Predictors of intention to use cervical cancer screening among women attending maternal and child health service in Yirgalem town health institutions, SNNPR, Ethiopia: The theory of planned behavior perspective

Abstract

Background: Cervical cancer is a global public health problem accounting for the fourth most common cancer-affecting women worldwide. Detection of the pre malignant form by cervical screening in the target age group is one of the strategies in the prevention of the disease. In Ethiopia, the proportion of women who receive cervical cancer screening service remains low. In order to promote screening behavior, it is important to understand the factors influencing people decision to use cervical cancer screening service. Objective: To assess the predictors of intention to use of cervical cancer screening services among women visiting maternal and child health services at health institutions in Yirgalem town using theory of planned behavior. Methods: Institutional based cross-sectional study design was used employing 422 women’s age between 30-49 years old. Systematic random sampling method was used to select participants. A structured pretested interview administered questionnaire was used to collect data. Theory of planned behavior principles was considered to measure intention, attitude, perceived social pressure and perceived difficulties or easiness towards cervical cancer screening. Data was entered in to Epi-data version 3.1, then exported, and analyzed using SPSS version 21.0 statistical package. Bivariate analysis (Independent t-test and one way ANOVA) was carried to examine the association between intention and socio-demographic variables, knowledge and maternal medical condition and to examine association between intention, direct and indirect measures, correlation analysis were done. Multiple linear regressions model was conducted to identify independent predictors of intention on cervical cancer screening among women. The study was obtain approval from Jimma university institutional review bored. Result: Out of 422 participants, 402 respondents were completed the interview. The study identified that 391(97.3%) of respondents had heard about cervical cancer, however, about 162(41.4%) of women were knowledgeable about the disease. Two hundred (44.2%),154 (39.4%), 136 (34.95%), and 42(11%)of the respondents were know the sign & symptoms, risk factors, prevention methods and screening frequency of cervical cancer respectively. Having knowledge about cervical cancer and past screening practice were positively associated with intention to screen (β = 0.145, CI, 0.001, 0.122), (β = 0.098, CI, 0.093, 1] respectively. Standardized regression coefficient shows; all constructs of the theory were positively and significantly associated with intention to cervical cancer screening. Perceived difficulty or easiness (β = 0.297, CI, 0.172, 0.343), perceived social pressure (β = 0.248, CI, 0.131, 0.30) and attitude (β=0.11, CI, 0.018, 0.158). Conclusion: The study revealed the likelihood of intention to use cervical cancer screening among women found that having knowledge and past screening practice were predictors of intention for future screening. Perceived difficulty or easiness being the important predictor. Due attention should be given for designing message aimed at increasing knowledge, perceived power that enable women to evaluate their control belief positively and empower them to develop ability against norms that compete with the use of cervical cancer screening and change community held norms towards screening and increase positive attitude towards outcome of screening.