The use of the Health Belief Model (HBM) in determining the factors associated with breast cancer screening among female students in Botswana

Abstract

ABSTRACT Breast cancer is the most common malignant condition afflicting females globally although there is limited information regarding the determinants that prompt females to participate in breast cancer screening in Botswana. The study explored the Health Belief Model (HBM) constructs in explaining factors associated with breast cancer screening amongst female students in Botswana. A cross-sectional study was conducted using multi-stage random sampling. Self-administered questionnaires were used to elicit information from 383 female participants. Binary logistic regression and chi-square statistic were used for inferential analysis. The results showed that 40 (10.4%) of the participants had gone for breast cancer screening and 195 (50.9%) participants obtained information on breast cancer screening via television. There was a significant relationship between breast cancer screening uptake and health professionals as the source of information (p < 0.001). A belief that screening leads to loss of breast was associated with fear of breast cancer screening uptake (Adjusted Odds Ratio [AOR]: 0.532, 95% Confidence Interval [CI]: 0.330–0.857). Female students who believed that having breast examinations performed by a physician was expensive were 0.63 times less likely to have breast cancer screening (AOR: 0.626, 95% CI: 0.465–0.843). The study revealed that breast cancer screening among female students was lower than the 93% target set by the Healthy People 2020 in the United States of America. Our findings suggest that there is a need for interventional health programs to encourage breast cancer screening uptake, targeting the negative beliefs and perceptions acting as barriers to breast cancer screening.