Understanding of Cervical Screening Adoption among Female University Students Based on the Precaution Adoption Process Model and Health-Belief Model

Abstract

This study aimed to identify the decisional stages for cervical screening and corresponding cognitive factors in female university students. A cross-sectional study was conducted among Korean female university students aged 20–29 years through an online survey. The main outcome was the decisional stage of cervical screening adoption using the precaution adoption process model. The stages were classified into pre-adoption (the unawareness, unengaged, and undecided stages), adoption (the decided to act and acting stages), and refusal (the decided not to act stage). The cognitive factors in each stage were analyzed using the key concepts of the health-belief model. Cervical screening was defined as a clinical Papanicolaou (Pap) smear performed by a physician in a clinic. The final analysis included 1024 students. Approximately 89.0%, 1.0%, and 10.2% were classified as the pre-adoption, refusal, and adoption stages, respectively. Compared to the pre-adoption stage group, the adoption stage group was more likely to be older and have higher self-efficacy and knowledge. Most participants belonged to the pre-adoption stage—those unaware of cervical screening. Furthermore, most had a low level of knowledge and perception of cervical cancer and its screening. Therefore, our study highlighted the need for education to increase awareness and knowledge of cervical screening in this population.

Factors affecting cervical screening using the health belief model during the last decade: A systematic review and meta‐analysis

“…3,[20][21][22] Of the included 21 studies, only 1 study reported on all HBM constructs, 10 while 8 reported on at least the 4 primary constructs. 3,4,8,10,16,19,20,23 Figure 2 showcases the distribution of publications over time.…”

“…Interestingly, no studies originated from the Middle East and North Africa (MENA) region. The earliest studies were published in 2007 and the latest were circulated during 2022 4,16,17 . The studies included a total of 15,365 participants with studies contributing at least 171 participants to a maximum of 3249 participants.…”

“…The earliest studies were published in 2007 and the latest were circulated during 2022. 4,16,17 The studies included a total of 15,365 participants with studies contributing at least 171 participants to a maximum of 3249 participants. While most studies recruited women in their childbearing age, others focused their studies on HIV-infected women (n = 2).…”

“…Furthermore, attempted interventions should be informed by health behavior theories as such theories focus the intervention on empirically proven factors influencing screening uptake while also providing a range of reliable outcome measures for effect evaluation 14 . For example, the current body of evidence showed that HBM‐based educational interventions successfully increase screening uptake and yield positive results in females of all ages 16,47 …”

“…14 For example, the current body of evidence showed that HBM-based educational interventions successfully increase screening uptake and yield positive results in females of all ages. 16,47…”