A review of the perceived barriers within the Health Belief Model on Pap smear screening as a cervical cancer prevention measure

Abstract

Aim: This study reviews the impact of perceived barriers on Pap cervical smear screening within the Health Belief Model (HBM) as an important prevention programme. Background: This research proposes to study perceived barrier constructs within the aforementioned model in order to understand reasons that might contribute to the consistency of Pap smear uptake. Previous use of HBM has shown that the main cause underpinning in affecting change is to alter behaviour (Webb and Sheeran, 2006). While use of HBM has made a positive influence on behavioural change by way of ‘cues to action’ element in its construct, the cues to action effect could be as good or as bad as the receivers’ perception (Rosenstock et al., 1994). It appears that HBM does not work when it comes to non-health behaviour prediction (GALVIN KT, 1992) Methods: a comprehensive literature review was carried out to identify, analyse, synthesize and evaluate the best-published information scholars, researchers and practitioners published in this subject area (Fink, 2009). Keywords used including perceived barriers of Health Belief Model, perceived barriers towards cervical cancer screening, perceived barriers towards pap smear in prevention of cervical cancer using the databases CINAHL, PubMed, Science Direct, Elsevier, and Emerald for journal papers published between the years 1994 until 2012. Studies published before 2008 normally focused on established theory and models, whereas subsequent studies were based on perceived or identified barriers to Pap smear screening uptake. Previously published barriers affecting cervical screening include differences in social class, education levels, knowledge and awareness, attitudes, fatalistic expressions, embarrassment issues, fear of pain, cost and time. Conclusion: an understanding and appreciation of perceived barriers inform healthcare providers in cervical cancer prevention screening and are described below. Perceived barriers construct rests in the middle of the process between intentions and behavioural change. Varying levels of perceived barriers to Pap smear uptake depend upon a countries socioeconomic development and culture.