{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:40:15Z","timestamp":1790685615484,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T00:00:00Z","timestamp":1630540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Effective screening can prevent cervical cancer, but many women choose not to attend their screening tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to investigate behavioural influences on cervical screening participation using the Theoretical Domains Framework (TDF) and COM\u2010B models of behaviour change.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A qualitative study and semistructured phone interviews were conducted with women invited for routine screening tests within the national cervical screening programme in Ireland.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting and Participants<\/jats:title><jats:p>Forty\u2010eight women aged 25\u201365 years were recruited from the national screening register.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seven core themes were identified that mapped to three COM\u2010B components and 11 TDF domains: (1) knowledge of cervical cancer and screening, (2) coping with smear tests, (3) competing motivational processes\u2014automatic and reflective, (4) cognitive resources, (5) role of social support, (6) environmental influences and (7) perceputal and practical influences. A range of knowledge about screening, perceived risk of cervical cancer and human papillomavirus infection was evident. Factors that influenced screening behaviours may be hierarchical\u2014some were assigned greater importance than others. Positive screening behaviours were linked to autonomous motivation. Deficits in physical and psychological capability (inadequate coping skills) were barriers to screening, while physical and social opportunity (e.g. healthcare professional \u2018champions\u2019) could facilitate participation. Older women raised age\u2010related issues (e.g. screening no longer necessary) and had more negative attitudes to screening, while younger women identified practical barriers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study provides insight into screening participation and will aid development of theoretically informed interventions to increase uptake.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patient or Public Contribution<\/jats:title><jats:p>Women invited for screening tests through the national screening programme were interviewed. A Public &amp; Patient Involvement (PPI) Panel, established to provide input into all CERVIVA research projects, advised the research team on recruitment materials and were given the opportunity to review and comment on the interview topic guide. This panel is made up of six women with various cervical screening histories and experiences.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hex.13346","type":"journal-article","created":{"date-parts":[[2021,9,3]],"date-time":"2021-09-03T04:40:00Z","timestamp":1630644000000},"page":"2023-2035","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Advancing understanding of influences on cervical screening (non)\u2010participation among younger and older women: A qualitative study using the theoretical domains framework and the COM\u2010B model"],"prefix":"10.1111","volume":"24","author":[{"given":"Bernadine","family":"O'Donovan","sequence":"first","affiliation":[{"name":"Royal College of Surgeons in Ireland (RCSI) Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Therese","family":"Mooney","sequence":"additional","affiliation":[{"name":"Programme Evaluation Unit, National Screening Service Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Rimmer","sequence":"additional","affiliation":[{"name":"Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Fitzpatrick","sequence":"additional","affiliation":[{"name":"Programme Evaluation Unit, National Screening Service Dublin Ireland"},{"name":"School of Public Health, Physiotherapy &amp; Sports Science, University College Dublin Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grainne","family":"Flannelly","sequence":"additional","affiliation":[{"name":"National Maternity Hospital,\u00a0St Vincent's Hospital Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine","family":"Doherty","sequence":"additional","affiliation":[{"name":"National Screening Service Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cara","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Histopathology Trinity College, University of Dublin Dublin Ireland"},{"name":"Department of Pathology Coombe Women and Infants University Hospital Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"O'Leary","sequence":"additional","affiliation":[{"name":"Department of Histopathology Trinity College, University of Dublin Dublin Ireland"},{"name":"Department of Pathology Coombe Women and Infants University Hospital Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mairead","family":"O'Connor","sequence":"additional","affiliation":[{"name":"School of Public Health University College Cork Cork Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Sharp","sequence":"additional","affiliation":[{"name":"Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9,2]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"World Health OrganizationCervix uteri fact sheet. 2018.http:\/\/gco.iarc.fr\/today\/data\/factsheets\/cancers\/23-Cervix-uteri-fact-sheet.pdf. 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