Women's motivation towards Pap smear screening based on sexual and screening status: A cross-sectional study using protection motivation theory.

INTRODUCTION: Cervical cancer remains a reproductive health burden. Pap smear (PS) screening can detect cervical cancer early but is underused despite being subsidized. Motivational factors play a role in promoting PS screening. This study aimed to determine the women's motivation toward PS screening based on Protection Motivation Theory (PMT), which mainly focused on sexual and screening status.

MATERIALS AND METHODS: The study was conducted electronically throughout Malaysia from January to February 2022 by disseminating Google Form (https://forms.gle/cD7fkUKYR4Cq6kZC8) via multiple WhatsApp groups to reach 526 women aged 21-65 years. The questionnaire consists of 24 items based on seven PMT constructs [perceived vulnerability, perceived severity, self-efficacy, response efficacy, fear (threat appraisal), response costs (coping appraisal), and protection motivation]. The descriptive statistics and independent t -test was used to analyze data using IBM SPSS Statistics software, version 25.

RESULTS: Most respondents were sexually active [80.6% ( n = 424)] and have heard of PS screening [95.8% ( n = 504)]. More than half of respondents did not have PS screening in the last three years [59.3% ( n = 312)]. Sexually active women have heard and have undergone PS screening feel less threatened with low coping appraisals. Undergoing PS screening made women perceived more response efficacy ( P =. 011), more self-efficacy ( P <. 001), and higher protection motivation ( P <. 001) toward PS screening.

CONCLUSIONS: Women's motivation related to PS screening needs to be highlighted. Future development of health education strategy should include motivation focused in emphasizing the threat and coping appraisal into educational plan to ensure women come forward for screening.