Journal of Health Psychology

Utilising the COM-B model to interpret barriers and facilitators to cervical cancer screening in young women

As most women now reaching the age for cervical cancer screening (24.5 years old) in the UK will be HPV vaccinated, their current perspectives on screening can inform effective interventions to increase screening uptake (and thus, early detection). Twenty-four interviews were conducted with women aged 24–30 years old to explore their views on cervical cancer screening ( n  = 12 attendees and n  = 12 non-attendees). Reflexive thematic analysis generated six themes that were then mapped onto the COM-B model. Reflective motivations (e.g. reassurance) were key facilitators to screening attendance for both groups. Social opportunities (e.g. open communication) contrasted between the groups, with attendees more likely to have discussed screening with friends. Automatic motivations (e.g. embarrassment) were key barriers to attending screening in both groups. Notably, HPV vaccination did not factor into the decision to attend screening. Interventions to increase screening uptake may target motivational and social factors.

“Taking responsibility for my health”: Health system barriers and women’s attitudes toward cervical cancer screening in Romania and Bulgaria

The study used mixed-methods to illustrate the complexity of the interplay between the contexts in Bulgaria and Romania and women’s attitudes and behaviors related to screening. A secondary analysis of quantitative data from Romanian (n = 1053) and Bulgarian (n = 1099) women and qualitative interviews ( n = 30 Romanian, n = 35 Bulgarian) was performed. Low rates of screening attendance were found in both countries. Regression analysis illustrates that attitudes and social norms significantly predicted intentions and screening behavior in both countries. Thematic analysis revealed that systemic barriers and cultural meanings were relevant to women’s decisions to attend screening or avoid contact with the health-care system.

Factors influencing the decision to undergo cervical cancer screening tests (Pap Smear and HPV-DNA testing) in women aged 30–65: The role of HPV knowledge, cancer screening perception, health anxiety, and behaviors for protection against sexually transmitted diseases

This study aimed to identify factors influencing cervical cancer screening participation among women aged 30–65, focusing on HPV knowledge, cancer screening perception, health anxiety, and behaviors for protection against sexually transmitted diseases (STDs). A total of 1755 women participated, with a cervical cancer screening rate of 56.2%. Logistic regression analysis revealed several significant predictors of screening participation, including higher health anxiety, history of STDs, chronic diseases, increased HPV knowledge, positive behaviors for STDs prevention, increasing age, being married or divorced, light physical activity, healthier dietary habits, and living in the Mediterranean region. These findings highlight the interplay of demographic, psychological, and health-related factors in cervical cancer screening decisions. To improve screening rates, public health initiatives should enhance HPV knowledge, address health anxiety, and promote STDs prevention behaviors while considering regional and demographic differences. Further research should comprehensively explore how these factors interact in various settings.

Current status and influencing factors of different dimensions of HPV knowledge among HPV-infected women

HR-HPV infection is a primary risk factor for the development of cervical cancer and its precursors. The perceived status of HPV among patients can trigger negative emotional responses, which subsequently impact their willingness to participate in disease screening and health promotion efforts. This study examined the current knowledge status and sources of information regarding various dimensions of HPV among women infected with HPV attending gynecology outpatient clinics in hospitals from September 2023 to June 2024. A total of 505 participants were included in the study, yielding an overall HPV-related knowledge score of 10 (range: 4–15) among infected women. Notably, 10.30% (52 participants) scored 0 for HPV knowledge. Additionally, those who acquired it through multiple channels had lower risks of low awareness regarding HPV risk factors, preventive measures, and general knowledge ( p  < 0.05). The overall awareness of HPV among women with HPV infection in Shanghai requires improvement.

How face-to-face and online patient–provider communication associate with cervical cancer screening behaviors: The mediating roles of human papillomavirus (HPV) awareness and cancer worry

Cervical cancer screening is a crucial cancer detection measure that can be facilitated by effective patient–provider communication (PPC). This study examined how face-to-face patient–provider communication (FPPC) and online patient–provider communication (OPPC) were associated with cervical cancer screening behaviors through the mediation of human papillomavirus (HPV) awareness and cancer worry. Using data from 3133 women in the Health Information National Trends Survey (HINTS 6, 2022), we applied structural equation modeling to examine our model. Results suggested that FPPC and OPPC positively correlated with screening behaviors. HPV awareness acted as a mediator in the relationship between OPPC and screening behaviors. Cancer worry mediated the association between FPPC/OPPC and screening behaviors but functioned differently: increased FPPC diminished cancer worry, whereas heightened OPPC augmented it. Only OPPC was linked to screening behaviors via sequential mediation of HPV awareness and cancer worry, underscoring the significance of promoting screening through cognition-affect mechanism in the digital era.

Navigating women’s cancer prevention: Two cross-sectional studies to investigate psychosocial antecedents of cervical and breast cancer screening attendance

Despite population-based cancer screening programmes effectively decreasing mortality, participation rates are unsatisfactory for both cervical and breast screening. This research tested an integrated theory of planned behaviour model applied to cervical cancer screening (CCS; Study 1) and breast cancer screening (BCS; Study 2) attendance. Women residing in Campania (Italy) and belonging to each screening target population joined two independent surveys (Study 1: n  = 332, M age  = 41.03, SD = 11.45; Study 2: n  = 298, M age  = 55.03; SD = 5.17). In both studies, screening behaviour was predicted by intention to undergo the screening, action and coping planning. Significant predictors of intention were subjective norms, perceived behavioural control and self-identity in Study 1, and subjective norms, anticipated regret and self-identity in Study 2. A mediation analysis confirmed the role of action and coping planning in the intention-behaviour relation. This model can guide forthcoming interventions and steer enhancements in healthcare access.