title: Using the health belief model to predict breast self examination among Saudi women.
abstract: BACKGROUND
  In the Kingdom of Saudi Arabia, breast cancer (BC) usually presents at advanced stages and more frequently in young pre-menopausal women in comparison to western countries. There is controversy surrounding the efficacy of breast self examination (BSE) for early detection of BC in countries where other methods are available. This study aims to explore the perception towards breast cancer and towards BSE among Saudi women, using the Health Belief Model (HBM).
  
  
  METHODS
  A convenient sample of adult Saudi female employees, working at King Abdulaziz Medical City, Riyadh, Saudi Arabia (n = 225), and their non-working adult female family members (n = 208), were subjected to the Arabic version of revised Champion's Health Belief Model Scale (CHBMS) and the Arabic version of Breast Cancer Awareness Measure (CAM), to assess their knowledge and attitude on BC respectively. Percentage mean score (PMS) for each HBM domain was calculated. Significant predictors of BSE practice were identified using logistic regression analysis and significance was considered at p < 0.05.
  
  
  RESULTS
  The majority of women heard about BSE (91.2 %), only 41.6 % reported ever practicing BSE and 21 % performed it regularly. Reported reasons for not doing BSE were: not knowing how to examine their breast (54.9 %), or untrusting themselves able to do it (24.5 %). Women were less knowledgeable about BC in general, its risk factors, warning signs, nature and screening measures (PMS:54.2 %, 44.5 %, 61.4 %, 53.2 %, 57.6 % respectively). They reported low scores of; perceived susceptibility, seriousness, confidence and barriers (PMS: 44.8 %, 55.6 %, 56.5 % & 41.7 % respectively), and high scores of perceived benefits and motivation (PMS: 73 % & 73.2 % respectively) to perform BSE. Significant predictors of BSE performance were: levels of perceived barriers (p = 0.046) and perceived confidence (p = 0.001) to BSE, overall knowledge on BC (p < 0.001), work status (p = 0.032) and family history of BC (p = 0.011).
  
  
  CONCLUSIONS
  Saudi women had poor knowledge on BC, reported negative attitude towards BSE and their practice was poor. Working women and those with family history of BC, higher perceived confidence and lower perceived barriers on HBM, and those with high level of knowledge on BC were more likely to perform BSE. Breast awareness as an alternative to BSE needs further investigations. HBM was shown as a valid tool to predict BSE practice among Saudi women.
authors.affiliation: King Abdullah International Medical Research Center (KAIMRC), Mail Code 1515, Riyadh, Saudi Arabia. mabolfotouh@gmail.com.|King Saud bin-Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia. mabolfotouh@gmail.com.|King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, POB 22490, Riyadh, 11426, Saudi Arabia. mabolfotouh@gmail.com.
authors.forename: Mostafa A
authors.initials: MA
authors.lastname: Abolfotouh
authors.affiliation: King Abdullah International Medical Research Center (KAIMRC), Mail Code 1515, Riyadh, Saudi Arabia. banimustafaal@ngha.med.sa.
authors.forename: Ala'a A
authors.initials: AA
authors.lastname: BaniMustafa
authors.affiliation: King Abdullah International Medical Research Center (KAIMRC), Mail Code 1515, Riyadh, Saudi Arabia. MahfouzA@ngha.med.sa.
authors.forename: Aisha A
authors.initials: AA
authors.lastname: Mahfouz
authors.affiliation: King Abdullah International Medical Research Center (KAIMRC), Mail Code 1515, Riyadh, Saudi Arabia. Assirim@ngha.med.sa.
authors.forename: Mohammed H
authors.initials: MH
authors.lastname: Al-Assiri
authors.affiliation: King Abdullah International Medical Research Center (KAIMRC), Mail Code 1515, Riyadh, Saudi Arabia. amalfj5@gmail.com.
authors.forename: Amal F
authors.initials: AF
authors.lastname: Al-Juhani
authors.affiliation: King Abdullah International Medical Research Center (KAIMRC), Mail Code 1515, Riyadh, Saudi Arabia. askaras@ngha.med.sa.|King Saud bin-Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia. askaras@ngha.med.sa.|King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, POB 22490, Riyadh, 11426, Saudi Arabia. askaras@ngha.med.sa.
authors.forename: Ahmed S
authors.initials: AS
authors.lastname: Alaskar
mesh_terms: D000293:Adolescent; D000328:Adult; D001364:Awareness; D001943:Breast Neoplasms / Q000175:diagnosis*; D016504:Breast Self-Examination; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009042:Motivation; D012307:Risk Factors; D012529:Saudi Arabia; D055815:Young Adult