Keshavarzi Ameneh, Asadi Saeedeh, Asadollahi Abdolrahim, Mohammadkhah Fatemeh, Khani Jeihooni Ali
Department of Gynecology, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran.
Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
Breast Cancer (Auckl). 2022 Sep 6;16:11782234221121001. doi: 10.1177/11782234221121001. eCollection 2022.
Early detection of breast cancer is a crucial factor in surviving the disease. This study aimed to investigate the mammography screening based on the theory of planned behavior (TPB) among rural women in Fasa and Shiraz cities, Iran.
This study is a cross-sectional study performed on 800 female clients referring to rural health centers in Fasa and Shiraz cities in southern Iran in early 2021. The authors decided to send and distribute the electronic questionnaire form through the WhatsApp application in collaboration with the health staff of rural health centers for the people covered by these centers. Data gathering tools were a questionnaire on demographic characteristics, a questionnaire based on constructs of TPB, and behavior of mammography screening. Using the structural equation model (SEM), the TPB constructs and demographic variables were entered into the model. Data analysis was executed employing SPSS software version 26 and Amos version 24 (IBM Co., Ann Arbor, MI, USA). Analyzing the data was carried out using the 1-way analysis of variance (ANOVA), logistic regression, and structural equation analysis. During data analysis, various model indicators such as the goodness of fit, including comparative fit index (CFI), goodness-of-fit index (GFI), root mean square error of approximation (RMSEA), and chi-square index/ were evaluated. The significance level in all tests was considered 0.05.
The knowledge, attitude, and perceived behavioral control were the predictors of intention and behavior of mammography screening among the women. Among demographic variables, age, literacy, being menopausal, cancer in family, city, and ethnicity contribute more to the variance variation in TPB constructs. In this study, 7.2% of Persians, 8% of Qashqai Turks, and 4.5% of Arabs are contemplating going to mammography screening. In total, 6.8% (54 people) of all individuals intended to go mammography screening, and 5.4% (43 people) had a history of mammography screening. Goodness-of-fit indices (χ = 18.45, = 10, n = 800, χ/ = 1.845, RMSEA = 0.032, GFI = 0.90, non-normed fit index (NNFI) = 0.91) of conceptual model of this study indicate the suitability of the model.
The results of the study indicated that the constructs of the TPB can predict mammography screening behaviors in rural women. It has also demonstrated that mammographic behavior can be improved in rural women using education based on the TPB model, emphasizing critical psychological factors of creating or changing behavior.
早期发现乳腺癌是该疾病存活的关键因素。本研究旨在基于计划行为理论（TPB）对伊朗法萨和设拉子市农村妇女的乳房X线筛查进行调查。
本研究是一项横断面研究，于2021年初对800名前往伊朗南部法萨和设拉子市农村卫生中心的女性客户进行。作者决定与农村卫生中心的医护人员合作，通过WhatsApp应用程序发送和分发电子问卷，面向这些中心覆盖的人群。数据收集工具包括一份关于人口统计学特征的问卷、一份基于TPB结构的问卷以及乳房X线筛查行为问卷。使用结构方程模型（SEM），将TPB结构和人口统计学变量纳入模型。数据分析使用SPSS软件26版和Amos软件24版（美国密歇根州安阿伯市IBM公司）进行。数据分析采用单因素方差分析（ANOVA）、逻辑回归和结构方程分析。在数据分析过程中，评估了各种模型指标，如拟合优度，包括比较拟合指数（CFI）、拟合优度指数（GFI）、近似均方根误差（RMSEA）和卡方指数等。所有检验的显著性水平均设定为0.05。
知识、态度和感知行为控制是女性乳房X线筛查意愿和行为的预测因素。在人口统计学变量中，年龄、识字率、绝经状态、家族癌症史、城市和种族对TPB结构的方差变异贡献更大。在本研究中，7.2%的波斯人、8%的卡什卡伊土耳其人和4.5%的阿拉伯人考虑进行乳房X线筛查。在所有个体中，总计6.8%（54人）打算进行乳房X线筛查，5.4%（43人）有过乳房X线筛查史。本研究概念模型的拟合优度指标（χ = 18.45，自由度 = 10，样本量n = 800，χ/ = 1.845，RMSEA = 0.032，GFI = 0.90，非标准化拟合指数（NNFI） = 0.91）表明该模型具有适用性。
研究结果表明，TPB结构可以预测农村妇女的乳房X线筛查行为。研究还表明，基于TPB模型进行教育，强调影响行为形成或改变的关键心理因素，可以改善农村妇女的乳房X线筛查行为。
