Determinants of performing breast self-examination in Omani women using health belief model: Confirmatory factor analysis with hierarchical logistic regression.

BACKGROUND

Breast cancer (BC) is the most frequently occurring malignancy among women worldwide and in Oman. Breast self-examination (BSE) is an important strategy for the early detection of BC. This study aimed to assess the practice of BSE among Omani women attending primary health centres using Champion's Health Belief Model Scale (CHBMS) adapted to the Omani context.

METHODS

A cross-sectional analytical study was conducted using a self-administered online survey among women attending six randomly selected primary health centres in Muscat. The questionnaire assessed socio-demographic characteristics, knowledge of BSE, and Health Belief Model constructs. Confirmatory factor analysis and hierarchical logistic regression were utilised to identify predictors of regular BSE practice. Analyses were conducted using SPSS version 21 and Python-Jupyter.

RESULTS

A total of 938 Omani women completed the questionnaire. Only 38.2% reported performing BSE regularly. Self-efficacy emerged as the strongest predictor of BSE practice (OR= 1.83, 95% CI:1.69-1.98, P = 0.053). Perceived susceptibility was also significantly associated with BSE practice (OR= 1.71, 95% CI:1.56-1.91, P = 0.008). Health-motivation demonstrated a positive association with BSE practice (OR= 1.29, 95% CI:1.08-1.54, P = 0.005). Among sociodemographic factors, women aged over 45 years showed the highest odds of performing BSE (OR= 3.09, 95% CI:1.52-6.29, P = 0.002). Higher household income was also associated with greater BSE practice (>1000 OMR: OR= 2.60, 95% CI:1.55-4.36, P < 0.001; 500-1000 OMR: OR= 2.35, 95% CI:1.43-3.87, P = 0.001). Employed vs unemployed women were more likely to perform BSE (OR= 0.57, 95% CI:0.38-0.87, P = 0.009).

CONCLUSION

Behavioural interventions to increase BSE uptake should prioritise psychological targets like enhancing self-efficacy, fostering susceptibility perceptions, and health-motivation. Skill-building strategies that strengthen women's confidence in performing regular BSE, coupled with interventions promoting proactive breast health-seeking behaviours, appear most promising for younger Omani women.