{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T19:28:07Z","timestamp":1790796487734,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Breast cancer is the most prevalent malignancy among women worldwide. Early detection through screening is crucial for reducing mortality. This study aimed to determine the association between Health Belief Model (HBM) constructs, health literacy, and breast cancer screening practices among women in Babol, Iran.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This descriptive\u2010analytical cross\u2010sectional study was conducted on 320 women aged 20\u221265 visiting healthcare centers in Babol in 2024. Data were collected using standardized questionnaires, including demographic information, Champion's Health Belief Model Scale (CHBMS), Breast Fear Scale, and the Health Literacy for Iranian Adults (HELIA) questionnaire. Screening performance was assessed based on breast self\u2010examination (BSE), clinical breast examination (CBE), and mammography (for women \u2265\u200940). Data analysis was performed using SPSS version 20, employing descriptive statistics, Chi\u2010square tests,\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests, and multivariable logistic regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean age of participants was 35.73 (\u00b1\u20097.74) years. The rates of BSE (137\/320, 42.8%), CBE (124\/320, 38.7%), and mammography (in women over 40: 38\/104, 36.5%) were observed. Multivariable analysis revealed that performing BSE was significantly associated with higher scores of self\u2010efficacy (OR\u2009=\u20091.15, 95% CI: 1.10\u22121.19,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), positive attitude (OR\u2009=\u20091.10, 95% CI: 1.03\u22121.16,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and cues to action (OR\u2009=\u20091.06, 95% CI: 1.00\u22121.13,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.046), while inversely associated with perceived barriers (OR\u2009=\u20090.96, 95% CI: 0.92\u22120.99,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048). For CBE, self\u2010efficacy (OR\u2009=\u20091.15, 95% CI: 1.11\u22121.20,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), fear of breast cancer (OR\u2009=\u20090.91, 95% CI: 0.87\u22120.95,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), age (OR\u2009=\u20091.11, 95% CI: 1.05\u22121.17,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and attitude (OR\u2009=\u20091.07, 95% CI: 1.01\u22121.13,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01) were significant predictors. In women over 40, performing mammography was positively associated with self\u2010efficacy (OR\u2009=\u20091.23, 95% CI: 1.09\u22121.39,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0012) and age (OR\u2009=\u20091.20, 95% CI: 1.07\u22121.35,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Breast cancer screening rates were suboptimal. Self\u2010efficacy was a strong, consistent predictor for all three screening methods (BSE, CBE, and mammography), while other psychological and demographic factors like attitude, fear, and age were uniquely associated with specific screening behaviors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.72533","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T05:33:31Z","timestamp":1778736811000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Determinants of Breast Cancer Screening Uptake Among Women in Northern Iran: A Cross\u2010Sectional Analysis of Health Beliefs and Health Literacy"],"prefix":"10.1002","volume":"9","author":[{"given":"Aida","family":"Hosseini","sequence":"first","affiliation":[{"name":"Student Research Committee Babol University of Medical Sciences Babol Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5026-9399","authenticated-orcid":false,"given":"Shabnam","family":"Omidvar","sequence":"additional","affiliation":[{"name":"Social Determinants of Health Research Center, Health Research Institute Babol University of Medical Sciences Babol Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hossein\u2010Ali","family":"Nikbakht","sequence":"additional","affiliation":[{"name":"Social Determinants of Health Research Center, Health Research Institute Babol University of Medical Sciences Babol Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Nikpour","sequence":"additional","affiliation":[{"name":"Non\u2010Communicable Pediatric Disease Research Center, Health Research Institute Babol University of Medical Sciences Babol Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8939-3186","authenticated-orcid":false,"given":"Farideh","family":"Mohsenzadeh\u2010Ledari","sequence":"additional","affiliation":[{"name":"Social Determinants of Health Research Center, Health Research Institute Babol University of Medical Sciences Babol Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30215-1"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(21)00071-1"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_13_5_1","first-page":"151","article-title":"Epidemiological Characteristics of and Risk Factors for Breast Cancer in the World","volume":"11","author":"Momenimovahed Z.","year":"2019","journal-title":"Breast Cancer (Dove Medical Press)"},{"key":"e_1_2_13_6_1","unstructured":"R.Ramezani \u201cIranian Annual of National Cancer Registration Report \u201d Tandis Tehran 2007."},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.12783"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.7326\/M15-0969"},{"key":"e_1_2_13_9_1","article-title":"Factors Influencing Iranian Women's Participation in Breast Cancer Screening Programs: A Systematic Review","volume":"7","author":"Hajizadeh A.","year":"2023","journal-title":"Evidence Based Health Policy, Management and Economics"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1155\/adph\/1301714"},{"key":"e_1_2_13_11_1","volume-title":"The Health Belief Model of Behavior Change","author":"Alyafei A.","year":"2024"},{"issue":"5","key":"e_1_2_13_12_1","first-page":"521","article-title":"The Health Belief Model's Application in the Development of Health Behaviors","volume":"9","author":"Daniati N.","year":"2025","journal-title":"Health Education and Health Promotion"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/nop2.696"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/1447-056X-7-6"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-025-13935-1"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-025-24280-0"},{"key":"e_1_2_13_17_1","unstructured":"N.NafisaandB.Murti \u201cApplication of the Health Belief Model in Breast Self\u2010Examination: A Meta\u2010Analysis \u201d The International Conference on Public Health Proceedings 2024."},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.26911\/thejhpb.2021.07.01.01"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2006.03.002"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s43046-022-00150-3"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmph.2025.101873"},{"issue":"1","key":"e_1_2_13_22_1","first-page":"3061","article-title":"Health Literacy, Social Determinants of Health, and Disease Prevention and Control","volume":"6","author":"Coughlin S. 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