Protection motivation theory in predicting cervical cancer screening participation: A longitudinal study in rural Chinese women

Abstract

Objective To examine factors longitudinally associated with cervical cancer screening uptake among rural Chinese women, guided by protection motivation theory (PMT). Methods A large sample of women (n = 2408, aged 35‐65 years old) was randomly selected from a rural county in China in 2015 and followed up for 2 years. Data for demographic factors, knowledge of cervical cancer screening, screening outcome, and six PMT constructs measured at the baseline in 2015 were used to predict cervical cancer screening participation at the follow‐up in 2017 using structural equation model method. Results Among the 2408 women at the baseline, 1879 (78.03%) participated in the screening services at the follow‐up. In addition to significant direct effect of age, social status and baseline screening outcome, and three (perceived severity, fear arousal and response efficacy) of the six PMT subconstructs, four variables (age, social status, knowledge of cervical cancer screening, and baseline screening outcome) at the baseline were indirectly associated with screening participation, mediated by the three significant PMT subconstructs. Conclusions Findings of this study indicate that the rate of participating in cervical cancer screening for rural women needs to be further improved. In addition to the commonly reported influential factors, PMT subconstructs play important roles in encouraging rural women in China to participate in cervical cancer screening. These longitudinal findings provided data much needed for future research to develop evidence‐based intervention programs to enhance cervical cancer screening among rural women in China.

Determinants of Intention to Participate in Breast Cancer Screening among Urban Chinese Women: An Application of the Protection Motivation Theory

“…Another PMT predictor of women’s intention to undergo screening was perceived severity, which was in accordance with previous studies [ 32 , 45 ]. A quasi-experimental study in Iran suggested that women are more likely to perform the screenings if they understand the severity and harm of the disease as well as the related consequences [ 46 ].…”

“…Protection motivation theory (PMT) was proposed by Rogers based on HBM in 1975 [ 27 ]. It is a cognitive social theory used to predict various health behaviors, such as schistosomiasis prevention [ 28 ], vaccination behavior [ 29 ], and cancer screening [ 30 , 31 , 32 ]. PMT considers threat appraisal and coping appraisal as the main predictors of health behavior [ 27 ].…”

The integrated screening action model (I-SAM): A theory-based approach to inform intervention development

“… Model Basic premise Example studies Health Belief Model ( Rosenstock, 1974 ) Behaviour result of beliefs about: perceived susceptibility; perceived severity; benefits and barriers; cues to action Wardle et al, 2000 , Yarbrough and Braden, 2001 , Orbell et al, 1996 Theory of Reasoned Action ( Ajzen and Fishbein, 1980 ), Theory of Planned Behaviour ( Ajzen, 1991 ) Behaviour result of attitudes, subjective norm, and perceived behavioural control* predicting intention and then behaviour. *can directly impact behaviour Cooke and French, 2008 , Orbell et al, 2006 , Drossaert et al, 2003 , Rutter, 2000 , Devellis et al, 1990 Protection Motivation Theory ( Rogers, 1975 ) Behaviour determined by threat appraisal and coping appraisal including key components of: perceived severity; perceived susceptibility; response efficacy and self-efficacy Orbell and Sheeran, 1998 , Li et al, 2020 Precaution adoption process model ( Weinstein and Sandman, 1992 ) Stage model explaining how a person decides to take action and how that decision translates into action Costanza et al, 2005 , Costanza et al, 2009 , Ferrer et al, 2011 , Marlow et al, 2018 Transtheoretical Model ( Prochaska and DiClemente, 1982 ) Stage model synthesising 18 therapies to elicit and maintain behaviour change. Key stages include: pre-contemplation; contemplation; preparation; action; maintenance Rakowski et al, 1996 , Lipkus et al, 1996 , Trauth et al, 2003 , Kelaher et al, 1999 Social Cognitive Theory ( Bandura, 1986 ) An extension of Social Learning Theory proposing a dynamic and reciprocal interaction of the person, environment, and behaviour.…”

Behaviour model integrated by protection motivation theory and information–motivation–behavioural skills model applying in pregnancy weight management (PrInMAMa): a study protocol for a randomised controlled trial in China

“…The PMT plays an important role in explaining and predicting the protection willingness and behaviours of individuals. [25][26][27][28][29] In terms of behavioural interventions, PMT-based interventions can increase the occurrence of benign behaviours by improving individual cognitive levels. 30 31 The information-motivation-behavioural skills (IMB) model, which was first proposed by Fisher et al 32 in their study of high-risk behaviours for HIV, has been applied to explain and predict the healthy lifestyle of adolescents 33 34 and the adherence to medication of patients with rare diseases.…”

“…The PMT plays an important role in explaining and predicting the protection willingness and behaviours of individuals. 25–29 In terms of behavioural interventions, PMT-based interventions can increase the occurrence of benign behaviours by improving individual cognitive levels. 30 31 …”