The Application of Health Belief Model in Assessing Intention to Participate in Cervical Cancer Screening among Women Aged 30-60 Years in Huai Thalaeng District, Nakhon Ratchasima Province : A Structural Equation Model

Abstract

This research is a correlation study aimed to investigate causal relationships between six dimensions of the Health Belief Model and intention to participate in cervical cancer screening among women aged 30-60 years in Huai Thalaeng District, Nakhon Ratchasima Province. The sample consisted of 327 participants from a population of 10,521, selected through Multi-stage random sampling. The variables in this study comprised six factors of perception according to the Health Belief Model. Data were collected using an online questionnaire developed by the researcher between December 2023 and January 2024. Data were analyzed using descriptive statistics and inferential statistics, specifically Structural Equation Modeling (SEM) with STATA software.

The research findings indicate that the intention to participate in cervical cancer screening among the sampled population stands at a significant 91.44%. All six factors influenced screening participation, with the perception of benefits of cervical cancer screening demonstrating the highest direct effect coefficient of 0.21. However, upon scrutinizing the structural equation model derived from the Health Belief Model's six dimensions concerning this intention, it was revealed that the model failed to align with the observational data. Statistical analysis demonstrated a lack of fit (x^2/df = 2.46, p-value = <0.001, CFI = 0.795, TLI = 0.765, RMSEA = 0.067, SRMR = 0.129), despite the model's predictive accuracy reaching 99.9%. Consequently, discrepancies within the model may arise from variables incongruous with the contextual background of the target group, or supplementary variables may warrant investigation alongside the six dimensions of the health belief model. Furthermore, for perception factors amenable to further improvement, dissemination of data can inform the public about the importance of continuous cervical cancer screening services.