Factors in Cervical and Breast Cancer Screening Participation among Married Women in Korea: Testing a Combined Model of Theory of Planned Behavior and the Transtheoretical Model Using Focus Group Interviews

Background: Cervical and breast cancers have been the cancer types with the highest incidence rates among married women in Korea. However, the screening rates for these cancer types have remained low in Korea. Behavioral research is needed to increase cancer screening rates for cervical and breast cancers. Objective: The purpose of this study was to identify factors in intention to participate in cancer screening for cervical and breast cancers. With a combined model built on theory of planned behavior (TBB) and transtheoretical model (TTM), we attempted to examine how individuals at different stages of change were different in attitude, subjective norm, and perceived behavioral controllability regarding cancer screening behaviors. Method: We conducted focus group interviews with 100 women (10 groups of 10 participants) between October 31 and November 2 in 2007. For each of breast and cervical cancers, we had five focus groups defined by stage of change for intention to get cancer screening. All participants in each group shared the same status in terms of the stage of change. Participants were recruited from a suburban area in Seoul. The data were analyzed using a qualitative content analysis technique. Results: Participants showed clear patterns of differences in attitude toward the screening behavior, subjective norm and perceived behavioral controllability based on their stages of change. These findings were consistent between the groups discussing cervical cancer and those discussing breast cancer. Conclusion: This study confirmed the applicability of the combined model of TPB and TTM to explain cancer screening participation.