Background: Breast cancer has become one of the most common causes of mortality among Indonesian women. Many women in Indonesia present with late-stage breast cancer, negatively affecting prognosis and treatment outcomes. Better prognosis of breast cancer will be achieved if it is diagnosed in an earlier stage, thus efforts to detect breast cancer earlier are important. Breast Self-Examination (BSE) is considered as an important first step to encourage women to actively be responsible for their own health, especially for women in low-and middle-income countries with limited resources and access to other forms of preventive healthcare (e.g., screening programs). The present study aimed to predict BSE practice among women in Surabaya, Indonesia using the Health Belief Model (HBM). Methods: This investigation was a cross-sectional survey which was distributed among 1967 women aged 20–60 years. The Indonesian version of Champion’s Health Belief Model Scale (I-CHBMS) was used to explain self-reported BSE practice. Logistic regression analysis was used to examine the association of HBM variables with BSE practice. Results: 44.4% of the respondents indicated they had performed BSE. Further, the results indicated that the HBM variables were significantly associated with BSE practice. Specifically, higher perceived benefits and self-efficacy, lower perceived barriers and less cues to action were unique correlates of BSE practice. The result also showed that perceived severity and susceptibility were not associated with BSE practice. Conclusion: This study indicated that several HBM constructs significantly associated with BSE practice among Indonesian women, suggesting that BSE health education programs should emphasize the perceived benefits of BSE, focus on increasing women’s self-efficacy to address and overcome perceived barriers in performing BSE, and help them in identifying personally relevant cues to action.

Background: Breast cancer has become a public health concern in Indonesia. Regular breast self-examination (BSE) is considered an important first step for its early detection, especially in countries with limited healthcare access, as it is the case in Indonesia. This study aimed to confirm and assess the psychosocial determinants of intention to perform BSE and BSE performance. Methods: The cross-sectional study was conducted on 204 women aged 18–65 years in Surabaya, Indonesia. A 64-item survey was conducted, included variables from the Reasoned Action Approach, and the Health Belief Model, presented questions about demographics, breast cancer knowledge, and behavior related to BSE. Results: Most women (72.5%) expressed intention to perform BSE; however, only 7.8% and 2.9% performed BSE per week and per month, respectively, in the past year. Breast cancer knowledge and attitudes towards BSE were uniquely associated with BSE performance. Perceived behavioral control (PBC) and BSE attitudes were unique correlates of intention. Perceived benefits and barriers and subjective norms were significantly associated with intention and BSE behavior in bivariate analyses. Conclusions: Breast screening education should incorporate strategies for improving attitudes towards BSE, PBC, and breast cancer knowledge with perceived benefits and barriers and subjective norms as relevant targets.

Purpose: The present study aimed to adapt and determine the psychometric properties of the Indonesian version of the Champion’s Health Belief Model Scale (I-CHBMS) of breast self-examination in the measurement of belief toward breast cancer screening. Subjects and methods: A convenience sample of 406 Indonesian women aged 19–60 years was recruited. This study was conducted in Surabaya from December 2016 to January 2017. The I-CHBMS applied a “forward–backward” translation procedure to translate from the English version into Indonesian. Validity of the I-CHBMS was assessed using content, face, and construct validity. Confirmatory factor analysis was used to assess the construct validity. Reliability was measured using Cronbach’s alpha coefficient. Results: The result of confirmatory factor analysis indicated 42 items of I-CHBMS with six-factor solution (susceptibility, severity, benefits, barriers, cues to action and self efficacy) were acceptable as a new instrument. Cronbach’s alpha of the subscale ranged from 0.669 to 0.866, indicating a good range of reliability. Conclusion: The finding of the study suggested that I-CHBMS of breast self-examination practice has good psychometric properties and could be an appropriate measure for health beliefs related to breast cancer screening.

Objective: The present study aimed to examine the applicability of the theory of reasoned action to explain intention to perform breast self-examination (BSE). Methods: A questionnaire was constructed to collect data. The hypothesis was tested in two steps. First, to assess the strength of the correlation among the constructs of theory of reasoned action (TRA), Pearson’s product moment correlations were applied. Second, multivariate relationships among the constructs were examined by performing hierarchical multiple linear regression analysis. Result: The findings supported the TRA model, explaining 45.8% of the variance in the students’ BSE intention, which was significantly correlated with attitude (r = 0.609, p = 0.000) and subjective norms (r = 0.420, p =0 .000). Conclusion: TRA could be a suitable model to predict BSE intentions . Participants who believed that doing BSE regularly is beneficial for early diagnosis of breast cancer and also believed that their significant referents think that doing BSE would significantly detect breast cancer earlier, were more likely to intend to perform BSE regularly. Therefore, the research findings supported the conclusion that promoting the importance of BSE at the community/social level would enhance individuals to perform BSE routinely.

Early presentation with breast cancer symptoms is crucial to the effectiveness of treatment and the affected women’s long-term survival. However, in Indonesia, 60–70% of breast cancer patients firs...

Background: Some parts of northern Surabaya are slum areas with dense populations, and the majority of the inhabitants are from low-income families. The condition of these areas is seemingly different from the fact that Surabaya city has won awards for its cleanliness, healthy environment preservation, and maintenance. Aim: This study aimed at turning the researched site into a clean and healthy environment. Methods: The research was conducted using a quasi-experiment technique with a non-randomized design and pretest–posttest procedures. The research subjects were 121 inhabitants who actively participated in the public commitment and psychoeducation program initiated by the researchers to learn and practice clean and healthy living behaviors. Results: The statistical data showed that there was a substantial increase in the aspects of public commitment (t-value = 4.008, p = 0.001) and psychoeducation (t-value = 4.038, p = 0.001) to begin and maintain a clean and healthy living behaviors. Conclusion: A public commitment in the form of a collective declaration to keep learning and practicing a clean and healthy living behaviors were achieved. This commitment followed by psychoeducation aimed at introducing and exercising such behaviors was found to have effectively increased the research subjects’ awareness to actively participate in preserving environmental hygiene. Developing communal behaviors toward clean and healthy living in inhabitants residing in an unhealthy slum area was a difficult task. Therefore, public commitment and psychoeducation must be aligned with the formulation of continuous habits demonstrating a clean and healthy living behaviors. These habits include the cessation of littering while putting trash in its place, optimizing the usage of public toilets, planting and maintaining vegetation around the area, joining and contributing to the “garbage bank” program, and participating in the Green and Clean Surabaya competition.