Investigation of Breast Self-Examination Behavior Based on Transtheoretical Model in Middle-Aged Women Covered by Alborz Health Centers in 2018

Introduction: Breast cancer is the most common cancer among women in the world and in Iran. The incidence of breast cancer in Iran is at least one decade lower than that in developed countries. Screening for prevention is the most important effort to improve health in diseases. Breast self-examination and breast examination by specialist physicians and mammography (40 years and older) are early diagnosis methods, among which self-examination is cost-effective. In this study, Prochaska et al (1983) transtheoretical behavioral change model was used. The present study was conducted in 2018 with the aim of investigating the selfexamination behavior based on the transtheoretical model in middle-aged women covered by Alborz health centers. Methodology: In this descriptive-analytical study conducted in 2018, 496 middle-aged women (30-59 years old) referred to Alborz health centers were selected by stratified sampling method. To determine the stages of change in breast self-examination behavior, a checklist of Prochaska model of breast self-examination behavior was used. This checklist includes stages to change the behavior in performing breast self-examination screening and the five stages of pre-contemplation, contemplation, preparation, action, and maintenance. To collect the data, the research subjects were included into study after providing explanations for them about the objectives of the study and the confidentiality of the study and lack of need to write their name and address and the data were analyzed through SPSS16 software. Results: In this study, 496 middle-aged women aged 30 to 59 years in Alborz province were studied. The age range of the subjects was 30 to 59 years with a mean age of 47.13 years and a standard deviation of 8.52. The distribution of subjects in each of the stages of breast self-examination behavior change was: 18.8% in pre-contemplation stage, 23.8% in contemplation stage, 29.4% in preparation stage, 15.1% in action stage, and 12.9% in maintenance stage. The relationship between age and breast self-examination behavior was evaluated based on a transtheoretical model (in three stages of pre-contemplation (1), contemplation + preparation (2), action + maintenance (3) through one-way analysis of variance (p-value=0.001). The results showed that this relationship was significant. Also, in this study, the relationship between education and breast self-examination behavior was investigated based on the transtheoretical model (in an integrated way: precontemplation, contemplation + preparation, action + maintenance) through Chi- Square test. The relationship between marital status and breast self-examination behavior was investigated based on a transtheoretical model (contemplation and preparation were combined and action and maintenance were combined) and their relationship was found to be significant (p-value=0.016). The relationship between the history of familial breast cancer and breast self-examination behavior was investigated based on the transtheoretical (3-stage) model with Chi-Square test. The test results showed a link between a familial history of breast cancer and breast selfexamination (p-value-0.005) and it was found that people with a familial history of breast cancer showed a higher level of self-examination in the pre-contemplation and preparation stages. Conclusion: The research results showed that most of the people were in the pre-action stage and a small percentage of the participants were in the action and maintenance stage. Therefore, it is necessary to conduct educational interventions to inform women to promote breast self-examination behavior.