Modeling breast cancer screening hesitancy among Chinese women: integrating the Knowledge–Attitude–Practice, health belief, and 5 C frameworks

Self-efficacy, perceived barriers, and cues to action were the strongest determinants of BSE hesitancy. The integrative KAP-HBM-5 C framework clarified the cognitive-belief-motivation pathways linking knowledge and practice to screening behavior. These findings highlight potential psychological leverage points for future intervention development, particularly with respect to strengthening self-efficacy, reducing perceived barriers, and enhancing actionable cues to promote sustainable screening behavior in community settings.