Factors Influencing Breast Cancer Screening Behavior among Iranian Women

Background: Early detection of breast cancer is of great importance to improve women’s health and to decrease the cost related to cancer death. Therefore, recognition of variables related to breast cancer screening behaviors is necessary. Objectives of this study were to identify the rates of breast self-examination (BSE) performance and mammography use in Iranian women, and to characterize the demographic and cognitive factors associated with their breast cancer screening behavior. Method: Data were collected from a convenience sample of 388 females, using an adapted version of Champion’s revised Health Belief Model Scale. Results: The results showed that 7.5% of the participants performed BSE on a regular monthly basis, and among the women aged 40 and older, 14.3% reported having had at least one mammography in their lifetime. Perceived self-efficacy and perceived barriers to BSE were significant predictors for BSE performance. For having mammography, health motivation was the main predictor. Conclusion: Eliminating barriers and increasing perceived self-efficacy with an emphasis to make the women acquainted with BSE performance; as well as increasing health motivation of women and persuading of physicians for clinical breast examination (CBE) performance with low cost and free access to m ammography, are important to promote BSE and mammography

Is Health Locus of Control a Modifying Factor in the Health Belief Model for Prediction of Breast Self-Examination?

Background: Breast cancer is one of the most common cancers among women in the world. Early detection is necessary to improve outcomes and decrease related costs. The aim of this study was to assess the predictive power of health locus of control as a modifying factor in the Health Belief Model (HBM) for prediction of breast self-examination. Materials and Methods: In this cross- sectional study, 400 women selected through the convenience sampling from health centers. Data were collected using part of the Champion’s HBM scale (CHBMS), the Health Locus of Control Scale and a self administered questionnaire. For data analysis by SPSS the independent T test, Chi square test, logistic and linear regression modes were appliedl. Results: The results showed that 10.9% of the participants reported performing BSE regularly. Health locus of control did not act as a predictor of BSE as a modifying factor. In this study, perceived self-efficacy was the strongest predictor of BSE performance (Exp (B) =1.863) with direct effect, while awareness had direct and indirect influence. Conclusions: For increasing BSE, improvement of self-efficacy especially in young women and increasing knowledge about cancer is necessary

Factors Influencing Breast Cancer Screening Behavior among Iranian Women

Background: Early detection of breast cancer is of great importance to improve women’s health and to decrease the cost related to cancer death. Therefore, recognition of variables related to breast cancer screening behaviors is necessary. Objectives of this study were to identify the rates of breast self-examination (BSE) performance and mammography use in Iranian women, and to characterize the demographic and cognitive factors associated with their breast cancer screening behavior. Method: Data were collected from a convenience sample of 388 females, using an adapted version of Champion’s revised Health Belief Model Scale. Results: The results showed that 7.5% of the participants performed BSE on a regular monthly basis, and among the women aged 40 and older, 14.3% reported having had at least one mammography in their lifetime. Perceived self-efficacy and perceived barriers to BSE were significant predictors for BSE performance. For having mammography, health motivation was the main predictor. Conclusion: Eliminating barriers and increasing perceived self-efficacy with an emphasis to make the women acquainted with BSE performance; as well as increasing health motivation of women and persuading of physicians for clinical breast examination (CBE) performance with low cost and free access to mammography, are important to promote BSE and mammography

Determinants of Breast Self-Examination Performance Among Iranian Women: An Application of the Health Belief Model

Abstract Breast cancer is one of the most common cancers among women. Screening behavior rates are low in the world. Therefore, the purpose of the current study was to investigate breast self-examination (BSE) rate and the relationships of Health Belief Model (HBM) constructs for predicting BSE. Path analysis was used to examine both one-way direct and indirect effects of HBM factors on BSE in this population (N=382). Data were collected by a part of Champion’s HBM Scale (CHBMS) and a selfadministered questionnaire. The results showed that 7.6% of the participants reported performing BSE regularly. The final model provided a good fit to the data, with 13 variables explaining 62% of the variance in BSE. Perceived self-efficacy was intermediate construct between modifying factors and HBM constructs. Also, perceived self-efficacy and perceived benefits were the most highly related to BSE. The results suggest that HBM is a useful framework for identifying factors influencing the use of BSE in Iranian women

Psychometric Evaluation of the Colorectal Cancer Screening Belief Scale Based on Health Belief Model’s Constructs for the Fecal Occult Blood Test

Background: It is important to validate scales related to cancer screening beliefs in order to better understand perceptions. The aim of this study was to test the psychometric properties of the colorectal cancer screening belief scale based on Health Belief Model (HBM) constructs. Materials and Methods: Data were collected from 600 persons referred to outpatient laboratory units in Iran through a convenience sampling procedure. In this cross-sectional study, exploratory and confirmatory factor analyses were used to examine construct validity of scale. Results: Through exploratory factor analysis, 52 items of the scale converged to five constructs of HBM with 4 items omission. Construct validity was determined by confirmatory factor analysis through which correlated model was supported. Cronbach’s alpha coefficient for the whole scale was obtained as 0.78, which indicates reliability of the scale. Conclusions: The study findings showed that this scale is a valid and reliable instrument that can be used for measuring HBM constructs about colorectal cancer screening with the fecal occult blood test

Assessment of the Extended Theory of Planned Behavior for Nicotine Dependence Prediction: An Application of Path Analysis

Background: Given the importance of water-pipe smoking cessation in health improvement, further studies are required to identify the predictors of this behavior. Objectives: This study aimed to examine both one-way direct and indirect effects of the constructs of the extended theory of planned behavior (TPB) on nicotine dependence among women residing in Bushehr, situated in Southwest of Iran. Methods: This cross sectional studywasperformed in Bushehr province in Southwest of Iran. In this study, 430womenwere selected through multistage, stratified, cluster, random sampling and were evaluated using a self-administered questionnaire. Path analysis was applied to estimate the direct and indirect effects of attitude, perceived norms, and personal agency on nicotine dependence. Results: The results demonstrated that extended TPB is a predictor of nicotinedependence (R2, 34%)andintention to quit water-pipe smoking (R2, 40%). According to the results, themodified model was a good fit for the data (RMSEA, 0.05; NFI, 0.97; AGFI, 0.91). Selfefficacy (factor loading, -0.30) and perceived behavioral control (factor loading, -0.17) both directly and indirectly affected nicotine dependence through intention. However, in this study, subjective norms did not predict nicotine dependence. Conclusions: The finding showed that skill-based training should be implemented in interventional programs to increase selfefficacy, alongside policies to constrain access to water-pipe smoking. Therefore, social and cognitive interventions can be effective only in the presence of political changes

Factors Predicting Fecal Occult Blood Testing among Residents of Bushehr, Iran, Based on the Health Belief Model

Colorectal cancer is a major cause of mortality worldwide. Fecal occult blood testing has proven a very effective screening tool for early detection and mortality reduction. The aim of this study was to determine predictors factors related to fecal occult blood testing using the Health Belief Model method among residents of Bushehr, Iran. A cross sectional study was performed on a sample of 600 men and women more than 50 years of age. The sample was selected by a convenience method from patients referred to public and private laboratories throughout the city. Each subject filled out a questionnaire which was designed and developed based on Health Belief Model constructs. Statistical analysis was conducted using ANOVA, T-test, chi-square test, and logistic regression. Fecal occult blood tests were performed on 179 (29.8%) out of 600 subjects, of which 95 patients (58.1%) did a periodic examination test and 84 patients (46.9%) had a doctor’s advice for testing. According to the logistic regression model, the perceived barriers (P=0.0, Exp(B)= 0.3), perceived benefits (P<0.01, Exp(B)= 1.9) and self-efficacy (P<0.01, Exp(B)= 1.6) were predictive factors related to occult blood testing among subjects. The results showed that reducing people’s perception of barriers to testing, increasing perceived benefits of screening, and reinforcing self efficacy can have major effect in increasing the rate of fecal occult blood screening for colorectal cancer prevention

Determinants of Self- Management Among Diabetic Patients: A Path Analysis

Diabetes self-management (DSM) is a complex behavior and various factors influence it. Despite continual recommendations to DSM, implementation of this behavior still remains a major health problem for diabetic patients. Identifying effective factors in DSM is useful to promote health in diabetic patients. The purpose of this study was to test the effects of individual and environmental factors on DSM. Path analysis was used to examine both one-way direct and indirect effects of 7 constructs and 3 demographic factors on DSM in this population (N = 396). Data were collected from a convenience sample of 104 (26.3%) males and 292 (73.7%) females with a median age 53 years. The final model provided a good fit to the data explaining 25% of the variance in DSM. Illness perception and provider–patient communication were the most effective factors in DSM. Knowledge and self-efficacy affected DSM indirectly via illness perception. The results of this study showed that effective DSM interventions should be designed to change illness perception and patient–provider communication, especially in patients with low duration of diabetes and low level of education

The Effect of Health Belief Model-Based Education through Telegram Instant Messaging Services on Pap smear performance

Background: Pap smear is an effective screening method for early detection of cervical cancer. This study aimed to investigate the effect of education based on Health Belief Model (HBM) through Telegram instant messaging services on the Pap smear test. Material and methods: This research was a quasi-experimental study which was performed on 106 eligible women (48 participants in the intervention group and 47 participants in the control group). The patients in both groups completed the written consent form and questionnaires at the beginning of the study. In intervention group, the educational content based on HBM was regularly sent via Telegram during one month. After education and three months later, both groups completed questionnaires. Then, the data was analyzed with using SPSS version 22. Results: The findings showed that the two groups at first were similar in demographic characteristics. In the intervention group, the mean difference of the scores before and immediate post training on the knowledge and all of the constructs were significant (P<0.001). Also, the mean difference of the scores before and three months after training on knowledge and all of the constructs (except for perceived barriers) has increased and about the perceived barriers this difference has decreased significantly compared to the score before the training. In the control group, changes in knowledge and other constructs were not significant in during the study. Within the three months after the training, 23 participants (47.9%) in the intervention group, and 4 participants (5.8%) in the control group performed Pap smear which indicates a statistically significant difference (P<0.001). Conclusion: With regard to the individuals’ access to mobile phone, content posted by Telegram on the HBM-based education affects the women’s belief and behavior regarding Pap smear test

Kinetic and degradation efficiency of trichloroethylene (TCE) via photochemical process from contaminated water

Trichloroethylene (TCE) is a common pollutant in groundwater and one of the priority pollutants listed by the U.S. EPA. With regard to concentration ranges in previous studies exceeding environmental levels by far with millimolar concentrations of TCE, this study deals with the degradation of TCE at micromolar concentrations by UV/H2O2. The degradation rate of TCE at different dilute solution levels, 30, 300 and 3000 g L-1 (0.22, 2.28 and 22.83 micromolar) at different initial pHs was examined. In addition, samples were taken from four contaminated wells to measure the degradation rate of TCE. It was shown that thedegradation rate of TCE increased due to the reduction of initial concentration in both aqueous solution and groundwater samples. The TCE degradation constants in groundwater samples increased by a factor of 2.05, while the initial concentration reduced from 1345.7 to 97.7 μg1 L-1. By increasing the molar ratios of H2O2 to TCE from 13 to 129, caused the degradation rates to increase in aqueous solutions. No harmful byproducts such as aloacetic acids (HAAs) were detected at these low levels of initial concentration of TCE during process. This study confirmed that application of UV/H2O2 process could be an effective method in treating contaminated groundwater by TCE at low concentrations