Enter your email address
Submit
Write your message
Iranian Journal of Breast Diseases
Back to the articles list |
Back to browse issues page
Ethics code: IR.HUMS.REC.1402.101
1- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
2- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
3- Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran ,mdadipoor@yahoo.com
4- Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
2- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
3- Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran ,
4- Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
Abstract: (14 Views)
Introduction: Breast cancer is a leading cause of cancer-related mortality among women, and mammography remains the most effective method for its early detection. However, mammography screening uptake among Iranian women remains low, with reported participation rates generally below 25%. Understanding the factors influencing screening behavior is therefore essential for designing effective interventions. This qualitative study aimed to explore and describe the multi-level determinants of mammography screening uptake using the Intervention Mapping framework.
Methods: Data were collected through semi-structured in-depth interviews and focus group discussions with 34 participants, including women aged 40–70 years who were eligible for breast cancer screening and healthcare providers involved in screening services. Participants were selected through purposive sampling with maximum variation. Data were analyzed using conventional content analysis to identify barriers and facilitators across five ecological levels.
Results: Mammography uptake was influenced by a complex interaction of factors at multiple levels. At the intrapersonal level, limited awareness, misconceptions about breast cancer and screening, fear of diagnosis, and low self-efficacy emerged as major barriers. At the interpersonal level, inadequate support from spouses and family members, as well as negative experiences with healthcare personnel, discouraged participation. Organizational and environmental barriers included high screening costs, limited physical access to services, time constraints, and insufficient privacy in screening facilities. At the community level, breast cancer screening was often perceived as a low priority. At the policy-related and structural levels, inadequate insurance coverage and broader economic difficulties were identified as important obstacles to screening participation.
Conclusion: The findings highlight that mammography screening behavior is shaped by determinants operating at multiple ecological levels. Efforts to improve screening participation should address individual knowledge and beliefs, strengthen family and healthcare-provider support, and reduce structural barriers related to affordability and access. These findings may inform the development of context-specific interventions and policies aimed at improving mammography screening uptake among women in southern Iran.
Methods: Data were collected through semi-structured in-depth interviews and focus group discussions with 34 participants, including women aged 40–70 years who were eligible for breast cancer screening and healthcare providers involved in screening services. Participants were selected through purposive sampling with maximum variation. Data were analyzed using conventional content analysis to identify barriers and facilitators across five ecological levels.
Results: Mammography uptake was influenced by a complex interaction of factors at multiple levels. At the intrapersonal level, limited awareness, misconceptions about breast cancer and screening, fear of diagnosis, and low self-efficacy emerged as major barriers. At the interpersonal level, inadequate support from spouses and family members, as well as negative experiences with healthcare personnel, discouraged participation. Organizational and environmental barriers included high screening costs, limited physical access to services, time constraints, and insufficient privacy in screening facilities. At the community level, breast cancer screening was often perceived as a low priority. At the policy-related and structural levels, inadequate insurance coverage and broader economic difficulties were identified as important obstacles to screening participation.
Conclusion: The findings highlight that mammography screening behavior is shaped by determinants operating at multiple ecological levels. Efforts to improve screening participation should address individual knowledge and beliefs, strengthen family and healthcare-provider support, and reduce structural barriers related to affordability and access. These findings may inform the development of context-specific interventions and policies aimed at improving mammography screening uptake among women in southern Iran.
Keywords: Breast Cancer, Mammography, Qualitative Study, Intervention Mapping, Conventional Content Analysis, Behavioral Determinants
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
