Background
Breast cancer represents a substantial public health issue worldwide, particularly in Saudi Arabia, where it is the predominant cancer affecting women. The prevalence of obesity among Saudi women has risen due to changes in lifestyle patterns and the assimilation of Western food patterns. Obesity has been established as a recognised risk factor for developing breast cancer. The elevated incidence of hormonal risk factors, such as premature onset of menstruation, delayed age of first delivery, and reduced number of pregnancies, is associated with a heightened susceptibility to breast cancer (Shubayr et al., 2022, p. 13615). Recently, Saudi women have shown a tendency to delay marriage and start parenthood at a later stage in their lives. Saudi women have a deficiency in their awareness and understanding of breast cancer and the significance of early diagnosis.
Cultural and religious factors, including modesty norms and gender segregation practices, may hinder engaging in conversations about breast health and preventive measures. According to MacLeod and Smith’s (2023) article, Life-saving scheme to improve cancer screening among Muslim women, Saudi Arabia women are shy about meeting male doctors for breast cancer screening. The presence of restricted healthcare accessibility and insufficient screening initiatives also lead to delayed diagnosis and suboptimal results. In Saudi Arabia, many women may have challenges obtaining regular access to mammograms or may not accord sufficient importance to their breast health, mainly owing to perceived social stigma or anxiety linked to examinations (Farsi et al., 2020, p. 133).
Problem Statement
Research is scarce about the factors that impede or promote breast cancer screening behaviour among women in Saudi Arabia. Insufficient study on the barriers and facilitators influencing breast cancer screening behaviour among women in Saudi Arabia detrimentally affects public health outcomes. The development of effective treatments and methods to raise screening rates is hindered by a lack of complete research on the variables that influence screening behaviour. This phenomenon may lead to delayed diagnoses, resulting in more advanced and challenging-to-manage instances of breast cancer (Asiri et al., 2020, p. 3). Inadequate study hinders identifying and resolving distinct cultural and religious obstacles that may be exclusive to women in Saudi Arabia. This proposal aims to conduct a qualitative investigation to examine the determinants that impact women’s behaviour in Saudi Arabia towards breast cancer screening. The results obtained from this study will provide valuable insights for creating culturally sensitive interventions aimed at enhancing breast cancer screening rates in Saudi Arabia.
Research Objectives
– To explore the knowledge, beliefs, and attitudes towards breast cancer screening among Saudi Arabian women.
– To identify the barriers and facilitators to breast cancer screening behaviour in Saudi Arabian women.
– To investigate the influence of cultural and religious factors on breast cancer screening behaviour in Saudi Arabian women.
Theoretical Framework
The Integrated Screening Action Model (I-SAM) paradigm emphasises the impact of individual, interpersonal, and socio-cultural factors on health behaviors. The examination of breast cancer screening behaviour in Saudi Arabia has significant importance since cultural and religious beliefs can potentially impact women’s decision-making and activities pertaining to screening. The model emphasises the significance of information, ideas, perceived risk, self-efficacy, and social support in facilitating health behaviours. The I-SAM framework is relevant to examining breast cancer screening behaviour among women in Saudi Arabia, particularly concerning their beliefs, perceived risk, and self-efficacy. The influence of cultural and religious beliefs is of considerable importance in defining how women see and comprehend breast cancer and the process of screening (Robb, 2021, p. 101427). Modesty and privacy considerations could impact a woman’s choice to undergo screening. Gaining an in-depth knowledge of these ideas is crucial to developing treatments that effectively target cultural norms and disseminate pertinent information compatible with these beliefs.
The impression of personal risk of breast cancer among women in Saudi Arabia might influence their inclination to participate in screening activities. Various factors, including family lineage, manifestation of symptoms, and personal encounters with breast cancer within their local community, might potentially impact individuals’ perceived risk. Interventions can potentially use culturally sensitive messaging to enhance knowledge about the significance of screening and facilitate women in appropriately evaluating their risk (Oyeniyi et al., 2023, p. 7). Self-efficacy pertains to an individual’s conviction in their capacity to execute a particular activity. Within the realm of breast cancer screening, self-efficacy plays a significant role in influencing a woman’s confidence level in her capacity to overcome obstacles and her ability to arrange and attend screening appointments (Robb, 2021, p. 101427). It is essential to confront barriers such as inadequate data, transportation constraints, and schedule difficulties to bolster self-efficacy and encourage women to engage in breast cancer screening.
In Saudi Arabia, where cultural and religious beliefs influence women’s decision-making and behaviour surrounding screening, the I-SAM framework offers a complete methodology for understanding the complex dynamics between individual, interpersonal, and socio-cultural elements. The statement recognises the significance of cultural and religious beliefs as influential elements in shaping health behaviour. It emphasises the need to implement treatments adapted to the cultural context to address these issues effectively. The I-SAM framework is valuable for examining the factors of beliefs, perceived risk, and self-efficacy to identify the distinct obstacles and potential avenues for promoting breast cancer screening behaviour among women in Saudi Arabia. For example, interventions may centre on providing precise and culturally sensitive information about breast cancer and the significance of screening (Al Khashan et al., 2021, p. 1018). These interventions may also include correcting misunderstandings or alleviating worries linked with screening, as well as utilising social support networks that boost self-efficacy. The I-SAM framework guarantees that interventions in Saudi Arabia are aligned with the cultural and religious context, thus increasing the likelihood of acceptance, effectiveness, and sustainability. This alignment ultimately leads to better breast cancer screening behaviour and results.
Methodology
The research will use a qualitative methodology, explicitly using in-depth interviews to collect thorough and contextually rich data. The study will use purposive sampling to identify a specific group of Saudi Arabian women between the ages of 30 and 60. This group will consist of individuals who have either participated in breast cancer screening or have deliberately decided to abstain from such screening. The sample will consist of roughly 20 to 25 people, with the aim of including a diverse range of age groups, socioeconomic statuses, educational backgrounds, and geographic locations. The principal data-gathering approach will include semi-structured interviews in Arabic, the participant’s native language. The interviews will be captured using audio technology and transcribed precisely for analysis. Thematic analysis will be used to conduct data analysis to identify and interpret patterns and themes derived from the interview transcripts. The analytical procedure will include the use of coding techniques, the categorisation of data, and the identification of emergent themes. The research will consist of ethical issues, including the provision of informed consent, maintaining secrecy, and protecting privacy. The acquisition of ethical permission will be sought from the Institutional Review Board.
Data Collection
A comprehensive interview guide will be produced by drawing upon the study goals and the I-SAM. The survey will include open-ended inquiries to examine participants’ understanding, perspectives, convictions, and encounters with breast cancer screening. A pilot study will be undertaken, using a limited number of participants, to assess the effectiveness of the interview guide and enhance the overall research methodology. The process of data collecting will continue until the point of data saturation, whereby no novel or relevant information is generated from the conducted interviews. Member checking will be implemented, whereby participants will be provided with the chance to examine and confirm the findings derived from their interviews, guaranteeing the correctness and dependability of the collected data.
Implications and Dissemination
The findings from this research will provide significant contributions to understanding the factors that hinder or support breast cancer screening practices among women in Saudi Arabia. The data may, after that, be used to formulate culturally sensitive interventions and tactics aimed at enhancing the adoption of breast cancer screening. The study results will be communicated via scholarly publications in peer-reviewed journals, presentations at academic conferences, and targeted distribution to healthcare professionals and policymakers. Furthermore, implementing community engagement tactics will be used to disseminate the study results to Saudi Arabian women, equipping them with information about breast cancer screening and fostering empowerment.
Limitations
Many anticipated limitations are likely to impede the progress of this research. One of the constraints pertains to the restricted applicability or generalizability. The generalizability of the results in this qualitative research may be limited to Saudi Arabian women owing to the small sample size and the particular features of the participants. Another constraint that should be considered is the presence of social desirability bias. The respondents can provide answers they see as socially acceptable, which might introduce bias into the collected data. It is also essential to consider the potential language barrier that may arise during the interviews since they will be done in Arabic. This could lead to issues in accurately transcribing and translating the collected data. Another limitation that should be considered is recruiting bias. The use of purposive sampling in research studies may introduce bias due to the increased likelihood of participation by those who actively seek breast cancer screening or have strong views on the topic. Cultural sensitivities might provide obstacles while researching breast cancer screening in Saudi Arabian culture. These problems may manifest in difficulties related to participant recruiting, conducting interviews, and receiving candid and transparent replies.
Conclusion
The primary objective of this qualitative study proposal is to investigate the many elements that affect the behaviour of Saudi Arabian women regarding breast cancer screening. This study aims to illuminate the factors influencing screening behaviour in this particular demographic using the I-SAM as a theoretical framework. These components include knowledge, beliefs, attitudes, and cultural influences. The results obtained from this research will provide valuable insights for formulating interventions and strategies to enhance breast cancer screening rates in Saudi Arabia. These efforts will contribute to the timely identification of breast cancer among women at risk, resulting in better outcomes for this population.
References List
Al Khashan, H., Abogazalah, F., Alomary, S., Nahhas, M., Alwadey, A., Al-Khudhair, B., Alamri, F., Aleisa, N., Mahmoud, N. and Hassanein, M., 2021. Primary health care reform in Saudi Arabia: progress, challenges and prospects. Eastern Mediterranean Health Journal, 27(10), pp.1016-1026. https://doi.org/10.26719/emhj.21.042
Asiri, S., Asiri, A., Ulahannan, S., Alanazi, M., Humran, A. and Hummadi, A., 2020. Incidence rates of breast cancer by age and tumor characteristics among Saudi women: recent trends. Cureus, 12(1). https://doi.org/10.7759/cureus.6664
Farsi, N.J., Al-Wassia, R. and Merdad, L., 2020. Do men and women in Saudi Arabia have the same awareness and knowledge of breast cancer? A cross-sectional study. Breast Cancer: Targets and Therapy, pp.131-139. https://doi.org/10.2147/bctt.s262544
MacLeod, F. & Jacob, S. Life-saving scheme to improve cancer screening among Muslim women. Cancer Research UK. Retrieved from https://news.cancerresearchuk.org/2023/07/20/life-saving-scheme-to-improve-cancer-screening-among-muslim-women/#:~:text=
Oyeniyi, O.S., Robb, K., Ling, J., Kotzur, M., Eberhardt, J., Kabuye, J., Kalemba, M. and Christie-de Jong, F., 2023. OP43 Early diagnosis of PROstate CANcer for Black men (PROCAN-B): identifying barriers and facilitators. https://doi.org/10.1136/jech-2023-ssmabstracts.43
Robb, K.A., 2021. The integrated screening action model (I-SAM): a theory-based approach to inform intervention development. Preventive Medicine Reports, 23, p.101427. https://doi.org/10.1016/j.pmedr.2021.101427
Shubayr, N., Khmees, R., Alyami, A., Majrashi, N., Alomairy, N. and Abdelwahab, S., 2022. Knowledge and Factors Associated with Breast Cancer Self-Screening Intention among Saudi Female College Students: Utilisation of the Health Belief Model. International Journal of Environmental Research and Public Health, 19(20), p.13615. https://doi.org/10.3390/ijerph192013615
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