Abstract
Purpose: This study utilizes Protection Motivation Theory as a theoretical framework to predict women’s intentions to go for mammogram screening in Singapore, a country with the highest incidence of breast cancer in Asia. Materials and Methods: A questionnaire centered on the theoretical predictive model of early detection behavior was developed to examine the hypothesized relationships. Data was collected from Singaporean women between 40 to 69 years of age. The data was analyzed using hierarchical regression. Results: Amongst all predictors tested, we found that Perceived Severity influences protection motivation (Beta=.346, p=.033), whereas Perceived Vulnerability has little effect on protection motivation (Beta= .075, p=. 355). There is also a significant relationship between Self-Efficacy and protection intention (Beta= .373, p<.001). However, contrary to expectations, neither Response Cost (Beta=.136, p=.101) nor Physical Cost (Beta=-.051, p=-.036) was related to protection intention. Conclusions: Our findings indicate that coping appraisal variables are more significantly associated with protection motivation than threat appraisal variables. In particular, self-efficacy was found to be the strongest predictor of breast cancer screening intentions, whereas response cost and physical cost were found to have little effect. This implies that breast cancer screening motivators should communicate the ease of undergoing the procedure and other confidence building messages. Implications for health education and policy are discussed.
Highlights
Breast cancer is currently the most common malignancy among women in both developed and developing regions of the world
Our findings indicate that coping appraisal variables are more significantly associated with protection motivation than threat appraisal variables
Self-efficacy was found to be the strongest predictor of breast cancer screening intentions, whereas response cost and physical cost were found to have little effect
Summary
Breast cancer is currently the most common malignancy among women in both developed and developing regions of the world. The incidence of breast cancer is higher in developed countries, the majority of mortalities occur in low-income areas where many cases are diagnosed at late stages [1]. Breast cancer has become an increasing burden in Asian countries, it has typically been perceived as a “Western” disease. The rate of breast cancer in Asian women below the age of 40 is higher than in Western women of the same age [2]. Singapore has the highest Age-Standardized Rate (ASR) of breast cancer in Asia [3]. In women below 50 all three major ethnic groups (Chinese, Malay, and Indian) are affected [7]. Indians living in Singapore have the highest breast cancer rate, and the ASR is the lowest among Malays [5]
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