Survey on determinants of intention to reduce nasopharyngeal cancer risk: an application of the theory of planned behavior

Su Hie Ting, Rayenda Khresna Brahmana, Collin Jerome, Yuwana Podin

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Abstract

Background: To have better prognostic outcomes and minimize deaths due to nasopharyngeal cancer, it is vital to understand factors that motivate the public to undertake cancer preventive measures. The study investigated determinants of intention to adopt measures to reduce nasopharyngeal cancer risk using the Theory of Planned Behavior. Method: A cross-sectional survey was conducted on Malaysians (n = 515) using a questionnaire on attitudes, subjective norm, perceived behavioral control, knowledge of nasopharyngeal cancer, past nasopharyngeal cancer preventive behavior, and intention to adopt preventive measures. The attitudes construct encompassed perceptions of susceptibility, severity, benefits and barriers. Hierarchical regression of mediation effect under structural equation model approach was used to test the theory. The model was re-estimated using the two-stage least square approach by instrumental approach. Next the Maximum Likelihood Estimation-Structural Equation Modeling was conducted to gauge the instrumentation and check the robustness of the model’s simultaneity. Results: The respondents had moderate knowledge of nasopharyngeal cancer, and reported high levels of perceived risk, perceived severity and perceived behavioral control. The respondents were under little social pressure (subjective norm) to perform nasopharyngeal cancer preventive actions, marginally believed in the benefits of medical tests and reported few barriers. The Partial Least Squares-Structural Equation Modeling results show that the relationship between intention and four independent variables were significant (perceived behavioral control, perceived risk, perceived severity, marital status) at p <.05. Tests of Two-stage Least Square Approach and Maximum Likelihood Estimation-Structural Equation Modeling confirm the four key factors in determining the intention to reduce nasopharyngeal cancer risk. The variance explained by these factors is 33.01 and 32.73% using Two-stage Least Square Approach and Maximum Likelihood Estimation-Structural Equation Modeling respectively. Intention to undertake nasopharyngeal cancer risk-reducing behavior has no significant relationship with subjective norm, attitudes (perceived benefits and barriers to screening), knowledge of nasopharyngeal cancer and past behavior in enacting nasopharyngeal cancer preventive measures. The only demographic variable that affects intention is marital status. Gender, age, race, religion, education level, and income are not significantly associated with intention. Conclusions: In contexts where knowledge of nasopharyngeal cancer is moderate, the factors associated with the intention to reduce risk are perceived risk and severity, perceived behavioral control, and marital status.

Original languageEnglish
Article number1774
Number of pages12
JournalBMC Public Health
Volume22
Issue number1
DOIs
Publication statusPublished - Dec 2022
Externally publishedYes

Bibliographical note

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Funder

The researchers thank Research, Innovation and Enterprise Centre, Universiti Malaysia Sarawak for supporting the research.

Funding Information:
Open Access funding provided by Universiti Malaysia Sarawak. The research was funded by the Ministry of Education, Malaysia via the Transdisciplinary Research Grant Scheme (TGRS) [Grant no. TRGS/1/2016/UNIMAS/02/1/1 and C09/TRGS/1519/2016].

Publisher Copyright:
© 2022, The Author(s).

Keywords

  • Attitudes
  • cancer prevention
  • Intention
  • Nasopharyngeal cancer
  • Perceived behavioral control
  • Subjective norm
  • Theory of planned behavior

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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