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Introducing the Delphi Screener: Understanding the intention to use a self-sampling method for cervical screening among Italian women according to the Health Belief Model

Saan, Daniëlle (2011) Introducing the Delphi Screener: Understanding the intention to use a self-sampling method for cervical screening among Italian women according to the Health Belief Model.

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Abstract:Background: In Italy, organized cervical cancer screening differs in its extension and coverage per region. Where in some regions the organized programs function relatively well, in others screening coverage is not as successful with a big portion of women who are un- or under-screened. Testing on the cause of cervical cancer, carcinogenic high risk types of the human Papillomavirus (HPV), allows for self sampling in cervical cancer screening. In order to improve cervical cancer screening coverage, this study utilizes the Health Belief Model (HBM) to explore beliefs and socio-demographic factors related to the intention to using a novel self sampling method for high risk HPV testing for cervical cancer screening, the Delphi ® Screener. Lastly, it was examined whether this intention towards self-sampling varies among women who have demonstrated different screening attendance behavior (under-screened, regularly screened and over-screened). Method: A telephone survey was performed to women between 25 and 64 years old, living in the Milan area (N = 193). The relationships between several Health Belief Model variables and the intention towards using the self-sampling method was examined by Spearman’s rank correlation and F-tests. Hierarchical multiple regression analyses were used to determine which components of the Health Belief Model contributed to the women’s intention to use the Screener, also whilst taking into account their differences in Pap screening frequency. Results: By comparing self-sampling with the private gynecologist and the public health services, perceived benefits and barriers were examined. Most women considered self-sampling to be the quickest and most convenient method, whereas the private gynecologist was perceived most trustworthy, reassuring and easy. Furthermore, the majority of the women found self-sampling the most risky, while the private gynecologist was believed the most expensive option. In addition, women reported a medium level of perceived susceptibility to cervical cancer. With respect to intention, most women were either definitely interested in using the Screener or definitely not interested (resulting in a neutral mean score). Results show that the psychological factors of the HBM could account for almost 40% of the variance in intention, with perceived benefits towards self-sampling and education being the significant positive predictors. Perceived susceptibility had no influence on the intention of women. The intention of regularly screened women was related to perceived benefits of self-sampling and the private gynecologist, whereas the intention of the over-screened was also explained by actual knowledge of the Pap test. The intention of under-screened women was further related to Pap test structure. Nevertheless, only perceived benefits towards self-sampling was found to be the significant explanatory variable in all regression models. Conclusion: Findings suggest that both perceived benefits and educational level play an important role in intention towards self-sampling. It is of interest to highlight the perceived benefits of self-sampling (i.e. quick and convenient) in communication to the women, since it might influence the acceptance towards this method. Offering the Delphi Screener can consequently contribute to an increased coverage of cervical cancer screening, thereby decreasing cervical cancer incidence and mortality.
Item Type:Essay (Master)
Delphi Bioscience
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:05 communication studies
Programme:Communication Studies MSc (60713)
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