A path analytic model of health beliefs on the behavioral adoption of breast self-examination

Soo-Foon Moey; Norfariha Che Mohamed; Bee-Chiu Lim; Soo-Foon Moey; Norfariha Che Mohamed; Bee-Chiu Lim

doi:10.3934/publichealth.2021002

AIMS Public Health

2021, Volume 8, Issue 1: 15-31. doi: 10.3934/publichealth.2021002

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Research article

A path analytic model of health beliefs on the behavioral adoption of breast self-examination

1.
Department of Diagnostic Imaging and Radiotherapy, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia (IIUM), Kuantan Campus, Pahang, Malaysia
2.
Clinical Research Centre, Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang, Malaysia

Received: 07 November 2020 Accepted: 17 December 2020 Published: 21 December 2020

Background
In Malaysia, breast cancer accounted for 34.1% of all female cancer cases with women presenting breast cancer at late stages. Breast cancer has a higher five-year survival rate if detected early. An increase of approximately 30% in the five-year survival rate is indicated if breast cancer is detected at stage III compared to stage IV. Thus, survival rate of breast cancer can be increased by creating awareness and encouraging breast cancer screening amongst women. Breast self-examination (BSE) is highly recommended for breast cancer screening due to its simplicity with no incurred cost. The Health Belief Model is used in this study to explain and predict the adoptive behavior of BSE amongst women in Kuantan, Pahang.

Materials and methods
This study employed a multi-stage sampling method using a simple proportion formula at 5% type 1 error, p < 0.05 and absolute error at 2% which resulted in a sample of 520 participants. The data for the study was obtained using a validated bilingual self-constructed questionnaire and the model constructed using Mplus software.

Results
Perceived severity, benefits and barriers were found to significantly influence the behavioral adoption of BSE. Married women aged from 45 to 55 years and knowledge were found to significantly moderate the relationship between perceived benefits and behavioral adoption of BSE. Further, self-efficacy was found as the core construct that mediates the relationship between married women aged 45 to 55 years and the behavioral adoption of BSE.

Conclusion
Self-efficacy is found in the study to influence the behavioral adoption of BSE. This is undeniable as self-efficacy can promote confidence in initiating and maintenance of behavioral change if the perceived change is beneficial at an acceptable cost.
- Health belief model,
- behavioral adoption,
- breast self-examination,
- breast cancer knowledge,
- structural equation modeling
Citation: Soo-Foon Moey, Norfariha Che Mohamed, Bee-Chiu Lim. A path analytic model of health beliefs on the behavioral adoption of breast self-examination[J]. AIMS Public Health, 2021, 8(1): 15-31. doi: 10.3934/publichealth.2021002

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Abstract

Background

In Malaysia, breast cancer accounted for 34.1% of all female cancer cases with women presenting breast cancer at late stages. Breast cancer has a higher five-year survival rate if detected early. An increase of approximately 30% in the five-year survival rate is indicated if breast cancer is detected at stage III compared to stage IV. Thus, survival rate of breast cancer can be increased by creating awareness and encouraging breast cancer screening amongst women. Breast self-examination (BSE) is highly recommended for breast cancer screening due to its simplicity with no incurred cost. The Health Belief Model is used in this study to explain and predict the adoptive behavior of BSE amongst women in Kuantan, Pahang.

Materials and methods

This study employed a multi-stage sampling method using a simple proportion formula at 5% type 1 error, p < 0.05 and absolute error at 2% which resulted in a sample of 520 participants. The data for the study was obtained using a validated bilingual self-constructed questionnaire and the model constructed using Mplus software.

Results

Perceived severity, benefits and barriers were found to significantly influence the behavioral adoption of BSE. Married women aged from 45 to 55 years and knowledge were found to significantly moderate the relationship between perceived benefits and behavioral adoption of BSE. Further, self-efficacy was found as the core construct that mediates the relationship between married women aged 45 to 55 years and the behavioral adoption of BSE.

Conclusion

Self-efficacy is found in the study to influence the behavioral adoption of BSE. This is undeniable as self-efficacy can promote confidence in initiating and maintenance of behavioral change if the perceived change is beneficial at an acceptable cost.

Abbreviations

BSE

Breast self-examination

HBM

Health belief model

EFA

Exploratory factor analysis

SEM

Structural equation modeling

Acknowledgments

The authors would like to acknowledge the help rendered by the polyclinics involved in the study. We also wish to thank all participants for voluntarily giving their time in completing the questionnaire. This study is funded by the Fundamental Research Grant (FRGS/1/2017/SKK05/UIAM/02/1), Ministry of Higher Education (MOHE), Malaysia.

Conflict of interest

All authors declare no conflicts of interest in this paper.

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