Predicting Mammography Screening Behavior Among Women Employed at University: A Theory of Planned Behavior Approach

Background: The prevalence of breast cancer (BC) has notably increased in Iran, making it the most frequently diagnosed cancer among women and the primary cause of new cases. Moreover, studies have indicated a low level of awareness among Iranian women regarding BC screening. Recognizing the impact of knowledge on behavioral intention, researchers proposed incorporating a knowledge-based structure into the theory of planned behavior (TPB) model. This conceptual model was subsequently tested to assess its effectiveness and predict mammography screening behavior. Methods: A cross-sectional survey was conducted among 320 women employed at Mashhad University of Medical Sciences in Iran. The applied instruments were the TPB scale and knowledge questionnaire. In this investigation, SPSS 22.0 and Amos 22.0 were employed for all analyses. A structural equation model (SEM) was also used to evaluate the relations between variables. Results: Individuals’ behavioral intention was significantly associated with higher levels of knowledge (β=0.29), perceived behavioral control (β=0.36), and subjective norms (β=0.32). The model demonstrated that perceived behavioral control was the strongest predictor of intention for mammography screening. Additionally, behavioral intention had a significant effect on mammography screening behavior (β=0.56). Furthermore, knowledge could directly influence behavioral intention, attitude, perceived behavioral control, and subjective norms. Conclusion: Our findings revealed that interventions aimed at increasing women’s sense of control over BC screening circumstances could have a significant impact on screening intention and behavior. By targeting these factors, healthcare providers and public health professionals can create specific interventions to enhance mammography screening rates among women.