Objective: Breast cancer is the most common cancer in women. Despite the availability of effective breast cancer screening programmes, there are only six countries in the European Union reaching the recommended target rate of 70% screened. In addition to the individual reasons for refraining from breast cancer screening, this research aims to follow earlier suggestions to use a practice theoretical approach.
Methods: The study sites were Estonia and Latvia, where 9 and 12 semi-structured interviews were conducted, respectively. Convenience and snowball sampling methods were used. The research was approved by ethics committees in both countries. The interviews passed textual analysis and coding.
Results: The findings revealed that there are three major types of reasons - habitual, practical, and emotional - that influence the formation of the final decision to participate in breast cancer screening.
Conclusion: The implementation of an individualistic approach is not sufficient to bring along desired health behaviour. All groups of reasons, individual and societal context are involved in the decision formation. Thus, structurally provided approaches and messages should be re-conceptualised and re-designed accordingly.
Practice implications: Future screening related campaigns and public health education should address the concerns derived from different types of reasons for refraining from screening.
Keywords: Breast cancer screening; Non-participation; Social practice theory.
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