Structural equation modeling analysis of determinants of barriers to breast self-examination among Eastern Chinese women

PLoS One. 2023 Mar 24;18(3):e0283525. doi: 10.1371/journal.pone.0283525. eCollection 2023.

Abstract

Background: This study aimed to establish a structural equation model to determine the associations among knowledge of breast cancer, beliefs about breast self-examination (BSE), BSE practice, socio-economic status (SES), and barriers to BSE among Eastern Chinese women.

Methods: An online cross-sectional correlational survey of 2026 women from Eastern China was undertaken by a self-administered questionnaire in 2020. Structural equation modeling was utilized for examining the interrelationships between BSE barriers and other variables.

Results: Our results suggested that BSE barriers were significantly and negatively related to SES, BSE beliefs, and BSE practices (β = -0.176, p < 0.001 and β = -0.118, p < 0.001 and β = -0.435, p < 0.001, respectively). Among them, participants' BSE practices had the strongest effects on BSE barriers, while the effect of breast cancer knowledge on BSE barriers was in an opposite direction (β = 0.177, p < 0.001).

Conclusions: BSE barriers were influenced by SES, breast cancer knowledge, BSE beliefs and BSE practices. Our results warn that breast cancer prevention education should strengthen knowledge of practical methods rather than general knowledge. Therefore, intervention strategies designed to develop BSE and breast cancer prevention should take into account multiple factors, in particular finding more effective ways for the public to turn knowledge into a motivator rather than a barrier.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breast Neoplasms* / diagnosis
  • Breast Neoplasms* / prevention & control
  • Breast Self-Examination
  • Cross-Sectional Studies
  • East Asian People
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Latent Class Analysis
  • Surveys and Questionnaires

Grants and funding

This research was supported by the Key Projects of Science Research in Colleges in Anhui Province, China (No. SK2020A0348, SK2018A1074), Anhui Provincial Colleges and Universities Ideological and Political Work Ability Improvement Project (No. sztsjh2019-7-14), and the Key Projects of Teaching Research for Colleges and Universities in Anhui Province, China (No. 2020jyxm1174).