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Hamdiui N, Marchena E, Stein ML, van Steenbergen JE, Crutzen R, van Keulen HM, Reis R, van den Muijsenbergh METC, Timen A. Decision-making, barriers, and facilitators regarding cervical cancer screening participation among Turkish and Moroccan women in the Netherlands: a focus group study. ETHNICITY & HEALTH 2022; 27:1147-1165. [PMID: 33412893 DOI: 10.1080/13557858.2020.1863921] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 12/09/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES: Whether the lower Dutch cervical cancer (CC) screening participation of Turkish- and Moroccan-Dutch women is based on informed decision-making is unknown. Our aim was to explore how and why Turkish- and Moroccan-Dutch women decide to participate or not in the current Dutch CC screening programme as well as to learn their perceptions on self-sampling.DESIGN: Six focus group discussions were conducted between March and April 2019 with Turkish (n = 24) and Moroccan (n = 20) women in the Netherlands, aged 30-60 years. Questions were based on an extended version of the Health Belief Model. Discussions were transcribed verbatim and thematically analysed.RESULTS: Participants lacked knowledge about CC and its screening, and seemed to be unaware of the cons of CC screening. Perceived barriers for screening were lack of a good command of the Dutch language, having a male general practitioner, fatalism, shame and taboo, and associations of CC with lack of femininity and infertility. Other barriers were fear of the test result, cancer, suffering, death, and leaving their children behind after death. Perceived facilitators were a high perceived severity of disease, social support, and short procedure time. An additional religious facilitator included the responsibility to take care of one's own health using medical options that God provided. Participants had low self-efficacy expectations towards performing correct self-sampling.CONCLUSIONS: Although participants' informed-decision making seems to be limited, this study showed that women do not only consider factual medical information, but also practical, emotional, cultural, and religious aspects prior to deciding to screen or not. Information materials should be tailored to these aspects, as well as translated to appropriate languages due to lack of a good command of the Dutch language. Self-efficacy expectations towards performing correct self-sampling should be enhanced to promote informed CC screening participation among Turkish- and Moroccan-Dutch women.
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Affiliation(s)
- Nora Hamdiui
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
| | - Eline Marchena
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Mart L Stein
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Jim E van Steenbergen
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
- Centre for Infectious Diseases, Leiden University Medical Centre, Leiden, Netherlands
| | - Rik Crutzen
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Hilde M van Keulen
- Child Health, Netherlands Organization for Applied Scientific Research (TNO), Leiden, Netherlands
| | - Ria Reis
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, Netherlands
- The Children's Institute, School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
| | - Maria E T C van den Muijsenbergh
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
- Pharos: Dutch Centre of Expertise on Health Disparities, Program Prevention and Care, Utrecht, Netherlands
| | - Aura Timen
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
- Athena Institute for Research on Innovation and Communication in Health and Life Sciences, VU University Amsterdam, Amsterdam, Netherlands
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Dsouza JP, Broucke SVD, Pattanshetty S, Dhoore W. A comparison of behavioural models explaining cervical cancer screening uptake. BMC Womens Health 2022; 22:235. [PMID: 35710374 PMCID: PMC9204900 DOI: 10.1186/s12905-022-01801-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 05/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cervical cancer represents a very high burden of disease, especially in Low- and Middle-income economies. Screening is a recommended prevention method in resource-poor settings. Cervical cancer screening (CCS) uptake is influenced by various psycho-social factors, most of which are included in behavioural models. Unlike demographic characteristics, these factors are modifiable. While few studies have compared these models in terms of their capacity to predict health behaviour, this study considers three health behaviour theories to assess and compare the predictors of CCS behaviour and intention. METHODS A survey was conducted among 607 sexually active women in the South Indian state of Karnataka. Data was collected regarding socio-demographic factors, health literacy, knowledge on CCS, and the socio-cognitive factors related to CCS that are represented in the Health Belief Model (HBM), Theory of Planned Behaviour (TPB) and Theory of Care-Seeking Behaviour (TCSB). Logistic regression analyses tested to what extent each of the theoretical models explained cervical cancer screening (CCS) intention and regular screening behaviour, comparing the variance explained by each of the models. RESULTS CCS intention was best explained by the TPB, followed by the HBM. Of the constructs included in these models, positive attitude towards the screening procedure and perceived benefits contributed most significantly to screening intention, followed by fear, anxiety or embarrassment related to the disease or screening procedure, and context specific barriers. CONCLUSION Health behavioural models such as the TPB and HBM can help to identify the main socio-cognitive factors explaining the intention of women to participate in CCS. As such, they can inform interventions to target specific determinants of screening intention and behaviour, and enhance their effectiveness by addressing women's screening attitude, perceived benefits, and emotions as well as reducing context specific barriers to screening.
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Affiliation(s)
- Jyoshma Preema Dsouza
- School of Public Health, Psychological Research Institute, Université Catholique de Louvain, 1348, Ottignies Louvain-la-Neuve, Belgium.
| | - Stephan Van den Broucke
- School of Public Health, Psychological Research Institute, Université Catholique de Louvain, 1348, Ottignies Louvain-la-Neuve, Belgium
| | - Sanjay Pattanshetty
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, 576104, India
| | - William Dhoore
- School of Public Health, Psychological Research Institute, Université Catholique de Louvain, 1348, Ottignies Louvain-la-Neuve, Belgium
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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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Evcili F, Bekar M. Prevention of gynecological cancers: the affecting factors and knowledge levels of Turkish women. JOURNAL OF HEALTH RESEARCH 2020. [DOI: 10.1108/jhr-07-2019-0171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
PurposeGynecological cancers are preventable and treatable diseases in case of early diagnosis. However, lack of knowledge is one of the factors preventing women from benefiting from early diagnosis. Increasing women's knowledge of gynecological cancers contributes to improving the health of both women and the community. The purpose of this research study was to determine the affecting factors and knowledge level of Turkish women-related gynecological cancer prevention.Design/methodology/approachThis was a cross-sectional descriptive study and was carried out at a state hospital's outpatient clinic between May and June 2019. The sampling included 496 women who are not diagnosed with gynecological cancer in the individual or in the family. Data were collected using the personal information form and Gynecological Cancer Prevention Information Scale (GCPIS). Data were evaluated using the SPSS 22.0 software program. Frequencies, mean and standard deviation were used for the descriptive variables. For the data that met the parametric conditions, those with two groups were analyzed using independent samplest-tests and those with more than two groups were analyzed usingF-test.FindingsIn this study, the GCPIS total mean score of women was found 16.22 ± 8.21 (min: 0, max: 35). A statistically significant difference was found between the women's level of knowledge according to the age group of the participants, education level, economic status perception, regular pap-smear test, regular vulva examination and getting information about prevention from gynecologic cancers (p < 0.05).Research limitations/implicationsThis study was conducted on a group of Turkish women and cannot be generalized to other cultures.Practical implicationsThis study can be beneficial for determining the Turkish women's knowledge levels about gynecological cancers of women and for providing data for health education programs planning to be created.Social implicationsThe data of this study can be used to improve women's knowledge and examination skills of gynecological cancers. Thus, the quality of life of women can be improved.Originality/valueHealthcare professionals can play vital roles in presenting needed knowledge about gynecological cancers and raising awareness in women. It is extremely important for women to be informed about gynecological cancers for prevention of gynecological cancers and health improvement.
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Yeo C, Fang H, Thilagamangai, Koh SSL, Shorey S. Factors affecting Pap smear uptake in a maternity hospital: A descriptive cross-sectional study. J Adv Nurs 2018; 74:2533-2543. [PMID: 29920737 DOI: 10.1111/jan.13769] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 05/24/2018] [Indexed: 11/30/2022]
Abstract
AIM To understand factors that influence women's decisions to go for Pap smears. BACKGROUND Globally, cervical cancer is the fourth most common cancer among women. In Singapore, cervical cancer is on the rise and has been found to be the eighth highest cause of death among women. Research has shown that regular screening for cervical cancer with Pap smear reduces cervical cancer-related mortality. However, Pap smear awareness is still limited and its uptake in Singapore is highly opportunistic, requiring the need for a deeper understanding of the factors that influence Pap smear uptake among women in Singapore. DESIGN A descriptive cross-sectional study design was used. METHODS Convenience sampling was used to recruit 350 participants (postnatal women of at least 21 years old) from a local maternity hospital. Data were collected using validated questionnaires. Logistic regression was used to analyse the data. RESULTS Demographic factors, such as age, ethnicity and religion, as well as women's beliefs about the effectiveness of Pap smear in detecting cervical cancer, the desire to discover health problems early and considering Pap smear to be painful, were found to be factors significantly influencing Pap smear uptake. Healthcare professionals need to be mindful of these factors to address women's needs to encourage women to go for Pap smears. CONCLUSION Various factors were found to influence Pap smear uptake. Future interventions can take these factors into account for increasing Pap smear awareness.
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Affiliation(s)
- Celestine Yeo
- Division of Nursing, KK Women's and Children's Hospital, Singapore
| | - Huang Fang
- Division of Nursing, KK Women's and Children's Hospital, Singapore
| | - Thilagamangai
- Division of Nursing, KK Women's and Children's Hospital, Singapore
| | - Serena Siew Lin Koh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,National University Health System, Singapore
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