Prediction of the factors influencing cervical cancer screening using the extended protection motivation model: A path analysis

Abstract

Background and aims: Cervical cancer is one of the most common cancers of the female reproductive system. Despite the importance of cervical cancer screening in early detection, the uptake of screening is poor. The present study aimed to predict the factors that influence the cervical cancer screening behavior of Iranian women visiting health centers. Methods: This cross-sectional study was performed on 661 women of reproductive age referred to health centers in Karaj, Iran, in 2021, who were selected by convenience sampling. Data collection was performed with a multi-sectional questionnaire designed to collect information about demographic characteristics and constructs of Protection Motivation Theory (PMT) and emotional support. Data analysis was performed using SPSS version 24.0, and AMOS version 24. Results: The mean age of the participants was 38.2±13.77. Most of the participants had a high school diploma and a moderate socioeconomic status. The results showed the direct effect of intention on behavior (β=0.54) and the direct effect of fear on intention (β=-0.66). Perceived self-efficacy had the greatest indirect effect on behavior through intention (β=0.34). All protection motivation constructs except response cost (β=0.06) showed a significant effect on cervical cancer screening behavior. Model fit indices showed the good capability of the extended protection motivation model to predict cervical cancer screening behavior. Conclusion: Perceived self-efficacy is the strongest predictor of cervical cancer screening behavior, and emotional support affects this behavior through self-efficacy and intention. Therefore, it is recommended to pay attention to these factors when designing and planning educational interventions for improving cervical cancer screening behavior.