Department of Epidemiology, School of Health Sciences, Wuhan University, Wuhan 430071, China.
Wuhan Center for Disease Control and Prevention, Wuhan 430015, China.
Int J Environ Res Public Health. 2021 Oct 21;18(21):11093. doi: 10.3390/ijerph182111093.
Despite the significance of early detection of breast cancer through screening, the screening uptake in China remains relatively low. Protection motivation theory (PMT) suggested by Rogers is one of the theories concerning threat appeal. This study aimed to apply the protection motivation theory (PMT) in predicting breast cancer screening intention. In this cross-sectional study, a sample of Chinese urban women was recruited using the convenient sampling method from five communities in Wuhan. Data were collected using a self-report questionnaire that included demographic variables, knowledge about breast cancer, six PMT subconstructs, and screening intention. We used the structural equation modeling (SEM) to identify the predictor factors associated with screening intention. Of the total sample ( = 412), 86.65% had intention to participate in screening. Our data fit the hypothesized SEM model well (Goodness of fit index (GFI) = 0.91, adjusted GFI (AGFI) = 0.89, comparative fit index (CFI) = 0.91, root mean square error of approximation (RMSEA) = 0.05, standardized root mean residual (SRMR) = 0.06, and Chi-square/df = 2.01). Three PMT subconstructs (perceived severity, response cost, and self-efficacy) were significantly associated with screening intention. Knowledge, social status, and medical history had significantly indirect associations with screening intention through the mediating effect of PMT subconstructs. Considering the utility of PMT, intervention programs might be more effective based on the subconstructs of PMT, especially to improve self-efficacy, perceived severity, and knowledge, reduce response cost, as well as targeting specific demographic groups.
尽管通过筛查早期发现乳腺癌具有重要意义，但中国的筛查率仍然相对较低。罗杰斯提出的保护动机理论（PMT）是涉及威胁诉求的理论之一。本研究旨在应用保护动机理论（PMT）预测乳腺癌筛查意向。在这项横断面研究中，采用方便抽样法从武汉市五个社区招募了中国城市女性样本。使用自报告问卷收集数据，问卷包括人口统计学变量、乳腺癌知识、六个 PMT 子结构和筛查意向。我们使用结构方程模型（SEM）来确定与筛查意向相关的预测因素。在总样本（n=412）中，86.65%的人有参加筛查的意向。我们的数据很好地符合假设的 SEM 模型（拟合优度指数（GFI）=0.91，调整后的 GFI（AGFI）=0.89，比较拟合指数（CFI）=0.91，近似误差平方根（RMSEA）=0.05，标准化根均方残差（SRMR）=0.06，卡方/自由度（Chi-square/df）=2.01）。三个 PMT 子结构（感知严重性、反应成本和自我效能）与筛查意向显著相关。知识、社会地位和病史通过 PMT 子结构的中介作用与筛查意向有显著的间接关联。考虑到 PMT 的实用性，干预计划可能基于 PMT 的子结构更有效，特别是要提高自我效能、感知严重性和知识，降低反应成本，并针对特定的人口统计学群体。
