Health beliefs, illness perceptions and determinants of breast screening uptake in Malta: a cross-sectional survey
- PMID: 28482828
- PMCID: PMC5422914
- DOI: 10.1186/s12889-017-4324-6
Health beliefs, illness perceptions and determinants of breast screening uptake in Malta: a cross-sectional survey
Abstract
Background: Women's beliefs and representations of breast cancer (BC) and breast screening (BS) are salient predictors for BS practices. This study utilized the health belief model (HBM) and common-sense model (CSM) of illness self-regulation to explore factors associated with BS uptake in Malta and subsequently, to identify the most important predictors to first screening uptake.
Methods: This cross-sectional survey enrolled Maltese women (n = 404) ages 50 to 60 at the time of their first screening invitation, invited to the National Breast Screening Programme by stratified random sampling, with no personal history of BC. Participants responded to a 121-item questionnaire by telephone between June-September 2015. Data were analyzed using descriptive statistics, chi-square tests and logistic regression.
Results: There is high awareness of BC signs and symptoms among Maltese women (>80% agreement for 7 out of 8 signs), but wide variation about causation (e.g., germ or virus: 38.6% 'agree', 30.7% 'disagree'). 'Fear' was the key reason for non-attendance to first invitation (41%, n = 66) and was statistically significant across all subscale items (p < 0.05). Most items within HBM constructs (perceived barriers; cues to action; self-efficacy) were significantly associated with first invitation to the National Breast Screening Programme, such as fear of result (χ2 = 12.0, p = 0.017) and life problems were considered greater than getting mammography (χ2 = 38.8, p = 0.000). Items within CSM constructs of Illness Representation (BC causes; cyclical cancer timeline; consequences) were also significantly associated, such as BC was considered to be life-changing (χ2 = 18.0, p = 0.000) with serious financial consequences (χ2 = 13.3, p = 0.004). There were no significant associations for socio-demographic or health status variables with uptake, except for family income (χ2 = 9.7, p = 0.047). Logistic regression analyses showed that HBM constructs, in particular perceived barriers, were the strongest predictors of non-attendance to first invitation throughout the analyses (p < 0.05). However, the inclusion of illness representation dimensions improved the model accuracy to predict non-attendance when compared to HBM alone (65% vs 38.8%).
Conclusions: Interventions should be based on theory including HBM and CSM constructs, and should target first BS uptake and specific barriers to reduce disparities and increase BS uptake in Malta.
Keywords: Breast cancer screening; Common-sense model; Factors; Health belief model; Mammography; Uptake.
Figures
Similar articles
-
Predicting reattendance to the second round of the Maltese national breast screening programme: an analytical descriptive study.BMC Public Health. 2019 Feb 13;19(1):189. doi: 10.1186/s12889-019-6507-9. BMC Public Health. 2019. PMID: 30760275 Free PMC article.
-
Lifetime utilization of mammography among Maltese women: a cross-sectional survey.BMC Public Health. 2018 Jan 25;18(1):182. doi: 10.1186/s12889-018-5093-6. BMC Public Health. 2018. PMID: 29370835 Free PMC article.
-
A national cross-sectional study of adherence to timely mammography use in Malta.BMC Cancer. 2018 Mar 27;18(1):346. doi: 10.1186/s12885-018-4278-9. BMC Cancer. 2018. PMID: 29587678 Free PMC article.
-
Knowledge, Beliefs, and Attitudes About Breast Cancer Screening in Latin America and the Caribbean: An In-Depth Narrative Review.J Glob Oncol. 2018 Aug;4:1-25. doi: 10.1200/JGO.18.00053. J Glob Oncol. 2018. PMID: 30156947 Free PMC article. Review.
-
A Systematic Review to Evaluate the Barriers to Breast Cancer Screening in Women with Disability.J Clin Med. 2024 Jun 2;13(11):3283. doi: 10.3390/jcm13113283. J Clin Med. 2024. PMID: 38892994 Free PMC article. Review.
Cited by
-
Perceived barriers and factors influencing uptake of breast cancer screening among women: a population-based cross-sectional study.Sci Rep. 2024 May 29;14(1):12291. doi: 10.1038/s41598-024-62218-5. Sci Rep. 2024. PMID: 38811672 Free PMC article.
-
Factors influencing breast cancer screening practices among women worldwide: a systematic review of observational and qualitative studies.BMC Womens Health. 2024 Apr 27;24(1):268. doi: 10.1186/s12905-024-03096-x. BMC Womens Health. 2024. PMID: 38678224 Free PMC article.
-
Predicting factors for breast cancer screening in Middle Eastern women based on health belief model: a systematic review.J Egypt Natl Canc Inst. 2022 Dec 5;34(1):50. doi: 10.1186/s43046-022-00150-3. J Egypt Natl Canc Inst. 2022. PMID: 36464741
-
Factors promoting breast, cervical and colorectal cancer screenings participation: A systematic review.Psychooncology. 2022 Sep;31(9):1435-1447. doi: 10.1002/pon.5997. Epub 2022 Jul 12. Psychooncology. 2022. PMID: 35793430 Free PMC article. Review.
-
Factors Associated with Screening Mammogram Uptake among Women Attending an Urban University Primary Care Clinic in Malaysia.Int J Environ Res Public Health. 2022 May 17;19(10):6103. doi: 10.3390/ijerph19106103. Int J Environ Res Public Health. 2022. PMID: 35627637 Free PMC article.
References
-
- Ferlay J, Héry C, Autier P, Sankaranarayanan R. Global burden of breast cancer. In: Li CI, editor. Breast cancer epidemiology. Springer; 2010. p. 1–19.
-
- Malta National Cancer Registry . Department of Health Information and Research. 2015.
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical