Factors determining the decision to participate during breast cancer screening

Breast cancer is the most common cancer in women. Despite the availability of effective breast cancer screening programs, only six countries in the European Union reach the recommended target rate of 70% screened. Previous research has shown the influence of existing habits to determine health behaviour, however current health communication campaigns do not address this area and focus rather mainly on the neoliberal individualistic approach promoting individual responsibility. The research aimed to explore the role of different influencing factors, including the role of existing health behaviour and habits in developing the decision to participate during breast cancer screening. The research has used mixed-method approach within the sequential approach where at the first stage, 21 in-depth interviews were performed in Estonia and Latvia and additional quantitative data collection was performed in Estonia among 1200 women. Statistical analysis with SPSS was performed The results of qualitative research highlighted that there are three main type of reasons (practical, emotional, and habitual) why women do not attend the screening procedure. The habitual ways of communication with the representatives of medical system might play an integral part of the formulation of the decision and it is noteworthy that habitually formed ways are not only individualistic but may be influenced by cultural and societal traditions. Following data analysis of quantitative data has confirmed the importance of existing Mechanisms of Action (influencing factors) of breast cancer prevention behaviour: perceived benefits and threats as well as self-efficiency and barriers (both are related to habits). Individualistic health communication approach is insufficient, as there are also other (e.g. non-individual) factors influencing the decision formation in the context of screenings. There is a need to address existing health behaviours and habitual ways of contacts with medical system to create and/or strengthen the understanding of preventive health behaviour.