Women's behaviours towards cervical cancer screening in the COVID-19 pandemic: A moderated-mediation-model based on Information-Motivation-Behavioural Skills.

Aims: (1) To establish a predictive model based on the Information-Motivation-Behavioural Skills model, which can analyse the factors affecting the behaviours of women towards cervical cancer screening in the COVID-19 pandemic, and (2) to test the mediating effects of behavioural skills in the model, and (3) to test the moderated mediation effect of age.

Design: A cross-sectional study was conducted among 354 women aged 30-65 between May and August 2021 in Turkey.

Methods: Data were collected by using an online survey. The direct and indirect effects were tested in the structural equation model and the moderated-mediation effect was tested in the PROCESS macro.

Results: Behavioural skills mediate the effect of motivation on cervical cancer screening behaviours. In addition, age has a moderated mediation effect on this mediation effect.

Conclusion: Our study revealed that as women's motivation for cervical cancer screening increased, their behavioural skills also increased. It can be stated that middle-aged and older women with higher behavioural skills are more likely to have screening during the pandemic and to comply with national recommendations.

Impact: This study is the first quantitative study to test the impact of the components of the Information-Motivation-Behavioural Skills model on cervical cancer screening during the COVID-19 pandemic. In addition, the results reveal the mediating effect of behavioural skills in the relationship between motivation and cervical cancer scanning behaviour and the moderated mediation effect of age. Our results can provide insight for nurses into how to triage women with delayed cervical cancer screening, how to build screening capacity, and how intervention strategies should be developed to improve compliance with cervical cancer screening and follow-up recommendations in women at risk during and after the pandemic.