article · Journal of Cancer Epidemiology
Cervical cancer remains a significant public health concern in developing regions, yet early detection and screening uptake in Ethiopia remain constrained. An assessment of 821 women and 12 female healthcare providers in Debre Berhan examined the drivers of screening intention through the framework of the theory of planned behaviour. Overall, 45.3 percent of the surveyed women expressed an intention to undergo screening within three months. Stronger screening intentions were significantly linked to positive attitudes, favourable subjective norms, and higher perceived behavioural control. Qualitative responses highlighted critical misconceptions deterring participation, including fears that the procedure pinches the cervix, potentially perforates the uterus, and causes infertility. Addressing these specific concerns through targeted behavioural change communication and engaging influential community figures may help dispel procedural anxieties and improve screening participation across the community.
Cervical cancer screening significantly reduces morbidity and mortality, but low uptake undermines these health benefits. Identifying behavioural barriers and specific procedural fears, such as concerns over infertility, enables public health teams to design culturally informed education campaigns. Engaging trusted community members can normalise preventative care and encourage more women to access life-saving early detection services.
The abstract does not indicate a commercial application pathway or product development opportunity. The findings are primarily applied public health research intended for healthcare planners, community health programmes, and policymakers seeking to design targeted behavioural change and educational interventions in clinical and community settings.
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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 <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mi>P</mml:mi></mml:math> 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 (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mtext>AOR</mml:mtext><mml:mo>=</mml:mo><mml:mn>6.164</mml:mn></mml:math>; 95% CI: 4.048, 9.387), positive subjective norm (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:mtext>AOR</mml:mtext><mml:mo>=</mml:mo><mml:mn>2.001</mml:mn></mml:math>; 95% CI: 1.342, 2.982), and higher perceived behavioral control (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M4"><mml:mtext>AOR</mml:mtext><mml:mo>=</mml:mo><mml:mn>7.105</mml:mn></mml:math>; 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.
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DOI: 10.1155/2020/3024578
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