breast cancer ; community health ; health belief model ; rural Vietnam ; screening ; transtheoretical model
Abstract
A stages-of-change approach would be helpful to understand cancer screening behaviors. This study aimed to identify the compliance and determinants of breast self-examination (BSE) based on transtheoretical model (TTM) and health belief model (HBM). A cross-sectional study was conducted with 296 rural Vietnamese women using a self-administered questionnaire consisting of Champion's HBM scales, breast cancer knowledge (BCK), integrated connection to neighborhood storytelling networks (ICSN), and TTM stages of BSE. A generalized ordered logistic regression was conducted to identify factors associated with TTM stages of BSE. About 61% of women did not currently perform BSE. Perceived benefit was significant in all stages changes. When changing to the action stage, perceived benefits, self-efficacy, and BCK were significant. When changing to the maintenance stage, perceived susceptibility, benefits, self-efficacy, and ICSN were significant. Determinants influencing BSE behavior were different in each TTM stage, indicating that educational programs should be introduced with stage-matched strategies to increase BSE.