Psychosocial predictors of cervical cancer screening intention among female teachers in Karaj, Iran: An integrated behavioral model

OBJECTIVE: To examine psychosocial factors associated with cervical cancer screening intention among employed women in Iran using an integrated framework based on the Theory of Planned Behavior and the Health Belief Model. METHODS: This cross-sectional study included 200 female teachers in Karaj, Iran, in 2023. A validated questionnaire assessed knowledge, psychosocial constructs, and screening intention. Path analysis of observed composite scores tested the hypothesized relationships. RESULTS: The model showed good fit and explained 47.70% of intention. Perceived behavioral control (β = 0.26, P < 0.01), perceived benefits (β = 0.24, P < 0.01), subjective norms (β = 0.22, P < 0.01), and attitude (β = 0.17, P = 0.01) were positively associated with intention, whereas perceived barriers were negatively associated (β = -0.15, P = 0.01). Knowledge was positively associated with attitude, subjective norms, and perceived behavioral control. Attitude and perceived behavioral control were positively associated with benefits, while attitude was negatively associated with barriers. CONCLUSIONS: Screening intention was associated with multiple psychosocial perceptions. Interventions should strengthen perceived control, communicate screening benefits, foster supportive norms, and address barriers.