Women's Decisions Research Articles

Reproductive Autonomy of Women in Rural Bangladesh

Introduction: Reproductive autonomy confers a women's decision and controls over, matters related to contraceptive use, pregnancy, and childbearing. Rural women of Bangladesh have very little control to shape up their family with their minimum empowerment and are lagging behind in the practice of use of family planning methods. Objective: To find out the association among rural women’s reproductive autonomy and contraceptive behavior. Materials and Methods: This cross sectional study was conducted among 284 married rural women of reproductive aged in Mohammadpur upazilla, Magura district of Bangladesh from June 2016 to December 2016 selected through simple random sampling. Mixed method approach was introduced for data collection through face to face interview using pretested questionnaire and focused group discussion. Results: Mean age of the respondents was 26.5±5.7 years with the range of 17 to 45 years. Average monthly family income was 12,561 Taka where majority of the respondents were housewives (83.8%). Education status above primary level was recorded in 23.6%. Early marriage was highly prevalent (77.5%) and mean age of marriage was 17.2±1.7 years. Mean parity was 2.3 per woman. Only 31% of the respondent found to have well reproductive autonomy. Contraceptive use was prevalent in 61.9% of the respondents and only educated women seen to have chance to participate in family planning decision-making. Male participation in contraceptive use was negligible but still men were in main role to give it the final shape to decide about family planning. Women’s reproductive autonomy found to be significantly associated with their contraceptive behavior (p<0.05). Educational status of the women and age gap with the spouse were significantly associated with their reproductive autonomy (p<0.05). Conclusion: Gender issues were prominent in family planning in rural community and rural women accepted the gender disparity in silence. Policy makers and family planning stake holders should put maximum endeavor to improve women’s reproductive autonomy to strengthen their negotiating capacity in fertility control. JAFMC Bangladesh. Vol 17, No 1 (June) 2021: 30-34

Influence of women's decision-making autonomy on antenatal care utilisation and institutional delivery services in Nigeria: evidence from the Nigeria Demographic and Health Survey 2018

BackgroundIn the context of global health priority, understanding the role of power dynamics among women as an important intervention required towards achieving optimum maternal and child health outcomes is crucial. This study examined the influence of women's decision-making autonomy on antenatal care utilisation and institutional delivery services in Nigeria.MethodsThe data for the study were derived from the 2018 Nigeria Demographic and Health Survey and comprised a weighted sample of 20,100 births in the last five years that preceded the survey among married/cohabiting childbearing women. Descriptive and analytical analyses were carried out, including frequency tables and multivariate using the binary logistic regression model.ResultsThe study revealed that despite a large number of women initiating antenatal care visits before 12 weeks of pregnancy (75.9%), far fewer numbers had at least eight antenatal care visits (24.2%) and delivered in a health facility (58.2%). It was established that the likelihood of having at least eight antenatal care visits was significantly increased among women who enjoyed decision-making autonomy on their healthcare (aOR: 1.24, CI: 1.02–1.51) and how their earnings are spent (aOR: 2.02, CI: 1.64–2.48). Surprisingly, women’s decision-making autonomy on how their earnings are spent significantly reduced the odds of initiating antenatal care visits early (aOR: 0.75, CI: 0.63–0.89). Some socio-economic and demographic factors were observed to have a positive influence on quality antenatal care utilisation and delivery in a health facility.ConclusionIn conclusion, women’s decision-making autonomy on their healthcare and how their earnings are spent was significantly found to be protective factors to having eight antenatal care visits during pregnancy. Conversely, women’s autonomy on how their earnings are spent significantly hindered their initiation of early antenatal care visits. There is a need for more pragmatic efforts through enlightenment and empowerment programmes of women to achieve universal access to quality maternal healthcare services in Nigeria.

Development and Psychometric Properties of Pregnant Women’s Decision-making Questionnaire for Choosing a Prenatal Care Provider (CPCP-60): A Research From Southwest of Iran

Background: The selection of a competent prenatal care provider for women is of a major concern. The purpose of this research was to design a questionnaire for pregnant women’s decision-making regarding choosing a prenatal care provider and to assess its psychometric properties. Methods: This study used an exploratory mixed method. In the qualitative phase, a semi-structured individual interview was done with 33 participants in Shiraz, Iran. Based on the outcomes of the previous step and the literature study, the items of the questionnaire were designed in the quantitative phase. Then, the Cosmin criteria were developed to consider the psychometric properties of the questionnaire. In order to examine the validity of the CPCP-60 questionnaire, an exploratory factor analysis was performed. Reliability was assessed by the Cronbach alpha coefficient test and retest. Data were analyzed using the SPSS Version 21. Results: The CPCP-60 questionnaire included 60 items. After the exploratory factor analysis, 4 factors were extracted that expressed 60.52% of the total variance: professional and communication skills, personal traits of prenatal care providers, and characteristics of pregnancy and childbirth centers. The content validity index and the content validity ratio were 0.90 and 0.76, respectively. A Cronbach alpha of 0.941 and a test-retest of 0.951 demonstrated excellent reliability for the CPCP-60 questionnaire. The responsiveness and the interpretability were acceptable. The minimal detectable change (MDC) of the questionnaire (9.70) was less than the minimal important change (MIC) (12.91). Conclusion: Considering the reliability and validity of the CPCP-60 questionnaire, and its compatibility to the culture of the Iranian society, it can be used in clinical research to evaluate the decision-making of pregnant women on choosing a competent prenatal care provider in Iran.

Disrespectful Maternity Care and Abuse During Childbirth: Exploring Perceptions and Experiences of Women Delivered at a Tertiary Hospital in Abakaliki, Nigeria.

An important but little understood component of poor care that women receive during antenatal care and childbirth is disrespect and abuse perpetuated by health workers. Fear of experiencing disrespect and abuse has a negative influence on women's decision to seek care at health facility during pregnancy, labour and delivery. The objective of this study is to determine the prevalence, pattern and predictors of disrespect and abuse during labour and delivery. This is a questionnaire-based cross-sectional study conducted from February 1, 2019, to July 31, 2019 among postnatal women delivered at Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Data were analyzed using SPSS version 22. The prevalence of disrespectful maternity care and abuse was 47.6%. The forms of disrespect and abuse experienced by the participants were detention in the health facility (40.2%), physical abuse (34.1%), non-dignified care (37.2%), non-consented care (20.1%), abandonment of care (18.9%), non-confidential care (25%) and discriminatory care (15.2%). Lack of companionship during delivery (AOR: 7.01, 95%CI: 1.27-4.49; p = 0.007), unbooked status (AOR: 2.37, 95%Cl: 0.31 - 0.92; p = 0.01) and rural residence (AOR = 4.52 95% CI: 2.33-8.75, P<0.0001) were factors associated with disrespect and abuse during childbirth. Disrespectful maternity care and abuse during childbirth among women seeking maternity care is still prevalent (47.6%) in our hospital. Educating health workers on the importance of respectful maternity care would ensure acceptable, quality and dignified care for all women seeking maternity care in our facility.

Disrespect and abusive maternity care and associated factors in the labor and delivery wards of public health facilities in Assosa Zone, Ethiopia

Background: Disrespect &amp; abuse during maternity care significantly affects a woman's decision to look for service and the quality of care she receives. Yet, its burden is not well identified in the developing regions of Ethiopia, specifically in the study area. Methods: Facility-based cross-sectional study design was employed. A total of 437 sampled mothers who attended labor and delivery wards of public health facilities of the Assosa zone were recruited using a systematic random sampling method. Data were collected using a semi-structured interviewer-administered questionnaire. Results: The overall prevalence of D&amp;A was 350 (82.4%). The most reported types of D&amp;A were non?consented care (68.0%), non-confidentiality (35.5%), and physical harm (33.6%). Conclusions: The prevalence of D&amp;A was high. Hence, health facility managers, professionals, and other development partners should aim to make healthcare facilities more client-centered and attuned to the community's needs for safe maternity care. Keywords: Disrespect; Abusive care; Mistreatment; Childbirth; Maternity care.

Impact of Gender-Based Violence (GBV) on Women’s Daily Travel Decisions: Τhe Case Study of Cairo

Gender-based violence (GBV) on public transportation (PUT) is a global phenomenon that many women face daily. This phenomenon impacts women's mobility decisions, ranging from changing trip mode and route to cancelling the trip or even in some cases resigning from work. PUT is a vital component of urban life by providing the means of accessibility and mobility. Violence towards women on PUT often results in negative impacts on women's life, such as loss of opportunities, loss of accessibility, and extra financial burdens. In this research, we discuss the issue in the context of data from a survey collected recently in Cairo, Egypt.

Outcomes of support groups for carriers of BRCA 1/2 pathogenic variants and their relatives: a systematic review.

People tested positive for BRCA1/2 face an increased risk of cancer; to help them cope with the genetic information received, support to BRCA1/2 families should be continued after testing. Nonetheless how such support should be provided has not been established yet. As a potentially valuable option is represented by support groups, the aim of this systematic review was to assess studies exploring the outcomes of support groups for BRCA1/2 carriers. This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42021238416). Peer-reviewed papers published between January 1995 and February 2021 were searched for, using four databases. Among 1586 records identified, 34 papers were reviewed in full-text and eleven were included in the qualitative synthesis of the results. Three themes emerged as major focuses of support groups: risk management decisions, family dynamics and risk communication, and psychosocial functioning. Our findings show that support groups proved helpful in supporting women's decision-making on risk-reducing options. Moreover, during those interventions, BRCA1/2 carriers had the opportunity to share thoughts and feelings, and felt that mutual support through interacting with other mutation carriers help them release the emotional pressure. However, no significant impact was reported in improving family communication. Overall, a high level of satisfaction and perceived helpfulness was reported for support group. The findings suggest that support groups represent a valuable tool for improving BRCA1/2 families care.

Web-Based Training for Nurses on Using a Decision Aid to Support Shared Decision-making About Prenatal Screening: Parallel Controlled Trial.

BackgroundNurses play an important role in supporting pregnant women making decisions about prenatal screening for Down syndrome. We developed a web-based shared decision-making (SDM) training program for health professionals focusing on Down syndrome screening decisions.ObjectiveIn this study, we aim to assess the impact of an SDM training program on nurses’ intention to use a decision aid with pregnant women deciding on prenatal screening for Down syndrome.MethodsIn this 2-arm, parallel controlled trial, French-speaking nurses working with pregnant women in the province of Quebec were recruited by a private survey firm. They were allocated by convenience either to the intervention group (web-based SDM course that included prenatal screening) or to the control group (web-based course focusing on prenatal screening alone, with no SDM content). The primary outcome was the intention to use a decision aid. Secondary outcomes were psychosocial variables of intention, knowledge, satisfaction, acceptability, perceived usefulness, and reaction to the pedagogical approach. All outcomes were self-assessed through web-based questionnaires, including the space for written comments. We used 2-tailed Student t test and Fisher exact test to compare continuous and categorical variables between groups, respectively.ResultsOf the 57 participants assessed for eligibility, 40 (70%) were allocated to the intervention (n=20) or control group (n=20) and 36 (n=18 in each) completed the courses. The mean age of the participants was 41 (SD 9) years. Most were women (39/40, 98%), White (38/40, 95%), clinical nurses (28/40, 70%), and had completed at least a bachelor’s degree (30/40, 75%). After the intervention, the mean score of intention was 6.3 (SD 0.8; 95% CI 5.9-6.7) for the intervention group and 6.0 (SD 1.2; 95% CI 5.42-6.64) for the control group (scale 1-7). The differences in intention and other psychosocial variable scores between the groups were not statistically significant. Knowledge scores for SDM were significantly higher in the intervention group (79%, 95% CI 70-89 vs 64%, 95% CI 57-71; P=.009). The intervention was significantly more acceptable in the intervention group (4.6, 95% CI 4.4-4.8 vs 4.3, 95% CI 4.1-4.5; P=.02), and reaction to the pedagogical approach was also significantly more positive in the intervention group (4.7, 95% CI 4.5-4.8 vs 4.4, 95% CI 4.2-4.5; P=.02). There was no significant difference in overall satisfaction (or in perceived usefulness). Furthermore, 17 participants (9 in the intervention group and 8 in the control group) provided written comments on the intervention.ConclusionsThis study focuses on web-based nursing education and its potential to support pregnant women’s decision-making needs. It shows that nurses’ intention to use a decision aid to enhance SDM in prenatal care is high, with or without training, but that their knowledge about SDM can be improved with web-based training.International Registered Report Identifier (IRRID)RR2-10.2196/17878

Financial access and women's role in household decisions: Empirical evidence from India's National Rural Livelihoods project

Government programs supporting self help groups (SHGs) generally target women on the assumption that doing so enhances women's decision-making. The empirical evidence, however, is mixed. We advance and test one explanation: the loan amounts offered by most SHGs may be too small to impact women. Our analysis is based on SHGs developed under India's National Rural Livelihoods Mission, a program that supported both small loans from internal savings and larger loans through Community Investment Funds (CIFs). Exploiting variation in their phasing and amount, we document a large effect of CIFs on women's decision-making and on intra-household allocations.

The disabling effects of enabling social policies on organisations’ human capital development practices for women

AbstractPaid parental leave and externally provided childcare are social policies designed to enhance parents' labour force participation. These policies influence not only men's and women's decisions regarding their labour market activity but also organisational decision makers' (ODMs) expectations about their employees' availability to work and thus, their willingness to invest in their employees' human capital. Using a sample of over 13,000 individuals from 19 countries, we investigate the interaction between gender and social policies on human capital development practices. In line with statistical discrimination theory, which suggests that ODMs hold different expectations about female and male productivity, we find that paid parental leave and externally provided childcare are negatively associated with the provision of human capital development for women but not for men.

Exploring Black Women's Pathways to Motherhood Within a Reproductive Justice Framework.

Amidst the increasing push to address racial disparities in maternal health equity, fewer studies have considered Black women's perspectives on their needs, concerns, and priorities regarding family planning care. Such evidence might help address the lack of support and information that many Black women report in patient-provider encounters, and broaden empirical knowledge on the contextual factors that influence Black women's reproductive decisions. In the present qualitative study, we explored Black women's pathways to motherhood within a reproductive justice framework. We drew on individual, semi-structured interview data from 31 Black mothers (25-50years, Mage = 35years) across the United States. Using consensual qualitative research methods, we elaborated on three themes: (1) intentional family planning, (2) unintended pregnancy, and (3) othermothering. The findings challenge deficit-based stereotypes of Black mothers' reproductive choices and illuminate how health practitioners can facilitate humanizing conversations that prioritize Black women's family planning goals and decision-making.

Women Decision-Making and Responsibility-Taking of Criminal Lifestyle: The Israeli Case

This study aims to investigate patterns of decision-making and responsibility-taking as opposed to the compulsion process selection of a criminal lifestyle among women in prison. A life story approach and semi-structured interviews sampling 30 Israeli women in prison during their first imprisonment were used. Using a mixed-method, results revealed that most of the participants claimed full or partial self-responsibility for having engaged in a criminal lifestyle or for the offense of which they had been convicted. This figure was consistent when the participants were divided by age of first offense or a history of abuse. The results support the need for an integrated approach explaining women’s criminal paths, including gender-specific as well as gender-neutral factors. The conclusion is that responsibility-taking for a criminal act should be one of the factors in intervention programs for women with delinquent behavior, regardless of whether there is a history of victimization or not.

Married women's decision-making autonomy on contraceptive use and its associated factors in Ethiopia: A multilevel analysis of 2016 demographic and health survey.

Introduction:Women’s decision-making autonomy has a positive effect on the scale-up of contraceptive use. In Ethiopia, evidence regarding women’s decision-making autonomy on contraceptive use and associated factors is limited and inconclusive. Therefore, this study was intended to assess married women’s decision-making autonomy on contraceptive use and associated factors in Ethiopia using a multilevel logistic regression model.Methods:The study used data from the 2016 Ethiopia Demographic and Health Survey that comprised of a weighted sample of 3668 married reproductive age women (15–49 years) currently using contraceptives. A multilevel logistic regression model was fitted to identify factors affecting married women’s decision-making autonomy on contraceptive use. Akaike’s information criterion was used to select the best-fitted model.Results:Overall, 21.6% (95% confidence interval = 20.3%–22.9%) of women had decision-making autonomy on contraceptive use. Community exposure to family planning messages (adjusted odds ratio = 2.22, 95% confidence interval = 1.67–3.05), media exposure (adjusted odds ratio = 2.13, 95% confidence interval = 1.52–3.23), age from 35 to 49 years (adjusted odds ratio = 2.09, 95% confidence interval = 1.36–4.69), living in the richer households (adjusted odds ratio = 1.67, 95% confidence interval = 1.32–3.11), and visiting health facility (adjusted odds ratio = 2.01, 95% confidence interval = 1.34–3.87) were positively associated with women’s decision-making autonomy on contraceptive use. On the contrary, being Muslim (adjusted odds ratio = 0.53, 95% confidence interval = 0.29–0.95), being married before the age of 18 years (adjusted odds ratio = 0.33, 95% confidence interval = 0.12–0.92), and residing in rural residence (adjusted odds ratio = 0.48, 95% confidence interval = 0.23–0.87) were negatively associated with women’s independent decision on contraceptive use.Conclusion:Less than one-fourth of married reproductive age women in Ethiopia had the decision-making autonomy on contraceptive use. Media exposure, women’s age, household wealth, religion, age at marriage, visiting health facilities, community exposure to family planning messages, and residence were the factors associated with women’s decision-making autonomy on contraceptive use. The government should promote women’s autonomy on contraceptive use as an essential component of sexual and reproductive health rights through mass media, with particular attention for adolescent women, women living in households with poor wealth, and those residing in rural settings.

Influenza vaccination among pregnant women in two hospitals in Sydney, NSW: what we can learn from women who decline vaccination.

Pregnant women are recognised as being at risk of serious illness from influenza. Despite this, and longstanding national recommendations for vaccination in pregnancy, vaccine uptake remains suboptimal. This study aims to determine factors associated with women declining influenza vaccination in pregnancy. We surveyed pregnant women from antenatal clinics at two Sydney hospitals as part of an evaluation of the New South Wales (NSW) Health 2017 influenza vaccination in pregnancy campaign. Factors associated with a woman's decision to decline influenza vaccination were assessed using Pearson's chi-square test and multivariable logistic regression. Among 642 women surveyed, 58% self-reported influenza vaccination during pregnancy and 19% reported they had declined vaccination. Factors associated with a decision to decline vaccination included lack of a recommendation from a maternity care provider (adjusted odds ratio [aOR] 6.06; 95% confidence interval [CI] 3.50, 10.50), recommendation against vaccination (aOR 4.17; 95% CI 2.07, 8.38), having never previously been vaccinated for influenza (aOR 2.75; 95% CI 1.64, 4.59) and, among third-trimester women, not having been vaccinated for pertussis (aOR 2.55; 95% CI 1.32, 4.89). On univariate analyses, women who declined vaccination were more likely to disagree or feel uncertain about vaccine safety or effectiveness compared with women who chose to be vaccinated. Recommendations from maternity care providers remain key to a woman's decision to be vaccinated for influenza during pregnancy. Time should be allocated for vaccine discussions early in pregnancy as part of routine care. Continued efforts are needed to improve messaging to pregnant women on the benefits, safety and efficacy of influenza vaccination.

Supplemental Material for No Evidence for a Causal Effect of Exogenous Testosterone on Risky Decision-Making in Women: An Experiment and Meta-Analysis

Supplemental Material for No Evidence for a Causal Effect of Exogenous Testosterone on Risky Decision-Making in Women: An Experiment and Meta-Analysis

Media Framing Women’s Participation in Decision-Making in East Africa: A Case of South Sudan Women in Decision Making

This research was to assess the media framing of women in decision-making. It is common that when the relationship between women, politics, and media is explored, researchers typically concentrate on the political elite. The finding indicated that the media covering women’s participation in parliament/executive proceedings is low compared to their men counterparts’ coverage while depending on proposal, development, and passage of legislation into law and other decisions that affect their lives from the ones on the street doing their private activities to the general issues with perspective examples from Sudan and Kenya. Given the difficulties faced by women in media portray women trying to enter decision-making life differently, the assumption that women can do better than men in decision making including in politics is perfectly plausible.

Involvement of Farm Women in Decision Making of Dairy Farm Activities in Krishna District of Andhra Pradesh

An investigation was conducted to study the involvement of farm women in decision making of different dairy farm activities in Krishna district of Andhra Pradesh .A total of 225 farm women were selected based on their land holding capacity. The study revealed that majority of the women in the study area took part in decision making on most of the dairy farm activities such as choosing the breed of the animal (68%), taking loans (79.11), purchase/ sale of animals (81.33), insurance of animals (77.77%), culling of animals (69.33%), construction of sheds (70.22%), farm expansion (72%), feeding of animals (77.33%), breeding practices ( 66.22%) health care of animals (87.55%), management of new born calves ( 88%), pregnant (87.11%) and sick (86.22%) animals, utility of dung(59.11%), adoption of scientific management practices( 55.55%) and sale of milk(73.33%), whereas majority (69.33%) of the women in study area were taking self decision regarding preparation of milk products. The study showed that among the landless, small and medium farmer categories the participation in decision making regarding choosing the breed of animal(74.66%), purchase or sale of animals(86.66%),insurance of animals (86.65%), culling of uneconomic animals (81.33%), construction of sheds (82.66%), farm expansion (76%), purchase of roughages and feeding of animals (86.66%), breeding practices (81.33%), utility of dung (69.33%) and adoption of scientific management practices (62.66%) was more in landless women compared to small and medium farmer categories.

SO CLOSE BUT YET SO FAR: SOUTH AFRICAN WOMEN’S CHALLENGES IN A POST-COLONIAL LOCAL GOVERNMENT

This study contributes to the current body of knowledge that suggests, there has been limited progress in decision-making between women and men, which hinders the use of women's skills, suggesting that very little has changed for women. There is an overwhelming amount of literature on gender and decision making, which has led to an increase in sufficient conceptual and theoretical frameworks. However, this study contributes to the rather limited literature on progress in women's decision-making in South Africa’s local government. This qualitative study presents the context of women in leadership positions in local government. Secondly, the study presents the barriers faced by women in leadership positions. Finally, the study critically analyzes and concludes on the challenges that hinder the empowerment of women in leadership positions in South Africa at the grassroots level. The findings of the study suggest that women are lagging in decision-making due to organizational structures attributable to the presence of dominant behaviors in the workplace that can be linked to patriarchy and male dominance which exclude and marginalize women. Furthermore, gender mainstreaming policies are weakly implemented in South Africa’s local government institutions.

The effect of motivational interviewing on self-efficacy and decision-making about type of delivery in primigravid women: A randomized clinical trial

Background: Childbirth self-efficacy is one of the most important factors affecting pregnant women's decision about the type of delivery. Low childbirth self-efficacy can lead to unnecessary cesarean sections (CS). Objective: This study aimed to examine the effectiveness of motivational interviewing (MI) on self-efficacy and the decision about the type of delivery in primigravid women requesting elective CS. Methods: A randomized controlled trial was conducted on 120 primigravid women at 28–31 weeks of gestation. The participants were selected through multistage sampling and randomly assigned into an intervention and a control group, each 60. The intervention group received four 90-min sessions of MI, whereas the control group received routine prenatal care. The Childbirth Self-Efficacy Inventory, and the Decision-Making Checklist were used to collect data before and 4 weeks after the intervention. Chi-square, independent-samples t-test, and paired t-test were used for data analysis. Results: The mean baseline childbirth self-efficacy score was 63.68 ± 18.91 in the intervention group and 71.58 ± 25.66 in the control group (P = 0.57). The mean score increased significantly in the intervention group at the end of the study (P = 0.001), whereas it decreased significantly in the control group (P = 0.003). Although all women preferred CS at baseline, 91.7% of the intervention group and 28.3% of the control group applied for normal delivery at the end of the study (P < 0.001). Conclusions: MI can increase childbirth self-efficacy and can be used by midwives and other health-care providers to encourage pregnant women to choose normal delivery.

Women's decision to adopt or not adopt cervical cancer screening: Application of precaution adoption process model as the theoretical framework.

The cancer is uncontrolled growth and spread of cells that affect almost all parts of the body. One of the most prevalent cancers in the female genital system is cervical cancer. The aim of present study was to determine the effect of educational intervention using the Precaution Adoption Process Model (PAPM) on cervical cancer screening behavior (Pap smear test) among women. In this interventional study that was done in Karaj health centers (2016), women (aged 15-49 years) were in the third stage of behavior change process based on PAPM randomly assigned to experimental and control groups. The data collection tool was a PAPM-based questionnaire whose validity and reliability were confirmed. Gathered data were analyzed using statistical software SPSS 16 and statistical tests (t-test, repeated measures analysis of variance, and Wilcoxon, Chi-squared, Fisher's exact, and Mann-Whitney tests). The result showed that the stages of the decision-making process between the two groups were significantly different at the time immediately and 2 months after the intervention (P > 0.001). Also the results of the intervention based on the health belief model health belief model (HBM) components, regarding variables of knowledge, perceived susceptibility, perceived benefits, perceived barriers, and subjective norms, the mean scores in the experimental group were significantly different between the three sections before, immediately, and 2 months after the intervention (P > 0.001). This study provides hints how persons could be influenced to move from the "Deciding about action" positions into to the stages of decided to act, adoption, and maintenance for promoting cervical cancer screening behavior.