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Li J. Relationships among health-related social media use, knowledge, worry, and cervical cancer screening: A cross-sectional study of US females. PATIENT EDUCATION AND COUNSELING 2024; 124:108283. [PMID: 38593482 DOI: 10.1016/j.pec.2024.108283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/19/2024] [Accepted: 03/28/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVE This study aimed to explore the relationship between health-related social media use and HPV-related health knowledge, attitudes, and practices (KAP). METHOD Data were derived from a subset of the national cohort from the 2022 Health Information National Trends Survey (HINTS 6), including only women aged 21 to 65 years old (n = 2013). Ordinary least squares regression and structural equation modeling were used to answer the research question and test hypotheses. RESULTS Participants with a family history of cancer, higher education, and White showed more HPV knowledge. Older females were associated with lower HPV knowledge, less worry and fewer timely cervical cancer screening. Additionally, HPV knowledge positively predicted worry and cervical cancer screening. Health-related social media use positively predicted HPV knowledge, worry, and cervical cancer screening. CONCLUSION This study identified populations with HPV knowledge and hesitated cervical cancer screening and tested hypothesized models that combine social media use with the KAP survey. PRACTICE IMPLICATIONS Future health interventions should strategically leverage the role of social media to enhance public awareness of HPV knowledge and cancer concerns. By promoting HPV knowledge and awareness, such interventions can subsequently encourage timely cervical cancer screening.
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Affiliation(s)
- Jinxu Li
- Department of Communication and Journalism, Texas A&M University, USA.
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Wang Y, Li C, Zhang J, Mao Y, Li W. Protection motivation theory in predicting intentional behaviors regards schistosomiasis: a WeChat-based qualitative study. Front Public Health 2024; 12:1295081. [PMID: 38864010 PMCID: PMC11165043 DOI: 10.3389/fpubh.2024.1295081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 05/10/2024] [Indexed: 06/13/2024] Open
Abstract
Background Modifications of behavior can help reduce the risk of transmission by disrupting the parasite life cycle. Behavior intension is a necessary intermediate step in behavior change. This study aimed to explore protection motivation theory (PMT) in predicting likelihood of engagement in protective behavior against infection with Schistosoma. Methods In China, a questionnaire for data collection was sent to users who followed the WeChat public account from June 2 to 6, 2023. Factors affecting intentional behavior of participants were analyzed using stepwise regression analysis and structural equation modeling. Results A total of 2,243 valid questionnaires were collected, with a mean age of 30 ± 8.4 years. Approximately 1,395 (62.2%) participants reported that they had been exposed to wild waters in daily work and life. About 51.0 and 50.7% of respondents reported never having been exposed to wild water in the last 3 and 6 months, respectively. Results indicated that prior knowledge of schistosomiasis was associated with the 7 PMT subconstructs, which then influenced future preventative behaviors. Conclusion Behavior intentionis a complicated and indispensable part of behavior change that is influenced by professional knowledge, socio-economic status, and personal characteristics. The effective dissemination of knowledge regards schistosomiasis should be strengthened to emphasize the effectiveness of protective measures against infection and severe disease.
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Affiliation(s)
| | | | | | - Yuanchun Mao
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Provincial Medical Key LaboratoryJiangsu Institute of Parasitic Diseases, Wuxi, China
| | - Wei Li
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Provincial Medical Key LaboratoryJiangsu Institute of Parasitic Diseases, Wuxi, China
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Romli R, Mohd Hashim S, Abd Rahman R, Chew KT, Mohamad EMW, Mohammed Nawi A. Understanding cervical cancer screening motivations from women and health practitioners' perspectives: A qualitative exploration. Gynecol Oncol Rep 2024; 52:101349. [PMID: 38435346 PMCID: PMC10909600 DOI: 10.1016/j.gore.2024.101349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 02/17/2024] [Accepted: 02/19/2024] [Indexed: 03/05/2024] Open
Abstract
Purpose Cervical cancer (CC) screening remains challenging, where the motivational focus towards utilizing CC screening services is rarely highlighted. This study aimed to understand the motivation to undergo CC screening from women and healthcare practitioners' perspectives based on Protection Motivation Theory (PMT). Method This qualitative study used the nominal group technique (NGT) and in-depth interview (IDI), where the NGT participants were healthcare practitioners from various disciplines (n = 12). Nominal group discussions were conducted via Zoom and involved one moderator, facilitator and observer. The IDI was conducted via Google Meet among seven women who had been included based on purposive sampling. All nominal group discussions and interviews were transcribed, verbatim and underwent deductive thematic analysis. Results Healthcare practitioners emphasized input on CC knowledge of epidemiology, risk, etiology, nature, and outcome to encourage motivation. Women underlined their important role in the family, and reducing the negative perception as a motivational focus. Having living example of witnessing the CC patient dying and fear of stigma of cancer could be the driven force to undergo screening. Emphasis on the important of sufficient knowledge and correct the misconceptions towards screening could impart the motivation among women. Conclusions The motivational focus was enriched by the differing perspectives of the healthcare practitioners and women. The findings can guide intervention program development towards enhancing CC screening in the future.
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Affiliation(s)
- Rodziah Romli
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
- Institut Latihan Kementerian Kesihatan Malaysia (Pembantu Perubatan) Alor Setar, Ministry of Health, Alor Setar, Kedah, Malaysia
| | - Syahnaz Mohd Hashim
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Rahana Abd Rahman
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Kah Teik Chew
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Emma Mirza Wati Mohamad
- Centre for Research in Media and Communication (MENTION), Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Azmawati Mohammed Nawi
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
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Ciceron AC, Berg CJ, Clausen M, Jeon MJ, Abroms LC, Le D. Development of a cervical cancer prevention text-messaging program for women living with HIV. HEALTH EDUCATION RESEARCH 2023; 38:587-596. [PMID: 37436827 DOI: 10.1093/her/cyad024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/30/2023] [Indexed: 07/13/2023]
Abstract
Cervical cancer screening and human papillomavirus (HPV) vaccination are critical for those immunocompromised due to human immunodeficiency virus (HIV). Health education programs, including text messaging, can effectively improve knowledge of cervical cancer and recommended screening. This paper describes the data-driven development of a 4-week text-messaging intervention to improve HPV and cervical cancer knowledge among women living with HIV (WLH). This study reports data from surveys (n = 81; January 2020 to September 2021) and focus group discussions (FGDs, n = 39; April-June 2020) conducted among WLH in the DC area. While most WLH revealed that their usual sources of health information were through in-person group sessions, they pointed out that these were impractical options due to the coronavirus 2019 pandemic. They noted that a text-messaging intervention was feasible and acceptable. FGD participants' responses structured around the Protection Motivation Theory constructs informed the text-messaging library, covering topics such as (I) understanding of cervical cancer and HPV, (II) cervical cancer prevention and (III) HPV self-sampling. The utilization of low-cost and easily accessible health education interventions, such as mobile-based text messaging, can effectively increase knowledge and awareness of cervical cancer in populations that have been historically difficult to access and during times when health services are disrupted such as during a global pandemic or public health emergency.
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Affiliation(s)
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
- George Washington University Cancer Center (GW Cancer Center), The George Washington University, Washington, DC 20052, USA
| | - Michelle Clausen
- School of Nursing, The George Washington University, Washington, DC 20052, USA
| | - Min Jeong Jeon
- School of Nursing, The George Washington University, Washington, DC 20052, USA
| | - Lorien C Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
- George Washington University Cancer Center (GW Cancer Center), The George Washington University, Washington, DC 20052, USA
| | - Daisy Le
- School of Nursing, The George Washington University, Washington, DC 20052, USA
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
- George Washington University Cancer Center (GW Cancer Center), The George Washington University, Washington, DC 20052, USA
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Zhang M, Sit JWH, Wang T, Chan CWH. Exploring the sources of cervical cancer screening self-efficacy among rural females: A qualitative study. Health Expect 2023; 26:2361-2373. [PMID: 37504888 PMCID: PMC10632632 DOI: 10.1111/hex.13840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 06/02/2023] [Accepted: 07/26/2023] [Indexed: 07/29/2023] Open
Abstract
AIM Evidence showed self-efficacy was relevant to rural females' cervical cancer screening behaviour. However, little is known about sources of self-efficacy in cervical cancer screening among rural females. This study aimed to explore sources of self-efficacy in cervical cancer screening among rural females. DESIGN A qualitative descriptive study was conducted. Both users and providers of cervical cancer screening services in rural areas of China were recruited through maximum variation sampling. METHODS Individual semi-structured interviews through telephone calls were conducted. Data were analysed via six main stages of the framework method, with the social cognitive theory as a reference. RESULTS Four main sources were identified, including personal screening experience, hearing about other women's screening experiences, professional health education and consultation, and emotional status. Personal screening experience included enactive mastery of completing the screening behaviour and cognitive mastery of internalisation of the screening. Only the experience of completing cervical cancer screening behaviour was not strong enough to improve self-efficacy. Cognitive mastery showed more critical influence. CONCLUSION These four sources of rural females' cervical cancer screening self-efficacy matched with the major sources of self-efficacy of the social cognitive theory. Cognition was critical to influencing the screening self-efficacy. Intervention strategies aimed at enhancing rural females' cervical cancer screening self-efficacy can be developed from these four major sources. PUBLIC CONTRIBUTION A registered nurse with rich experience in cervical cancer-related research and qualitative study was the interviewer of this study. Rural females and cervical cancer screening services providers (healthcare professionals and village staff) were recruited as interviewees. The interview guides were developed by the research team and evaluated by an expert panel including two nurse leaders of gynaecological cancer, one doctor specialised in cervical cancer, and one medical director in a local rural hospital.
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Affiliation(s)
- Mengyue Zhang
- The Nethersole School of Nursing, Faculty of MedicineThe Chinese University of Hong KongHong KongChina
| | - Janet W. H. Sit
- The Nethersole School of Nursing, Faculty of MedicineThe Chinese University of Hong KongHong KongChina
| | - Tingxuan Wang
- School of Nursing, LKS Faculty of MedicineThe University of Hong KongHong KongChina
| | - Carmen W. H. Chan
- The Nethersole School of Nursing, Faculty of MedicineThe Chinese University of Hong KongHong KongChina
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Romli R, Abd Rahman R, Mohd Hashim S, Chew KT, Mohamad EMW, Mohammed Nawi A. Women's motivation towards Pap smear screening based on sexual and screening status: A cross-sectional study using protection motivation theory. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:357. [PMID: 38144028 PMCID: PMC10743857 DOI: 10.4103/jehp.jehp_1842_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 03/01/2023] [Indexed: 12/26/2023]
Abstract
INTRODUCTION Cervical cancer remains a reproductive health burden. Pap smear (PS) screening can detect cervical cancer early but is underused despite being subsidized. Motivational factors play a role in promoting PS screening. This study aimed to determine the women's motivation toward PS screening based on Protection Motivation Theory (PMT), which mainly focused on sexual and screening status. MATERIALS AND METHODS The study was conducted electronically throughout Malaysia from January to February 2022 by disseminating Google Form (https://forms.gle/cD7fkUKYR4Cq6kZC8) via multiple WhatsApp groups to reach 526 women aged 21-65 years. The questionnaire consists of 24 items based on seven PMT constructs [perceived vulnerability, perceived severity, self-efficacy, response efficacy, fear (threat appraisal), response costs (coping appraisal), and protection motivation]. The descriptive statistics and independent t-test was used to analyze data using IBM SPSS Statistics software, version 25. RESULTS Most respondents were sexually active [80.6% (n = 424)] and have heard of PS screening [95.8% (n = 504)]. More than half of respondents did not have PS screening in the last three years [59.3% (n = 312)]. Sexually active women have heard and have undergone PS screening feel less threatened with low coping appraisals. Undergoing PS screening made women perceived more response efficacy (P =. 011), more self-efficacy (P <. 001), and higher protection motivation (P <. 001) toward PS screening. CONCLUSIONS Women's motivation related to PS screening needs to be highlighted. Future development of health education strategy should include motivation focused in emphasizing the threat and coping appraisal into educational plan to ensure women come forward for screening.
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Affiliation(s)
- Rodziah Romli
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
- Institut Latihan Kementerian Kesihatan Malaysia Alor Setar, Ministry of Health, Alor Setar, Kedah, Malaysia
| | - Rahana Abd Rahman
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Syahnaz Mohd Hashim
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Kah Teik Chew
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Emma Mirza Wati Mohamad
- Centre for Research in Media and Communication (MENTION), Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Azmawati Mohammed Nawi
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
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Zhang M, Sit JW, Choi KC, Chan CW. A theory-driven, culture-tailored educational intervention for cervical cancer screening among rural Chinese females: A feasibility and pilot study. Asia Pac J Oncol Nurs 2023; 10:100218. [PMID: 37288349 PMCID: PMC10242496 DOI: 10.1016/j.apjon.2023.100218] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/20/2023] [Indexed: 06/09/2023] Open
Abstract
Objective This study aimed to evaluate the feasibility and preliminarily estimate the effects of a theory-driven, culture-tailored, community-based educational intervention promoting cervical cancer screening among rural females. Methods An experimental study with the two-arm parallel, nonrandomized control trial design was implemented, followed by individual semi-structured interviews. Thirty rural females between 26 and 64 were recruited, with 15 in each group. Both groups were exposed to the usual care about cervical cancer screening promotion from the local clinics, while participants in the intervention group additionally received five educational sessions in 5 weeks. Data were collected at baseline and immediately postintervention. Results All participants completed the study, and the retention rate was 100%. Participants in the intervention group had more significant increments in cervical cancer screening-related self-efficacy (P < 0.001), knowledge (P < 0.001), and intention levels (P = 0.003) than those in the control group. Most participants showed acceptance and satisfaction with this educational intervention. Conclusions This study revealed that the theory-driven, culture-tailored, community-based educational intervention was feasible among the rural populations to promote cervical cancer screening. A large-scale interventional study with a prolonged follow-up duration is warranted to explore this educational intervention's effectiveness further.
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Taheri-Kharameh Z, Bashirian S, Moghadam RH, Poorolajal J, Barati M, Ramezani T, Rásky É. Development and validation of the Iranian version of the protection motivation theory questionnaire for fall prevention in older people. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2023. [DOI: 10.12968/ijtr.2020.0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background/Aims The protection motivation theory is a common framework illustrating the use of protective behaviours. The aim of this study was to develop and evaluate the psychometric properties of the protection motivation theory questionnaire for fall prevention in older people in Iran. Methods This study used a psychometric design. A literature review was initially performed and developed a 35-item questionnaire consisting of eight sub-constructs of the protection motivation theory. A panel of experts and a group of older people aged 60 years or above were invited to assess the content and face validity of the questionnaire. Thereafter, construct validity was evaluated by using confirmatory factor analysis. The reliability of the questionnaire was examined using test–retest reliability and internal consistency. Data analysis was performed using the partial least squares path modelling version three software. Results A total of 300 people living in retirement centres completed the questionnaire. In the expert panel review, all tasks received a content validity index above 0.90 and a content validity ratio above 0.80, representing good content validity. In total, 32 items remained in the final version of the questionnaire. Confirmatory factor analysis confirmed an acceptable eight-factor model fit of the protection motivation theory sub-constructs with factor loadings from 0.59 to 0.93. The discriminant validity was verified using the Fornell–Larcker criterion. The Cronbach's alpha ranged from 0.68 to 0.90 and the test–retest reliability ranged from 0.78 to 0.90, displaying an acceptable result. Conclusions The results of this study suggest that the protection motivation theory questionnaire had good validation and can be used to measure the psychological predictors of fall behaviour in older people. Further studies are needed to evaluate the validity in various settings.
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Affiliation(s)
| | - Saeed Bashirian
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Rashid Heidari Moghadam
- Department of Ergonomics, School of Health, Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Jalal Poorolajal
- Research Center for Health Sciences, Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Barati
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Public Health, Asadabad School of Medical Sciences, Asadabad, Iran
| | - Tahereh Ramezani
- Student Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Éva Rásky
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria
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Desta AA, Alemu FT, Gudeta MB, Dirirsa DE, Kebede AG. Willingness to utilize cervical cancer screening among Ethiopian women aged 30–65 years. Front Glob Womens Health 2022; 3:939639. [PMID: 36110581 PMCID: PMC9468704 DOI: 10.3389/fgwh.2022.939639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundCervical cancer screening is a means of detecting cervical cancer early, before it develops, in order to reduce disease mortality and morbidity. When women are screened for cervical cancer between the ages of 30 and 40 years at least one time in their life, their risk of cancer could be decreased by 25–36%. Despite this advantage, cervical cancer screening coverage in Ethiopia is still <2%. As a result, we wanted to see how ready women in the Girar Jarso district, Ethiopia, were to get a cervical cancer test.MethodologyCommunity-based cross-sectional study was done using a stratified cluster sampling technique among 855 women aged 30–65 years in the Girar Jarso district, Ethiopia, from 1 June 2021 to 1 September 2021. A pretested and semi-structured interviewer-administered questionnaire was used to collect the data. EpiData management version 4.6 was used to enter data, which was then exported to SPSS version 23 for analysis. Logistic regression analysis was performed, and variables with a p-value of <0.05 were taken as statistically significant predictors of the willingness to utilize cervical cancer screening.ResultsOf the 855 women, only 315 (46.7%, CI = 43–50.3) women were willing to be checked for cervical cancer, with 181 (21.2%) women having been screened at least one time in their life. Age of 30–39 years [AOR = 2.80 (95% CI: 1.05, 7.48)], urban resident [AOR = 2.12 (95% CI: 1.06, 4.48)], positive attitude [AOR = 1.68 (95% CI: 1.11, 2.53)], wealth status, awareness of cervical cancer, and low perceived barriers were independent predictors of the willingness to utilize cervical cancer screening.Conclusion and recommendationThe willingness to utilize cervical cancer screening services is low in the Girar Jarso district. To improve community awareness and attitude, continued and sustainable advocacy on the value of cervical cancer screening should be offered through mass media and health extension workers.
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Al-Qahtani AM, Ibrahim HA, Elgzar WT. Predictors of breast self-examination behavior among adult females in Najran city, Saudi Arabia. Jpn J Nurs Sci 2022; 19:e12503. [PMID: 35699332 DOI: 10.1111/jjns.12503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 05/04/2022] [Accepted: 05/16/2022] [Indexed: 12/24/2022]
Abstract
AIM This study aimed to explore the predictors of breast self-examination (BSE) behavior among adult females in Najran city, Saudi Arabia. METHODS A descriptive correlational design was utilized to recruit 1,075 participants from the primary health centers in Najran city, Saudi Arabia, from the beginning of March to the end of October 2021. A self-reported questionnaire was used for data collection; it consisted of demographic data and health history, breast cancer knowledge test and protection motivation theory (PMT) scale. Data analysis was performed using the Statistical Package for Social Science software, version 23 (IBM, Armonk, NY, USA). RESULTS Only 38.2% of the study participants had ever-performed BSE. Participants' knowledge, education, previous family history of breast cancer, and personal history of benign breast tumors are significant socio-demographic predictors of BSE behavior (p < .001). Also, the higher threats appraisal, reward appraisal, and efficacy appraisal increased the participants' probability of practicing BSE (p < .001) compared to a low level as references based on binary logistic regression results. In addition, low response cost was another predictor for BSE behavior compared with higher levels (p < .001). CONCLUSION Participants' knowledge, education, previous family history of breast cancer, and the PMT constructs (threats appraisal, reward appraisal, efficacy appraisal, and response cost) were significant predictors of BSE behavior.
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Affiliation(s)
- Awad M Al-Qahtani
- Family Medicine Department, College of Medicine, Najran University, KSA, Najran, Saudi Arabia
| | - Heba A Ibrahim
- Department of Maternity and Childhood Nursing, Nursing College, Najran University, KSA, Najran, Saudi Arabia
| | - Wafaa T Elgzar
- Department of Maternity and Childhood Nursing, Nursing College, Najran University, KSA, Najran, Saudi Arabia
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Translation, Cross-Cultural Adaptation, and Validation of the Malay Version of the Protection Motivation Theory Scale Questionnaire for Pap Smear Screening. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116858. [PMID: 35682440 PMCID: PMC9180031 DOI: 10.3390/ijerph19116858] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/20/2022] [Accepted: 06/02/2022] [Indexed: 02/04/2023]
Abstract
Pap smear screening can detect cervical cancer early, but is underutilized. Motivational factors play a role in ensuring that women undergo Pap smear screening. This study was conducted to validate the adapted instrument, which was based on the protection motivation theory (PMT), into the Malay language to evaluate the motivational factors for Pap smear screening among women. The original 26-item PMT scale was developed based on seven constructs of the PMT framework. The adaptation involved translation by bilingual experts (n = 4), followed by synthesis (n = 6). Subsequently, we performed content validation (content validation index, CVI) among the health experts (n = 5) and face validation (face validation index, FVI) among women (n = 11). Reliability testing for internal consistency was determined via the confirmatory factor analysis (CFA) of women aged between 21 and 65 years (n = 150). One item was deleted based on the expert consensus, leaving a total of 25 items after the adaptation. The validation yielded a good CVI and FVI. Prior to CFA reliability testing, one item was deleted due to very low factor loading. The CFA indicated a good fit for 24 items. The factor loading (range: 0.45–0.98), average variance extracted (range: 0.44–0.90), and composite reliability (range: 0.69–0.97) indicated that the convergent validity for each construct was acceptable, except for the perceived vulnerability. However, the perceived vulnerability construct was accepted based on expert verification. We confirmed that the translation, cross-cultural, adaptation, and validation of the Malay-version PMT scale were valid and reliable. The scale contains 24 items that represent the seven constructs of the PMT framework.
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Screening Intention Prediction of Colorectal Cancer among Urban Chinese Based on the Protection Motivation Theory. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074203. [PMID: 35409885 PMCID: PMC8998218 DOI: 10.3390/ijerph19074203] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/30/2022] [Accepted: 03/30/2022] [Indexed: 02/04/2023]
Abstract
Colorectal cancer poses a serious threat worldwide. Although early screening has been proved to be the most effective way to prevent and control colorectal cancer, the current situation of colorectal cancer screening remains not optimistic. The aim of this article is to apply the protection motivation theory (PMT) to examine the influencing factors on screening intention of colorectal cancer (CRC). This cross-sectional survey was launched in five communities in Wuhan, China. All the eligible urban Chinese were recruited and interviewed using paper-and-pencil questionnaires. The intention of colorectal cancer screening (CRCS) was measured using six PMT subconstructs, including perceived risk, perceived severity, fear arousal, response efficacy, response cost, and self-efficacy. Data on sociodemographic variables and knowledge of CRC were also collected. The structural equation modeling (SEM) method was used for data analysis. Among all the 569 respondents, 83.66% expressed willingness to participate in CRCS. Data of the research fit the proposed SEM model well (Chi-square/df = 2.04, GFI = 0.93, AGFI = 0.91, CFI = 0.91, IFI = 0.91, RMSEA = 0.04). Two subconstructs of PMT (response efficacy and self-efficacy) and CRC knowledge were directly and positively associated with screening intention. Age, social status, medical history, physical activity, and CRC knowledge were indirectly related to the screening intention through at least one of the two PMT subconstructs (response efficacy and self-efficacy). The findings of this study suggest the significance of enhancing response efficacy and self-efficacy in motivating urban Chinese adults to participate in CRC screening. Knowledge of CRC is significantly associated with screening intention. This study can provide useful information for the formulation and improvement of colorectal cancer screening strategies and plans.
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Kim HK, Jeong GH. Effect of Pro-Environmental Prenatal Education Program on Pregnant Women’s Environmental Health Awareness and Behaviors based on the Protection Motivation Theory. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580211047045. [PMID: 35227127 PMCID: PMC8891827 DOI: 10.1177/00469580211047045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
This study aimed to verify whether a pro-environmental prenatal education program has an effect on pregnant women’s environmental health awareness and behaviors in Korea. This quasi-experimental study employed a nonequivalent control group and nonsynchronized design based on the protection motivation theory as a theoretical framework. In total, 96 pregnant women had their data collected and analyzed in Korea (40 in the experimental group; and 56 in the control group). Data collection through self-reported questionnaire was conducted between September 2017 and August 2018. The program consisted of lectures and group activities aimed at educating participants on environmental awareness and behaviors. The data were analyzed using t-test, chi square test, and ANCOVA using SPSS 24.0 program. After the intervention, the experimental group showed significantly higher sensitivity (54.78 ± 9.47 and 49.75 ± 5.42; F = 15.13, P < .001), susceptibility (26.30 ± 5.18 and 24.28 ± 4.53; F = 53.94, P < .001), response efficacy (27.40 ± 3.40 and 25.18 ± 4.23; F = 39.42, P < .001), self-efficacy (22.43 ± 4.15 and 21.35 ± 4.25; F = 41.13, P < .001), individual environmental behavior (58.59 ± 12.25 and 51.93 ± 12.64; F = 172.75, P < .001), and communal environmental behavior (18.45 ± 9.68 and 13.13 ± 8.24; F = 126.26, P < .001) than the control group. The developed pro-environmental prenatal education program contained content on the environment and pregnancy, environmental toxin, effects of endocrine disruptors, airborne pollutants, water pollutant, soil pollutant, radio-electronic exposure, and pro-environmental health behaviors during pregnancy. Pregnant women who participated in the pro-environmental prenatal education program had positive changes in environmental health perceptions and behaviors. As environmental hazards continue to increase, pregnant women should receive effective motivational education on eco-environmental protection to increase their sensitivity to environmental risk factors and to encourage active environmental health behaviors.
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Zhang M, Wei W, Li Q, Chen X, Zhang M, Zuo D, Liu Q. Determinants of Intention to Participate in Breast Cancer Screening among Urban Chinese Women: An Application of the Protection Motivation Theory. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111093. [PMID: 34769613 PMCID: PMC8583142 DOI: 10.3390/ijerph182111093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 10/09/2021] [Accepted: 10/18/2021] [Indexed: 11/16/2022]
Abstract
Despite the significance of early detection of breast cancer through screening, the screening uptake in China remains relatively low. Protection motivation theory (PMT) suggested by Rogers is one of the theories concerning threat appeal. This study aimed to apply the protection motivation theory (PMT) in predicting breast cancer screening intention. In this cross-sectional study, a sample of Chinese urban women was recruited using the convenient sampling method from five communities in Wuhan. Data were collected using a self-report questionnaire that included demographic variables, knowledge about breast cancer, six PMT subconstructs, and screening intention. We used the structural equation modeling (SEM) to identify the predictor factors associated with screening intention. Of the total sample (n = 412), 86.65% had intention to participate in screening. Our data fit the hypothesized SEM model well (Goodness of fit index (GFI) = 0.91, adjusted GFI (AGFI) = 0.89, comparative fit index (CFI) = 0.91, root mean square error of approximation (RMSEA) = 0.05, standardized root mean residual (SRMR) = 0.06, and Chi-square/df = 2.01). Three PMT subconstructs (perceived severity, response cost, and self-efficacy) were significantly associated with screening intention. Knowledge, social status, and medical history had significantly indirect associations with screening intention through the mediating effect of PMT subconstructs. Considering the utility of PMT, intervention programs might be more effective based on the subconstructs of PMT, especially to improve self-efficacy, perceived severity, and knowledge, reduce response cost, as well as targeting specific demographic groups.
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Affiliation(s)
- Miao Zhang
- Department of Epidemiology, School of Health Sciences, Wuhan University, Wuhan 430071, China; (M.Z.); (W.W.); (D.Z.)
| | - Wenshuang Wei
- Department of Epidemiology, School of Health Sciences, Wuhan University, Wuhan 430071, China; (M.Z.); (W.W.); (D.Z.)
| | - Qinmei Li
- Wuhan Center for Disease Control and Prevention, Wuhan 430015, China;
| | - Xinguang Chen
- Department of Epidemiology, University of Florida, Gainesville, FL 32610, USA;
| | - Min Zhang
- Institute of Cancer Prevention and Control, Wuhan 430079, China;
| | - Dan Zuo
- Department of Epidemiology, School of Health Sciences, Wuhan University, Wuhan 430071, China; (M.Z.); (W.W.); (D.Z.)
| | - Qing Liu
- Department of Epidemiology, School of Health Sciences, Wuhan University, Wuhan 430071, China; (M.Z.); (W.W.); (D.Z.)
- Correspondence: ; Tel.: +86-1372-026-4816
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Dsouza JP, Van den Broucke S, Pattanshetty S, Dhoore W. The application of health behavior theories to promote cervical cancer screening uptake. Public Health Nurs 2021; 38:1039-1079. [PMID: 34231254 DOI: 10.1111/phn.12944] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 05/26/2021] [Accepted: 06/02/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND While cervical cancer is a major cause of mortality, its progress and survival rate can be improved through screening. Yet despite their wide availability, women's participation in cervical cancer screening (CCS) programs is often suboptimal, especially in low- and middle-income countries. Besides demographic and organizational characteristics, screening uptake is influenced by psychological factors, most of which are included in health behavior theories. This systematic review compared different health behavior theories in terms of their capacity to explain CCS uptake and inform CCS promotion campaigns. METHODS A comprehensive search and analysis of published intervention and non-intervention (observational) studies that applied at least one health behavior theory to CCS participation. RESULTS After quality screening, 48 observational and 21 intervention studies were identified that applied the Health Belief Model (HBM), Theory of Reasoned Action (TRA), Theory of Planned Behaviour (TPB), Transtheoretical model (TTM), Social-ecological Model (SEM), and/or Theory of Triadic Influence (TTI) to CCS. The HBM was most frequently used to explain behavior, whereas the TPB was better at explaining screening intentions. Tailored intervention studies focusing on all theoretical constructs were most effective in modifying perceptions and increasing CCS uptake. CONCLUSIONS Despite their inconsistent use, health behavior theories can explain CCS intentions and behavior and contribute to the development of targeted interventions to promote screening uptake.
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Affiliation(s)
| | - Stephan Van den Broucke
- Faculty of Psychology and Educational Sciences, Université Catholique de Louvain, Louvain, Belgium
| | - Sanjay Pattanshetty
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - William Dhoore
- Faculty of Public Health, Université Catholique de Louvain, Louvain, Belgium
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Huang R, Wang Z, Yuan T, Nadarzynski T, Qian HZ, Li P, Meng X, Wang G, Zhou Y, Luo D, Wang Y, Cai Y, Zou H. Using protection motivation theory to explain the intention to initiate human papillomavirus vaccination among men who have sex with men in China. Tumour Virus Res 2021; 12:200222. [PMID: 34175495 PMCID: PMC8261654 DOI: 10.1016/j.tvr.2021.200222] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/29/2021] [Accepted: 05/18/2021] [Indexed: 12/11/2022] Open
Abstract
Human papillomavirus (HPV) infection and related diseases are common among men who have sex with men (MSM). The most effective prevention is HPV vaccination. In China, however, men are not included in the HPV vaccination plan. We investigated the intention to initiate HPV vaccination and associated factors among MSM in China. Methods We surveyed 563 unvaccinated MSM aged 18 or older from six cities in China. Participants completed an electronic questionnaire about demographics, knowledge of and attitude towards HPV and HPV vaccine, intention to initiate HPV vaccination, willingness to recommend HPV vaccine to peers, feeling about government policy about HPV vaccination. We used the structural equation modeling (SEM) to analyze factors associated with HPV vaccine intention. Results The knowledge of HPV and HPV vaccine among participants was low. The mean score of knowledge about HPV and HPV vaccine was only 1.59 (range 0–11). The intention to initiate HPV vaccination within 6 months among participants was moderate (43.3% in total, 18.1% for ‘very high' and 25.2% for ‘above average'). Low level of knowledge and intention to initiate HPV vaccination among MSM in China. Most variables of The Protection Motivation Theory were associated factors. Tailored intervention should be applied among MSM in China. Promotion of publicity and subsidization should be also considered.
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Affiliation(s)
- Ruonan Huang
- School of Public Health, Sun Yat-sen University, Guangzhou, PR China
| | - Zhenyu Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, PR China
| | - Tanwei Yuan
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, PR China
| | - Tom Nadarzynski
- The University of Westminster, 115 New Cavendish St, Fitzrovia, London, W1W 6UW, United Kingdom
| | - Han-Zhu Qian
- Yale School of Public Health, New Haven, CT, USA
| | - Peiyang Li
- School of Public Health, Sun Yat-sen University, Guangzhou, PR China
| | - Xiaojun Meng
- Wuxi Municipal Center for Disease Control and Prevention, Wuxi, PR China
| | - Guanghui Wang
- Qingdao Qingtong AIDS Prevention Volunteer Service Center, Qingdao, PR China
| | - Yepeng Zhou
- Foshan Friends Care Center for AIDS/HIV Control, Foshan, PR China
| | - Danyang Luo
- Zhitong LGBT Service Center, Guangzhou, PR China
| | - Ying Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yong Cai
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, PR China; School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Kirby Institute, University of New South Wales, Sydney, Australia.
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Feng GC, Lin Z, Ou W, Su X, Yan Q. A Model-Based Meta-Analysis of Willingness to Participate in Cancer Screening. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2580. [PMID: 33806652 PMCID: PMC7967393 DOI: 10.3390/ijerph18052580] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/26/2021] [Accepted: 02/27/2021] [Indexed: 12/31/2022]
Abstract
Although early screening tests are beneficial for the detection and treatment of cancers, many people have failed to participate in screening tests. The present study aims to explore the theoretical underpinning of low participation in screening programs using the method of meta-analytic structural equation modeling. It was found that the health belief model is the most adopted theoretical framework. Moreover, the intended uptake of screening was positively predicted only by cues to action, health literacy, and perceived susceptibility. As a result, a health intention model, including the three significant variables, is proposed. The practical implications of the findings are that health communication campaigns should focus on enlightening and engaging the public through all necessary means to raise awareness and transfer knowledge in relation to screening procedures as well as cancers per se.
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Affiliation(s)
| | - Zhiliang Lin
- School of Literature and Media, Nanfang College of Sun Yat-sen University, Guangzhou 510970, China;
| | - Wanhua Ou
- College of Communication, Shenzhen University, Shenzhen 518600, China; (W.O.); (X.S.)
| | - Xianglin Su
- College of Communication, Shenzhen University, Shenzhen 518600, China; (W.O.); (X.S.)
| | - Qing Yan
- School of Journalism and Communication, Jinan University, Guangzhou 510610, China;
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Heydari E, Dehdari T, Solhi M. Can adopting skin cancer preventive behaviors among seafarers be increased via a theory-based mobile phone-based text message intervention? A randomized clinical trial. BMC Public Health 2021; 21:134. [PMID: 33446158 PMCID: PMC7807693 DOI: 10.1186/s12889-020-09893-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 11/15/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND One of the main occupational hazards for seafarers is the long exposure to sunlight. This study aimed to determine the efficacy of a mobile phone-based text message intervention in adopting skin cancer preventive behaviors among a sample of seafarers in Genaveh port located in Bushehr province, Iran. METHODS In this randomized controlled trial, 136 seafarers were randomly selected and assigned to the intervention (n = 68) or a control groups (n = 68). As a theoretical basis, we followed the Protection Motivation Theory (PMT) variables to develop the text messages. The data related to PMT variables and skin cancer preventive behaviors were collected through a questionnaire. Forty-five text messages were designed, pre-tested and sent to the seafarers' phones in the intervention group in 45 days. Both groups were followed up 1 month after the intervention. Data collected in the two stages were analyzed using paired-samples t-test, ANCOVA, and Chi-square tests. RESULTS Following the intervention, the mean scores of adopting skin cancer preventive behaviors (p = 0.001), perceived self-efficacy (p = 0.01), protection motivation (p = 0.02), and fear (p = 0.001) were significantly higher in the intervention group than the control group. There was significant reduction in the response costs (p = 0.05) and perceived rewards (p = 0.01) scores in the intervention group compared with the control group after the intervention. However, there were no significant differences in the perceived vulnerability (p = 0.14), perceived severity (p = 0.09), and response efficacy (p = 0.64) between the two groups after the intervention. CONCLUSIONS The results of the study indicated the effectiveness of mobile phone-based text message intervention for increasing skin cancer preventive behaviors in Iranian seafarers. TRIAL REGISTRATION Iranian Registry for Clinical Trial (the link to trial: https://www.irct.ir/trial/7572 ). Registered 16 July, 2016. Prospectively registered.
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Affiliation(s)
- Esmat Heydari
- Department of Health Education and Health Promotion, Faculty of Public Health, Iran University of Medical Sciences, Shahid Hemmat Highway, Tehran, Iran
| | - Tahereh Dehdari
- Department of Health Education and Health Promotion, Faculty of Public Health, Iran University of Medical Sciences, Shahid Hemmat Highway, Tehran, Iran.
| | - Mahnaz Solhi
- Department of Health Education and Health Promotion, Faculty of Public Health, Iran University of Medical Sciences, Shahid Hemmat Highway, Tehran, Iran
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Roozbahani N, Kaviani AH, Khorsandi M. Path analysis of skin cancer preventive behavior among the rural women based on protection motivation theory. BMC Womens Health 2020; 20:121. [PMID: 32527329 PMCID: PMC7291759 DOI: 10.1186/s12905-020-00978-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 05/24/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Determining the effective factors on the adoption of preventive behaviors capable of reducing the risk of skin cancer is an important step in designing interventions to promote these behaviors. Based on the protection motivation theory, the present study is aimed to conduct a path analysis of skin cancer preventive behaviors in rural women to explore these factors. METHODS In this cross-sectional study, 243 rural women were randomly selected from the west of Iran to receive a valid and reliable questionnaire assessing constructs from the protection motivation theory, as well as demographic information. Fully completed questionnaires were returned by 230 women and the data were analyzed by SPSS 22 and LISREL8.8. RESULTS Concerning skin cancer preventive behaviors, 27.8% of women wore sun-blocking clothing when working under the sun, 21.7% used sunscreen cream, 5.7% wore a cap, and 4.8% used gloves and sunglasses. Protection motivation theory and per capita income explained 51% of motivation variance and 25% of the variance of skin cancer preventive behaviors. The response efficacy construct was the strongest predictor of the motivation of protection (ß = - 0.44, p < 0/001). Per-capita income (ß = - 0.34, p < 0/001) and motivation (ß = - 0.33, p < 0/001) were the strongest predictors of these behaviors. CONCLUSIONS This study showed that protection motivation theory is efficient in predicting skin cancer preventive behaviors and the interventions can be designed and implemented by this theory. Proper planning is also necessary for promoting these behaviors among people with low per-capita income.
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Affiliation(s)
- Nasrin Roozbahani
- Department of Health Education & Promotion, School of Health, Arak University of Medical Science, Arak, Iran.
| | - Abdol-Hossain Kaviani
- Department of Health Education & Promotion, School of Health, Arak University of Medical Science, Arak, Iran
| | - Mahboobeh Khorsandi
- Department of Health Education & Promotion, School of Health, Arak University of Medical Science, Arak, Iran
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Taheri-Kharameh Z, Bashirian S, Heidarimoghadam R, Poorolajal J, Barati M, Rásky É. Predictors of Fall Protective Behaviors Among Iranian Community-Dwelling Older Adults: An Application of the Protection Motivation Theory. Clin Interv Aging 2020; 15:123-129. [PMID: 32103913 PMCID: PMC7008394 DOI: 10.2147/cia.s224224] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 12/20/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose The protection motivation theory (PMT) is a common framework understanding the use of protective behaviors. The aim of this study was to assess the predictors of fall protective behaviors among community-dwelling older adults, Iran. Methods The cross-sectional study was conducted in Qom, Iran, from May to October 2018. Three hundred older people were selected from retirement centers via stratified sampling method. Data were collected by a questionnaire containing items on socio-demographic information, Falls Behavioral (FaB) Scale, and PMT constructs scale. Data analysis was performed using descriptive statistics and structural equation modeling. Results The mean (SD) age of the participants was 64.6 (5.5) and the majority were male (77.7%). Level of perceived fall threat was lower than perceived efficacy of fall protective behaviors. There was a significant relationship between protection motivation and fall protective behaviors (β= 0.515, t-value= 13.650). Coping appraisals (β= 0.409, t-value= 7.352) and fear (β= 0.194, t-value= 2.462) were associated with motivation. The model explained approximately 27% of the variance in fall protective behaviors. The goodness of fit index of 0.48 indicating the model good fit. Conclusion The results indicated that protection motivation, coping appraisals and reasonable fear are considered as the strongest predictors of fall protective behaviors among older people. The results can help health care providers to develop appropriate interventions to fall prevention among older people.
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Affiliation(s)
- Zahra Taheri-Kharameh
- Student Research Committee, Department of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Saeed Bashirian
- Department of Public Health, School of Health, Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Rashid Heidarimoghadam
- Department of Ergonomics, School of Health, Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Jalal Poorolajal
- Research Center for Health Sciences, Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Barati
- Department of Public Health, School of Health, Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Éva Rásky
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria
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Weng Q, Jiang J, Haji FM, Nondo LH, Zhou H. Women's knowledge of and attitudes toward cervical cancer and cervical cancer screening in Zanzibar, Tanzania: a cross-sectional study. BMC Cancer 2020; 20:63. [PMID: 31992250 PMCID: PMC6988189 DOI: 10.1186/s12885-020-6528-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 01/09/2020] [Indexed: 12/09/2022] Open
Abstract
Background Cervical cancer is the most common cancer and the leading cause of cancer death among women in Tanzania. Knowledge of and willingness to receive a cervical cancer screening are important determinants of prevention. This study aimed to describe women’s awareness of cervical cancer and to explore the attitudes toward, acceptability of and barriers to cervical cancer screening (CCS) in Zanzibar. Methods A cross-sectional study was conducted from March to June 2018 involving 1483 women from 10 districts in Zanzibar who responded to questionnaires concerning their general demo-graphic characteristics, screening willingness and awareness of cervical cancer. Chi-square tests, analysis of variance (ANOVA) and stepwise multiple regression were conducted using STATA 15.1 software. Results The average total knowledge score (TKS) was 7.84 ± 5.32 on a 23-point scale. Educational level and family income were positively correlated with the TKS. Previous schistosomiasis history and family genetic disease history were strong predictors of screening willingness. Women were less likely to be screened freely if they had 7 or more deliveries and were unaware of any previous family tumor history. Age and educational level were negatively associated non-free screening willingness, while family income was positively associated; being divorced/widowed or single and being unaware of any previous family tumor history were predictors of screening reluctance, while previous disease history was a strong predictor of non-free screening willingness. Fear of screening and inconvenience were the primary concerns among the Zanzibari interviewees. Compared to the 20–49 age group, more women in the less than 20 and 50 or more age groups thought cervical cancer screening was not necessary. The highest rate of cognitive accuracy in regard to cervical cancer warning signs and risk factors was only 37.76%. Conclusions The findings revealed that knowledge of cervical cancer was poor. Educational level, family income and awareness of previous disease history were significant influencing factors of screening uptake. Specific awareness programs to increase knowledge of cervical cancer and screening willingness should be designed and implemented in the public without delay, especially for younger and elderly women.
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Affiliation(s)
- Qiao Weng
- Department of Obstetrics & Gynecology, Nanjing Drum Tower Hospital, Affiliated to Nanjing University Medical College, Nanjing, 210008, China.,Department of Obstetrics & Gynecology, Drum Tower Clinical Medical College, Nanjing Medical University, Nanjing, 210008, China
| | - Jie Jiang
- Jiangsu Province Center for Disease Prevention and Control, Nanjing, China
| | - Fatma Mrisho Haji
- Department of Obstetrics & Gynecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania
| | - Lamlet Hassan Nondo
- Department of Obstetrics & Gynecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania
| | - Huaijun Zhou
- Department of Obstetrics & Gynecology, Nanjing Drum Tower Hospital, Affiliated to Nanjing University Medical College, Nanjing, 210008, China. .,Department of Obstetrics & Gynecology, Drum Tower Clinical Medical College, Nanjing Medical University, Nanjing, 210008, China.
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