| Objective1.To understand the current level of breast cancer screening knowledge,health beliefs and screening behaviors of women in the community and analyze their influencing factors.2.To construct a community-based health education intervention program for women breast cancer screening based on the integrated model of Health belief mode(HBM)and Theory of planned behavior(TPB).3.To evaluate the effectiveness of a health education intervention program based on an integrated model of HBM and TPB for breast cancer screening in community women.Method1.From December 2020 to February 2021,a convenience sampling method was used to select 553 women who met the criteria of inclusion and exclusion from two communities in Hengyang City,Hunan Province,and surveyed using the General Information Questionnaire,Breast Cancer Early Screening Knowledge Questionnaire,Breast Cancer Early Screening Health Beliefs Scale,and Breast Cancer Early Screening Behavior Questionnaire to understand their breast cancer screening knowledge level,health belief level,and screening behavior status,and to analyze their influencing factors.2.From March to June 2021,the integrated model of HBM and TPB was used as a theoretical guide,combined with the research results of the current status survey,and the preliminary intervention program was constructed through literature review and semi-structured interviews,and then the final version of the intervention program was determined through expert review and pre-testing.3.From July to September 2021,a random sampling method was used to select two community women in Hengyang City,Hunan Province,and the study subjects were randomly divided into the intervention and control groups using the random number table method.The control group implemented conventional health education,and the intervention group implemented health education based on integration model on the basis of conventional health education.The level of breast cancer screening knowledge,health beliefs and screening behaviors of community women in the two groups were compared before the intervention,at week 6 and at week 12 of the intervention.4.SPSS 25.0 was used for data analysis,and frequency,percentage(%),and mean ± standard deviation were used for statistical description.Independent samples t-test,chi-square test,binary logistic regression analysis,and repetitive measure analysis of variance(ANOVA)were used for statistical analysis.Result1.A total of 553 community women were surveyed,and the average knowledge of breast cancer screening among community women was 58.4%.The scores for the dimensions of beliefs about breast cancer screening in community women were as follows: perceived susceptibility dimension was11.00(SD=4.25),perceived severity dimension was 22.25(SD=6.24),perceived benefits dimension was 20.90(SD=5.87),and perceived barriers dimension was 68.32(SD=16.35).The community women’s breast screening participation rate in descending order was breast self-examination(n=339,61.3%),breast clinical examination(n=261,47.2%),breast ultrasound examination(n=223,40.3%),and mammography examination(n=151,27.3%).There was a statistical difference(P<0.05)in the participation rate of breast self-examination among community women with different education levels,different monthly household income,family history of breast cancer,and history of benign breast disease.There was a statistical difference(P<0.05)in the participation rates of breast clinical examination,breast ultrasound,and mammography among community women with different levels of education and history of benign breast disease.2.Through semi-structured interviews,it was concluded that community women had insufficient knowledge about breast cancer,including early symptoms,high-risk factors and preventive measures;community women had low breast cancer screening rates;factors influencing community women’s participation in breast cancer screening included low awareness of screening,work and family factors.A health education intervention program for community women’s breast cancer screening based on the integrated model of HBM and TBP was constructed based on the current situation survey,literature review,semi-structured interview and expert review.3.There was no statistically significant difference in the pre-intervention general information,breast cancer screening knowledge scores,and breast cancer health beliefs scores on each dimension between the two groups of community women(P>0.05).Repeated measures ANOVA showed statistically significant differences in the time main effect and interaction effect of breast cancer screening knowledge between the two groups of community women after 6 and 12 weeks of the intervention(F=75.561,P<0.001;F=33.917,P<0.001).Breast cancer knowledge scores of community women in the intervention group were significantly higher than those of the control group at the end of week 12 of the intervention,with a statistically significant difference(t=4.589,P<0.001).At week 6 and 12 of the intervention,the differences in the scores of perceived susceptibility,perceived severity,perceived benefits,and perceived barriers to knowledge dimensions of breast cancer screening between the two groups of community women had a time main effect with statistically significant(F=91.172,P<0.001;F=74.174,P<0.001;F=91.041,P<0.001;F=62.116,P<0.001),interaction effects differences were statistically significant(F=28.816,P<0.001;F=48.308,P<0.001;F=44.461,P<0.001,F=22.422,P<0.001).The perceived susceptibility,perceived severity,and perceived benefit scores of breast cancer screening among community women in the intervention group at the end of the 12 th week of the intervention were significantly higher than those of the control group(t=6.328,P<0.001;t=5.066,P<0.001;t=5.371,P<0.001),and the perceived barriers scores were significantly lower than those of the control group(t=-6.274,P<0.001).The differences in the participation rates of breast self-examination and breast clinical examination before and after the intervention group were statistically significant(P < 0.001),and the differences in the participation rates of breast ultrasonography and mammography were not statistically significant(P>0.05).Conclusion1.Women in the community had moderate knowledge of breast cancer screening and low rates of breast cancer screening.Education level,monthly household income,family history of breast cancer,and history of benign breast disease were the main factors influencing breast self-examination;education level and history of benign breast disease were the main factors influencing breast clinical examination,breast ultrasound examination,and mammography examination.2.The health education intervention program based on the integrated model of HBM and TBP is comprehensive,targeted,and feasible.3.The health education intervention program based on the integrated model of HBM and TBP can improve community women’s breast cancer screening knowledge and health beliefs,and promote breast cancer screening behavior. |
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