Determinants of Cervical Cancer Screening Among Women Living In Deprived Areas: Applying the Extensive Parallel Process Model

Document Type : Original Research Article

Authors

1 a) Assistant Professor, Social Determinants of Health Research Center, Institute of Health Sciences and Technology, Hamadan University of Medical Sciences, Hamadan, Iran b) Assistant Professor, Department of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran

2 BSc of Public Health, Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran

3 Professor, Department of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran

4 PhD in Health Education and Health Promotion, Department of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran

5 BSc in Midwifery, Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran

6 Assistant Professor, Department of Public Health, Asadabad School of Medical Sciences, Asadabad, Iran

10.22038/jmrh.2024.75074.2206

Abstract

Background & aim: Regular Pap smear testing is an effective method for detecting cervical cancer in apparently healthy women and is considered as a health-promoting behavior. So, identifying factors related to cervical cancer screening is important. This study was conducted to determine the factors associated with cervical cancer screening among women applying Extensive Parallel Process Model (EPPM).
Methods: This study used a cross-sectional design to collect data from 409 women who visited comprehensive health service centers in the outskirts of Hamadan,  western Iran. Participants were selected through cluster sampling from seven comprehensive health service centers. The data collection tool was a self-structured questionnaire containing demographic variables, as well as the EPPM constructs and was filled out through closed interview. Data was analyzed using the Pearson correlation coefficient and multiple logistic regression with SPSS 24 software. 
Results: The majority of participants (79.4%) either never had a Pap smear or had not one, regularly. Several variables were found to be related to regular Pap smear, including family history of cervical cancer (OR=1.05), age at the first marriage (OR=0.41), educational level (OR=10.22), marital status (OR=1.42), and age of the women (P<0.05). Also, a significant relationship was seen between Pap smear and two constructs of EPPM including perceived susceptibility (OR=1.54), and perceived response efficacy (OR=1.43) of.
Conclusion: Several factors influence women’s decision to undergo regular Pap smear. Considering the significant relationship between Pap smear and EPPM constructs, it can be used as a theoretical framework to know factors that are associated with cervical cancer screening and to tailor appropriate interventions, accordingly.

Keywords

Main Subjects

References

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Journal of Midwifery and Reproductive Health
Volume 14, Issue 2
April 2026
Pages 5376-5383

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