The mediating role of breast Self-Examination education based on the stages of change and health belief model on factors affecting breast cancer early detection ability

Breast cancer remains the leading cause of death among women worldwide.Early detection through Breast Self-Examination (BSE) is a simple yet effective measure to increase the likelihood of recovery.However, limited knowledge, motivation, and skills among women of reproductive age in performing BSE remain major barriers.Educational interventions based on the Stages of Change and Health Belief Model (HBM) frameworks have the potential to strengthen behavioral changes toward early detection.To analyze the influence of women's characteristics, health service facilities, and cues to action on the ability for early breast cancer detection, as well as the mediating role of BSE education using the Stages of Change technique and the Health Belief Model.This study employed an observational analytic design with a cross-sectional approach involving 120 women of reproductive age in Pidie District, Aceh.Samples were selected using a multistage random sampling technique.Data were collected through standardized questionnaires and analyzed using Structural Equation Modeling-Partial Least Square (SEM-PLS) to examine direct and indirect relationships among variables.Women's characteristics (p=0.000) and health service facilities (p=0.009) had significant effects on BSE education using the Stages of Change technique, whereas cues to action showed no direct effect (p=0.171).BSE education strongly influenced perceived health threat (p=0.000) and perceived health benefits (p=0.000),both of which enhanced early breast cancer detection ability (R²=0.992).The research model demonstrated strong predictive relevance (Q²>0.8).The characteristics of women of reproductive age and the support of health service facilities play crucial roles in improving early breast cancer detection through BSE education based on the Stages of Change and Health Belief Model frameworks.This approach is effective in strengthening awareness, motivation, and sustainable early detection behavior.