Comparison of competitive cognitive models in explanation of women breast cancer screening behaviours using structural equation modelling: Health belief model and theory of reasoned action

Abstract

Introduction The efficacy of the theory of reasoned action (TRA), compared with the health belief model (HBM), has not been fully elucidated in screening practices. Methods This population‐based cross‐sectional study was conducted with samples of 500 women aged 35–85 years, in the north of Iran. The data of demographic characteristics, awareness, health belief, subjective norms and screening behaviours were collected using standard instruments. Structural equation modelling (SEM) was applied to estimate the pathways of regression coefficients. Results The model that incorporated the health belief and the standardised coefficient of the knowledge scores influenced significantly on the health belief perception (beta = 0.375), and consequently, the health belief directly affected screening behaviours (beta = 0.73). In contrast, In TRA model, while the direct effect of knowledge on intention was negligible it has a greater indirect effect by mediating health belief and subjective norms (indirect beta = 0.35) on behaviour intention. A high coefficient of intention was observed by subjective norms (beta = 0.626), and the intention has a great positive effect on screening behaviour (beta = 0.601). All fitting indexes were quietly improved in the TRA model as compared with HBM. Conclusion Thus, the unifying structure of knowledge, health belief, subjective norms and intention improves the predictor power in breast cancer screening behaviours.

Development and validation of the MARA scale in Spanish to assess knowledge and perceived risks and barriers relating to breast cancer prevention

“…On a personal level, possessing knowledge increases intentions to adopt healthy behaviors [24]. Specifically, in the case of breast cancer, it acts as a mediating factor in predicting breast cancer screening practice [5,25]. Additionally, as the HBM suggests, an absence of knowledge directly affects perception [2].…”

Development and validation of the MARA scale in Spanish to assess knowledge, risks and barriers relating to breast cancer prevention

“…On a personal level, possessing knowledge increases intentions to adopt healthy behaviours [24]. Speci cally, in the case of breast cancer, it acts as a mediating factor in predicting breast cancer screening practice [5,25]. Additionally, as the HBM suggests, an absence of knowledge directly affects perception [2].…”

Exploring the impact of perceived risk and trust on tourist acceptance intentions in the post-COVID-19 era: A case study of Hainan residents

“…For example, Polat et al ( 2021 ) expanded trust and social norms in airline services, directly and indirectly, affecting air travel intentions by reducing perceived risks. Firouzbakht et al ( 2021 ) found moderating health beliefs and subjective norms (indirect beta = 0.35) exert a greater indirect effect on behavioral intentions and a higher intention coefficient (β = 0.626) was observed for subjective norms. This study draws from previous studies to formulate hypotheses 4 and 5 to examine the acceptance of tourists by residents of Hainan impacted by the COVID-19 pandemic.…”