Communication strategies to enhance health behaviour of women in Saudi Arabia

Breast cancer is one of the most common causes of death among women in Saudi Arabia (Gonzales, Analita, Alzaatreh, Mari, Saleh, & Alloubani, 2018). Statistics from the Saudi Health Council revealed a dramatic increase in breast cancer in a thirteen-year period. Reported breast cancer increased from 10.2% in 2000 to nearly 29% in 2013, with most cases occurring in Saudi women aged between 30 and 44 years (Abolfotouh et al., 2015). Early detection of breast cancer, however, can be lifesaving. Indeed, the prognosis for breast cancer strongly depends on the stage at which it is detected (LaRosa, Alexander, & Bader, 2016). While breast cancer screening (BCS) is the most effective way to identify tumours, the practice is not widespread in Saudi Arabia. This study aimed to analyse the factors that could contribute towards effective communication strategies to increase the early detection of breast cancer among Saudi women. The study investigated factors with the most promising effects on adoption of early detection of breast cancer among Saudi women. It examined relationships between Saudi women’s early detection of breast cancer and other variables, including the following: awareness campaigns, healthcare systems, information, motivation, and behaviour skills related to breast cancer screening (BCS). The study evaluated the different effects of messages in BCS communication for Saudi women. The thesis also examined the influences of demographic factors on Saudi women’s early detection of breast cancer such as age, education level, marital status and regions. The thesis concluded that a proper understanding of the fundamental factors affecting adoption of early detection of breast cancer can significantly increase BCS behaviour among Saudi women. This thesis presented a conceptual model to identify certain relationships between and among social marketing principles and the IMB model to predict an increased adoption rate of 2 early detection of breast cancer among Saudi women. It employed two social marketing principles, place and promotion (Andreasen, Alan R, 2006) and the information-motivation - behavioural skills (IMB) model (Fisher, Jeffrey D., Fisher, Bryan, & Misovich, 2002). Following a comprehensive review of the related literature, the thesis proposed ten hypotheses to be tested. To address the research goal, this study employed a sequential mixed methods approach, consisting of qualitative and quantitative methods. Firstly, qualitative data were gathered via in-depth interviews with 10 Saudi Arabian women. Thematic analysis was then used to analyse the data. In the second stage, which consisted of a quantitative study, data were collected from 266 female Saudi participants via an online survey. The survey data were analysed using SPSS and the model was evaluated using “SmartPLS”. A questionnaire, developed as a result of the study findings, is a valuable contribution of this research to future researchers. The creation of newly validated instruments (Bhattacherjee, 2012) combines concepts that affect Saudi women’s BCS knowledge, motivation, attitudes, skills, awareness and healthcare services in Saudi Arabia that relate to adoption of BCS. Application of the social marketing mix elements particularly promotion and place, were applied to assess the gap between Saudi women’s expectations and perceptions of practising BCS. The study’s findings supported the suggestion by Cheng, Kotler, and Lee (2010) that applying social marketing mix could increase the possibility of “a truly successful social marketing campaign” (p. 9). This study revealed that awareness campaigns and healthcare have a significant positive effect on information, motivation, and behaviour skills regarding Saudi women’s BCS. The results emphasised the importance of incorporating social marketing mix elements into efforts to encourage women to undergo BCS, which can offer 3 insights into communication strategies that would improve health behaviour intervention offered to Saudi women regarding sensitive issues, such as early breast cancer detection. The research model in this study also offered new insights that can promote a better understanding of initiatives that could increase the adoption of early BCS among Saudi women. Findings supported the IMB model by Fisher, Jeffrey D. et al., (2002), premised on the fact that “information, motivation, and behavioural skills are fundamental determinants of the performance of a particular health behaviour” (p. 777). IMB factors contributed significantly to predicting BCS behaviour, with the study’s results revealing the strong positive effects of information and motivation on behavioural skills. A consequential outcome from this study was an understanding of the theoretical linkages with each factor believed to enhance BCS among Saudi women. The research findings can support decision makers and the healthcare organisations in reaching Saudi women with effective communication strategies. They will become more knowledgeable of the current state of Saudi women BCS behaviour and the factors that affect the adoption of BCS. Thus, it can be predicted with some confidence that these strategies will be effective in increasing Saudi women’s participation in BCS. This approach represents a step towards better understanding of health issues that are difficult to discuss, not only in Saudi Arabia, but also internationally