Application of Theory of Planned Behavior on Factors Associated with Pap Smear Uptake: A Meta-Analysis

Authors

  • Elvira Purnamasari Master's Program of Public Health, Universitas Sebelas Maret, Indonesia
  • Argyo Demartoto Faculty of Social and Political Sciences, Universitas Sebelas Maret, Indonesia
  • Uki Retno Budihastuti Department of Obstetrics and Gynecology, Dr. Moewardi Hospital, Surakarta, Indonesia

DOI:

https://doi.org/10.26911/thejhpb.2024.09.02.02

Abstract

Background: Pap smear is a cervical cancer prevention method that has been proven to be effective in reducing the incidence of cervical cancer. Utilization of Pap smears is influenced by various factors. Family or partner support can also affect the use of Pap smears in women of reproductive age. This study aimed to estimate the effects of Theory of Planned Behavior (TPB) and family support on Pap Smear utilization.

Subjects and Method: This was a systematic review and meta-analysis based on data obtained through Google Scholar, PubMed, and Science Direct published in the last 10 years. Article search was performed using the PICO model. Population: women of reproductive age. Intervention: positive attitude, perception of strong behavioral control and positive family support. Comparison: negative attitude, perception of weak behavioral control and negative family support. Outcome: utilization of Pap smears. Article searches were carried out using the keywords “Papanicolau test” OR “Pap test” AND “attitude” AND “self-efficacy” OR “perceived behavior control” AND “family support” OR “spouse support” OR “husband support”. The article used is full text in English with a cross sectional design. Articles were collected using PRISMA flow diagrams and then analyzed using the Review Manager 5.4 application.

Results: 22 cross-sectional study from Nigeria, Ghana, South Africa, Uganda, Ethiopia, Malaysia, Hong Kong, Iran, and the US were selected for meta-analysis. The total sample size is 13,330. Recent meta-analysis found that positive attitude (aOR= 1.53; 95% CI= 1.35 to 1.72; p<0.001) and perceived strong behavioral control (aOR= 2.01; 95% CI= 1.56 to 2.59; p< 0.001) increased Pap smear utilization. Strong family support increased Pap smear utilization, but it was statistically non-significant (aOR= 2.53; 95% CI= 0.79 to 8.10; p< 0.001).

Conclusion: Positive attitudes, perceptions of strong behavioral control and positive family support can increase Pap smear utilization.

Keywords:

theory of planned behavior, family support, pap smear, reproductive age, woman

References

Agustiansyah P, Sanif R, Nurmaini S, Irfannuddin, Legiran (2021) Screening for cervical cancer. BScMed. 5(10): 916–925. DOI: 10.32539/bsm.v5i10.-329.

Anggraeni FD, Murti B, Dharmawan R (2016) Path analysis and theory of planned behavior on using PAP SMEAR as early detection of cervical cancer in Sewon I Community Health Center, Bantul, Yogyakarta, Indonesia. J Health Promot Behav. 01(01): 1-8. DOI: 10.26911/thejhpb.2016.01.01.01.

Assefa AA, Astawesegn FH, Eshetu B. (2019) Cervical cancer screening service utilization and associated factors among HIV positive women attending adult ART clinic in public health facilities, Hawassa town, Ethiopia: a cross-sectional study. BMC Health Serv Res. 19: 847.

Aynalem BY, Anteneh KT, Enyew MM (2020) Utilization of cervical cancer screening and associated factors among women in Debremarkos town, Amhara region, Northwest Ethiopia: community-based cross-sectional study. PLoS ONE. 15 (4): 1-13.

Bekele T, Arba A, Getahun D, Gebretsadik W (2021) Cervical cancer screening service utilization and associated factors among women in reproductive age group attending public health facilities of Sodo Town, Wolaita Sodo. EC Gynaecology. 10 (2): 32-42.

Belay Y, Dheresa M, Sema A, Desalew A, Assefa N (2020) Cervical cancer screening utilization and associated factors among women aged 30 to 49 years in Dire Dawa, Eastern Ethiopia. Cancer Control. 27(1). DOI: 10.1177/-1073274¬820958701.

Chin SS, Jamhuri NAJ, Hussin N, Zubir NL, Tan JR, Chan SCW (2022) Factors influencing pap smear screening uptake among women visiting outpatient clinics in Johor. Malays Fam Physician. 17 (1).

Chirayil EI, Thompson CL and Burney S (2014) Predicting human papillomavirus vaccination and pap smear screening intentions among young Singaporean women using the theory of planned behavior. SAGE Open. 4(4). Doi: 10.1177/2158244014554961.

Cudjoe J, Budhathoki C, Roter D, Gallo JJ, Shraps P, Han HR (2021) Exploring health literacy and the correlates of pap testing among African immigrant women: findings from the Afropap study. J Canc Educ. 36: 441-451.

Dsouza JP, Broucke SV, Pattanshetty S, Dhoore W (2022) Factors explaining men’s intentions to support their partner’s participation in cervical cancer screening. BMC Womens Health. 22:443.

Enyan N, Davies A, Opoku-Danso R, Annor F, Obiri-Yeboah D (2022) Correlates of cervical cancer screening participation, intention, and self-efficacy among Muslim women in Southern Ghana. BMC Womens Health. 22(1): 1–11. DOI: 10.1186/s12905-022-01803-0.

Feriyawati L, Anggraini DR, Fitrie AA, Anggreini RN (2018) Knowledge of cervical cancer, attitude and husband’s support of Pap smear among multiparous women which have Pap’s smear examination in Aviati clinic Padang Bulan Medan. IOP Conference Series: Earth and Environmental Science. DOI: 10.1088/1755-1315/125/1/012194.

Gebreegziabher M, Asefa NG, Berhe S (2016) Factors affecting the practices of cervical cancer screening among female nurses at public health institutions in Mekelle Town, Northern Ethi-opia, 2014: a cross-sectional study. J Cancer Res.

Gemeda EY, Kare B, Negera D, Bona L, Derese B, Akale N, Kebede K, et al. (2020) Prevalence and predictor of cervical cancer screening service uptake among women aged 25 years and above in Sidama Zone, Southern Ethiopia, using health belief model. Cancer Control. 27(1): 1–8. DOI: 10.1177/1073274820954460.

Getahun T, Kaba M and Derseh BT (2020) Intention to screen for cervical cancer in Debre Berhan Town, Amhara Regional State, Ethiopia: application of theory of planned behavior. J Cancer Epidemiol. DOI:10.1155/2020/3024-578

Ghalavandi S, Heidarnia A, Zarei F, Beiran-vand R (2021) Knowledge, attitude, practice, and self-efficacy of women regarding cervical cancer screening. Obstet Gynecol Sci. 64(2): 216–225. DOI: 10.5468/ogs.20236.

Gizaw AT, Khatib ZE, Wolancho W, Amdissa D, Bamboro S, Boltena MT, Appiah SCY, et al. (2022) Uptake of cervical cancer screening and its predictors among women of reproductive age in Gomma district, South West Ethiopia: a community-based cross-sectional study. Infect. Agents Cancer. 17: 43.

Higgins LM, Dirksing KN, Ding L, Morrow CD, Widdice LA, Kahn JA (2016) Adolescent’s intention and self-efficacy to follow Pap testing recommendations after receiving the HPV vaccine. Hum. Vaccines Immunother. 12(6): 1498-1503.

Idowu A, Olowookere SA, Fagbemi AT, Ogunlaja OA (2016) Determinants of cervical cancer screening uptake among women in Ilorin, North Central Nigeria: a community-based study. J Cancer Epidemiol.

Isabirye A (2022) Individual and intimate-partner factors associated with cervical cancer screening in Central Uganda. PLoS ONE. 17(9): e0274602.

Juwitasari, Harini R, Rosyad AA (2021) Husband support mediates the association between self-efficacy and cervical cancer screening among women in the rural area of Indonesia. Asia-Pac J Oncol Nurs. 8(5): 560–564. DOI: 10.4103/apjon.apjon-2085.

Mabotja MC, Levin J, Kawonga M (2021) Beliefs and perceptions regarding cervical cancer and screening associated with pap smear uptake in Johanne¬s-burg: a cross-sectional study. PLoS ONE. 16(2): e0246574.

Majdfar Z, Mahmoud K, Freshteh M, Abbas R, Mohsen S, Gohar M (2016) Relationships between self-efficacy and pap smear screening in Iranian women. Asian Pac J Cancer Prev. 17: 263–268. DOI: 10.7314/APJCP.2016.17.S3.263.

Momeni R, Hosseini Z, Aghamolaei T, Ghanbarnejad A (2020) Determinants factors to pap smear screening among married women in a city of South Iran: applying the BASNEF model. BMC Womens Health. 20(1): 1–7. DOI: 10.1186/s12905-020-01102-6.

Mousavi F, Shojaei P, Aryan H (2018) Knowledge, attitude and practice related to pap smear test among Iranian women. Int J Womens Health Wellness. 4 (2): 1-8.

Ogilvie GS, Smith LW, Niekerk DV, Khursed F, Pedersen HN, Taylor D, Thomson K, et al. (2016) Correlates of women’s intentions to be screened for human papillomavirus for cervical cancer screening with an extended interval. BMC Public Health. 16: 213.

Ogunwale AN, Haleh SH, Jane M, Yiwen C, Maria JW, Matthew LA (2016) Non-utilization of the pap test among women with frequent health system contact. J Immigr Minor Health, 18(6): 1404–1412. DOI: 10.1007/s10903-015-0287-9.

Puspitasari S, Murti B, Prasetya H (2022) Meta-analysis: application of health belief model theory on pap smear screening uptake in women of reproductive age. J Health Promot Behav. 07(04): 322-335.

Razi NAM, Manaf RA, Ismail S (2017) Prevalence and predictors of pap smear practice among staff of a public university in Nilai, Negeri Sembilan. Mal J Med Health Sci. 13(3): 33-42.

Romli R, Shahabudin S, Saddki N, Mokhtar N (2018) Cervical cancer and pap smear screening: knowledge, attitude, and practice among working women in northern state of Malaysia. Med J Malaysia. 74 (1). 8-14.

Solomon K, Tamire M, Kaba M (2019) Predictors of cervical cancer screening practice among HIV positive women attending adult anti retroviral treatment clinics in Bishoftu town, Ethiopia: the application of a health belief model. BMC Cancer. 19: 989.

Sumarmi S, Yu-Yun H, Ya-Min C, Shu-Hsin L (2021) Factors associated with the intention to undergo pap smear testing in the rural areas of Indonesia: a health belief model. Reprod Health. 18(1): 1–10. DOI: 10.1186/s12978-021-01188-7.

The Joanna Briggs Institute (2017) Critical Appraisal Cheklist for Analytical Cross Sectional Studies.

Wakhidah MS, Hastuti URB, Dewi YLR (2017) The influence of personal factor, husband’s support, health workers and peers toward the use of IVA screening among women of reproductive age in the Regency of Karanganyar. J Health Promot Behav. 2(2): 124-137. DOI: 10.26911/thejhpb.2017.02.02.03.

Wang LDL, Lam WWT, Fielding R (2015) Cervical cancer prevention practices through screening and vaccination: a cross-sectional study among Hong Kong Chinese women. Gynecol Oncol. 138: 311-316.

Wati PA, Januraga PP and Putri WCWS (2021) Utilization of cervical cancer screening program and its predictors in the universal health coverage era in Badung District, Bali. Public Health Prev Med Arch. 9(1): 59. DOI: 10.-15562/phpma.v9i1.326.

Zhang J, Sha Z, Gu Y, Li Y, Yang Q, Zhu Y, He Y (2019) Predicting behavioral intentions related to cervical cancer screening using a three-level model for the TPB and SCT in Nanjing, China. Int J Environ Res Public Health. 16(19). DOI: 10.3390/ijerph16193575.

Zhang X, Zeng Q, Cai W, Ruan W (2021) Trends of cervical cancer at global, regional, and national level: data from the Global Burden of Disease study 2019. BMC Public Health. 21(1): 1–10. DOI: 10.1186/s12889-021-10907-5.

Downloads

Published

2024-04-16

How to Cite

Purnamasari, E., Demartoto, A., & Budihastuti, U. R. (2024). Application of Theory of Planned Behavior on Factors Associated with Pap Smear Uptake: A Meta-Analysis. Journal of Health Promotion and Behavior, 9(2), 102–118. https://doi.org/10.26911/thejhpb.2024.09.02.02

Issue

Section

Articles

Most read articles by the same author(s)

<< < 1 2 3 4 5