Abstract
Background Cervical cancer is a major public health problem in many developing countries. Despite the value of screening to prevent morbidity and mortality from cervical cancer, little available literature shows early detection and treatment to be limited in Ethiopia. The aim of this study was to determine the magnitude of and identify factors associated with women's intention to screen for cervical cancer using the theory of planned behavior. Methods A community-based cross-sectional study design supplemented with a qualitative approach was employed. Using multistage sampling, a total of 821 women were used in the study. An interviewer-administered survey questionnaire was used to collect quantitative data, whereas purposively selected 12 female health care providers were included in in-depth interviews. Descriptive statistics and simple and multiple binary logistic regression analysis were used to determine the magnitude of women's intention, identify associated factors, and explore barriers for intention to cervical cancer screening among Debre Berhan women, Ethiopia. The statistical association was determined at a P value of less than 0.05. Moreover, thematic analysis was used to search the hindrances of women's intention to screen for cervical cancer. Results The median age of women who participated in this study was 39 years with IQR of 35 to 42 years. Three hundred sixty-one (361, 45.3%) of women had an intention to screen for cervical cancer within three months from the date of the interview. Positive attitude towards cervical cancer screening (AOR = 6.164; 95% CI: 4.048, 9.387), positive subjective norm (AOR = 2.001; 95% CI: 1.342, 2.982), and higher perceived behavioral control (AOR = 7.105; 95% CI: 4.671, 10.807) were predictors of the women's intention to screen for cervical cancer. The qualitative finding revealed that women did not like to be screened for cervical cancer because they thought that procedure pinch the cervix and it may result in perforating the uterus that would expose them for infertility. In addition, the qualitative findings supported quantitative results, where the constructs of the theory of planned behavior play an essential role in the betterment of women's intention. Conclusion This study showed that women's intention to screen for cervical cancer was low. Positive attitudes towards cervical cancer screening (CCS), subjective norms, and perceived behavioral control were predictors of women's intention to screen for cervical cancer. Thus, efforts should be exerted to improve the attitude of women involving influential people, which could improve women's intention for cervical cancer screening. Moreover, behavioral change communication focusing on the constructs of the theory of planned behavior is crucial.
Highlights
Cervical cancer is a major public health problem in many developing countries
Respondents who had a positive attitude towards cancer screening (CCS) were 6 times (AOR = 6:164; 95% confidence intervals (CI): 4.405, 9.387) more likely to have the intention to screen for cervical cancer than respondents who had a negative attitude towards CCS
Respondents who had positive subjective norms were 2 times (AOR = 2:001; 95% CI: 1.342, 2.982) more likely to have intention compared to those with a negative subjective norm
Summary
Cervical cancer is a major public health problem in many developing countries. The aim of this study was to determine the magnitude of and identify factors associated with women’s intention to screen for cervical cancer using the theory of planned behavior. The qualitative findings supported quantitative results, where the constructs of the theory of planned behavior play an essential role in the betterment of women’s intention. Cervical cancer is the second most common type of woman cancer with an estimated 530,000 new cases and 270,000 deaths every year [1] In developing countries, it is a major public health problem where 85% of new cases and 87% of deaths take place. There were an estimated 7,095 new cases of cervical cancer and 4,732
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