title: Psychosocial Predictors of Breast Self-Examination among Female Students in Malaysia: A Study to Assess the Roles of Body Image, Self-efficacy and Perceived Barriers.
abstract: BACKGROUND
  Early detection is a critical part of reducing the burden of breast cancer and breast selfexamination (BSE) has been found to be an especially important early detection strategy in low and middle income countries such as Malaysia. Although reports indicate that Malaysian women report an increase in BSE activity in recent years, additional research is needed to explore factors that may help to increase this behavior among Southeastern Asian women.
  
  
  OBJECTIVE
  This study is the first of its kind to explore how the predicting variables of self-efficacy, perceived barriers, and body image factors correlate with self-reports of past BSE, and intention to conduct future breast self-exams among female students in Malaysia.
  
  
  METHODS
  Through the analysis of data collected from a prior study of female students from nine Malaysian universities (n=842), this study found that self-efficacy, perceived barriers and specific body image sub-constructs (MBSRQ-Appearance Scales) were correlated with, and at times predicted, both the likelihood of past BSE and the intention to conduct breast self-exams in the future.
  
  
  RESULTS
  Self-efficacy (SE) positively predicted the likelihood of past self-exam behavior, and intention to conduct future breast self-exams. Perceived barriers (BR) negatively predicted past behavior and future intention of breast self-exams. The body image sub-constructs of appearance evaluation (AE) and overweight preoccupation (OWP) predicted the likelihood of past behavior but did not predict intention for future behavior. Appearance orientation (AO) had a somewhat opposite effect: AO did not correlate with or predict past behavior but did correlate with intention to conduct breast self-exams in the future. The body image sub-constructs of body area satisfaction (BASS) and self-classified weight (SCW) showed no correlation with the subjects' past breast self-exam behavior nor with their intention to conduct breast self-exams in the future.
  
  
  CONCLUSIONS
  Findings from this study indicate that both self-efficacy and perceived barriers to BSE are significant psychosocial factors that influence BSE behavior. These results suggest that health promotion interventions that help enhance self-efficacy and reduce perceived barriers have the potential to increase the intentions of Malaysian women to perform breast self-exams, which can promote early detection of breast cancers. Future research should evaluate targeted communication interventions for addressing self-efficacy and perceived barriers to breast self-exams with at-risk Malaysian women. and further explore the relationship between BSE and body image.
authors.affiliation: Center for Health and Risk Communication, George Mason University, Fairfax, USA E-mail : asnarulhadi@gmail.com.
authors.forename: Maryam
authors.initials: M
authors.lastname: Ahmadian
authors.forename: Suzie
authors.initials: S
authors.lastname: Carmack
authors.forename: Asnarulkhadi Abu
authors.initials: AA
authors.lastname: Samah
authors.forename: Gary
authors.initials: G
authors.lastname: Kreps
authors.forename: Mohammed Bashir
authors.initials: MB
authors.lastname: Saidu
mesh_terms: D000293:Adolescent; D000328:Adult; D001828:Body Image; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D016504:Breast Self-Examination / Q000523:psychology / Q000706:statistics & numerical data*; D055088:Early Detection of Cancer / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008296:Malaysia / Q000453:epidemiology; D008875:Middle Aged; D011379:Prognosis; D020377:Self Efficacy; D013334:Students / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult