastcancer practices. Breast self-examination, doctor examination and periodic mammography screening werereported by 34.9%, 16.8% and 8.6% of study participants, respectively. Additionally 3.8% underwent breastcancer screening at least once but not periodically, while 87.6% had never undergone mammography screening.Reported reasons for conducting the screening were: perceived benefit (50%); family history of breast cancer(23.1%); perceived severity (21.2%); and advice from friend or family member (5.8%). City residents haveshown higher probability of undergoing mammogram than those who live in towns or villages. Results revealednegative perceptions and limited knowledge of study participants on breast cancer and breast cancer screening.The most commonly reported barriers for women who never underwent screening were: fear of results (63.8%);no support from surrounding environment (59.7); cost of the test (53.4%); and religious belief, i.e. Qadaa WaQadar (51.1%). Conclusions: In the absence of regular systematic screening for breast cancer in Jordan, theuptake of this preventive service is very low. It is essential for the country of Jordan to work on applying regularsystematic mammography screening for breast cancer. Additionally, there is a need for improvement in thecurrent health promotion programmes targeting breast cancer screening. Other areas that could be targeted infuture initiatives in this field include access to screening in rural areas and removal of current barriers.     

Breast Cancer Knowledge,Perception and Breast Self- Examination Practices among Yemeni Women: an Application of the Health Belief Model

Background: The incidence of breast cancer is rapidly increasing in Yemen with recent indications of constituting one-third of female cancers. The main problem in Yemen remains very late presentation of breast cancer, most of which should have been easily recognisable. Since stage of disease at diagnosis is the most important prognostic variable, early diagnosis is an important option to be considered for control of breast cancer in low resourced settings like Yemen. In the present study, we aimed at describing breast cancer knowledge, perceptions and breast self-examination (BSE) practices among a sample of Yemeni women. Materials and Methods: This cross-sectional study covered 400 women attending four reproductive health centres in Aden, Yemen through face-to-face interview using a structured questionnaire during April - July 2014. We collected data on sociodemographic characteristics, knowledge about breast cancer, and screening practices as well as respondents' perceptions based on the five sub scales of the Health Belief Model (HBM): perceived susceptibility; perceived severity; perceived barriers; perceived benefits; and self-efficacy. The response format was a fivepoint Likert scale. Statistical Package for Social Sciences (SPSS 20) was used for statistical analysis. Statistical significance was set at pResults: The mean age of women was 26.5 (S.D=5.6) years. The majority (89.0%) had never ever performed any screening. Two-thirds of respondents had poor knowledge. Perceived BSE benefits and self-efficacy and lower BSE barriers perception were significant independent predictors of BSE practice. Conclusions: Poor knowledge and inadequate BSE practices are prevailing in Yemen. The need for implementing culturally sensitive targeted education measures is mandatory in the effort to improve early detection and reduce the burden of breast cancer.     

Breast cancer screening in relation to access to health services.

PURPOSE/OBJECTIVES: This study examined mammography screening and breast self-examination (BSE) in relation to perceived access to health services to identify persistent barriers to earlier detection. DESIGN: Community-based, cross-sectional, survey, and interview. SETTING: More than 80 nonhealthcare-related, women's group settings in northern California. SAMPLE: Convenience sample of 838 black/African American, Latina/Hispanic, and Caucasian/Anglo women varying in age, annual family income, sexual orientation, and educational history. METHODS: Survey and interview (in English or Spanish) by on-site research assistants facilitating participation of women with limited reading capability. MAIN RESEARCH VARIABLES: Perceived access to services, breast cancer screening behaviors, acculturation and spoken language, habits of use, perceived prejudice in health delivery, available economic resources, and other social and behavioral variables reported elsewhere. FINDINGS: Healthcare habits, the perception of prejudicial treatment in health service delivery, spoken language, and three different measures of financial capability explained a large degree of perceived access to services. Perceptions of a lack of access to services were related to decreased mammography screening participation and to decreased BSE behavior. CONCLUSIONS: Participation in cancer screening depends on real economic access and previous health service delivery experience. BSE behavior may be influenced by lack of money to pay for healthcare services, and experienced prejudice in healthcare delivery appears to have a lasting influence on mammography screening behavior. IMPLICATIONS FOR NURSING PRACTICE: Tolerance and culturally sensitive service delivery coupled with economic access to both screening and necessary treatment will be vital to eliciting women's complete participation in attaining desired earlier detection goals for breast cancer.     

Mammography Screening Uptake among Female Health Care Workers in Primary Health Care Centers in Palestine - Motivators and Barriers

Background: Early detection remains the cornerstone of breast cancer control in terms of outcome and survival. Thus far the only breast cancer screening method proven effective is mammography. The awareness of female health care workers (HCW) about breast cancer prevention is of vital importance, as their beliefs and behavior may have a major impact on other women. This study was designed to assess mammography screening uptake among female healthcare workers at primary healthcare centers, and to identify the primary motivators and barriers that affect uptake results. Materials and Methods: A cross sectional study design was used to assess mammography screening by 299 female healthcare workers who completed a self-administered questionnaire that assessed demographics, screening uptake, motivators and barriers. Results: The mean age was 46 years (within age of risk). The majority (95.1%) demonstrated adequate knowledge about breast cancer and mammography screening and 50% of the participants reported having at least one mammogram; however only 21% of them had regularly scheduled mammograms. The most frequent reported motivator was the perceived benefit that early detection of breast cancer is important for its management (89.6%), followed by the belief that mammography can detect breast cancer before its symptoms appear (84.4%). On the other hand, the most frequent barrier reported was being busy (46.7%), followed by the lack of perceived susceptibility (41.5%). Conclusions: Mammography screening was found to be sub-optimal in a population of HCW's with 50 % stating that they received a mammogram at least once, and a minority reported regular screening. There is a pressing need for educational programs aimed at removing the barriers that limit compliance with recommendations for mammography screening, and to emphasize the importance of early detection in breast cancer treatment. Ensuring the availability and accessibility of screening services, particularly for healthcare workers within their work settings are other important factors that would improve the acceptance and compliance for mammography screening programs.     

Determinants of Breast Self-Examination Performance Among Iranian Women: An Application of the Health Belief Model

Breast cancer is one of the most common cancers among women. Screening behavior rates are low in the world. Therefore, the purpose of the current study was to investigate breast self-examination (BSE) rate and the relationships of Health Belief Model (HBM) constructs for predicting BSE. Path analysis was used to examine both one-way direct and indirect effects of HBM factors on BSE in this population (N = 382). Data were collected by a part of Champion’s HBM Scale (CHBMS) and a self-administered questionnaire. The results showed that 7.6% of the participants reported performing BSE regularly. The final model provided a good fit to the data, with 13 variables explaining 62% of the variance in BSE. Perceived self-efficacy was intermediate construct between modifying factors and HBM constructs. Also, perceived self-efficacy and perceived benefits were the most highly related to BSE. The results suggest that HBM is a useful framework for identifying factors influencing the use of BSE in Iranian women.