Knowledge, attitude, practice, and self-efficacy in pap smear adherence intent: a cross-sectional study
- 1Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University
- 2Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University
Abstract
Although knowledge, attitude, practice, and self-efficacy are recognized as important determinants of cervical cancer screening behavior, evidence examining their combined influence on Pap smear testing adherence remains limited. This cross-sectional study of 985 women aged 30–59 years in Saveh, Iran, used two-stage sampling. Validated questionnaires assessed KAPSE and PST adherence intent. Mann–Whitney U, Kruskal–Wallis, and Spearman correlation tests were used. Linear regression evaluated a composite KAPSE variable’s impact on screening adherence. Participants had a median age of 40 years (IQR: 34–47). Most were housewives (79.3%) and reported below-average economic status (51.7%). Median (IQR) scores were 6 (4–8) for knowledge, 39 (36–42) for attitude, 4 (3–4) for practice, 31 (25–34) for self-efficacy, and 66 (56–74) for PST adherence intent. Self-efficacy demonstrated the strongest positive correlation with adherence (r = 0.597, p < 0.001). Regression analysis showed that the composite KAPSE score was a significant predictor of adherence; a one-unit increase in the KAPSE index was associated with a 7.2-unit increase in PST adherence (B = 7.20, t = 27.69, p < 0.001). Education level and previous screening history were the strongest demographic determinants (p < 0.001). Self-efficacy and prior practice are critical drivers of screening adherence. Health promotion programs should move beyond simple knowledge transfer to build women’s confidence and address socioeconomic barriers. Culturally tailored interventions that strengthen KAPSE synergy can significantly improve cervical cancer prevention outcomes in Iran. Clinical trial number: IRCT20231130060228N1. Registration date: 2024-02-19, 1402/11/30. URL: https://irct.behdasht.gov.ir/trial/74165 .
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BibTeX
@article{ahadi2026knowledge,
title = {{Knowledge, attitude, practice, and self-efficacy in pap smear adherence intent: a cross-sectional study}},
author = {Leila Ahadi and Fatemeh Zarei and Anoshirvan Kazemnejad},
journal = {Scientific Reports},
year = {2026},
month = jul,
doi = {10.1038/s41598-026-62735-5},
url = {https://doi.org/10.1038/s41598-026-62735-5},
note = {CC BY},
}
RIS
TY - JOUR
TI - Knowledge, attitude, practice, and self-efficacy in pap smear adherence intent: a cross-sectional study
AU - Leila Ahadi
AU - Fatemeh Zarei
AU - Anoshirvan Kazemnejad
PY - 2026
DA - 2026/07/01
JO - Scientific Reports
DO - 10.1038/s41598-026-62735-5
UR - https://doi.org/10.1038/s41598-026-62735-5
AB - Although knowledge, attitude, practice, and self-efficacy are recognized as important determinants of cervical cancer screening behavior, evidence examining their combined influence on Pap smear testing adherence remains limited. This cross-sectional study of 985 women aged 30–59 years in Saveh, Iran, used two-stage sampling. Validated questionnaires assessed KAPSE and PST adherence intent. Mann–Whitney U, Kruskal–Wallis, and Spearman correlation tests were used. Linear regression evaluated a composite KAPSE variable’s impact on screening adherence. Participants had a median age of 40 years (IQR: 34–47). Most were housewives (79.3%) and reported below-average economic status (51.7%). Median (IQR) scores were 6 (4–8) for knowledge, 39 (36–42) for attitude, 4 (3–4) for practice, 31 (25–34) for self-efficacy, and 66 (56–74) for PST adherence intent. Self-efficacy demonstrated the strongest positive correlation with adherence (r = 0.597, p < 0.001). Regression analysis showed that the composite KAPSE score was a significant predictor of adherence; a one-unit increase in the KAPSE index was associated with a 7.2-unit increase in PST adherence (B = 7.20, t = 27.69, p < 0.001). Education level and previous screening history were the strongest demographic determinants (p < 0.001). Self-efficacy and prior practice are critical drivers of screening adherence. Health promotion programs should move beyond simple knowledge transfer to build women’s confidence and address socioeconomic barriers. Culturally tailored interventions that strengthen KAPSE synergy can significantly improve cervical cancer prevention outcomes in Iran. Clinical trial number: IRCT20231130060228N1. Registration date: 2024-02-19, 1402/11/30. URL: https://irct.behdasht.gov.ir/trial/74165 .
SN - 2045-2322
ER -