Promoting Cancer Screening

The current ANS featured article is titled “A Critique of the Theory of Planned Behavior in the Cancer
Screening Domain” authored by Jinghua An, MSN, RN and Catherine Vincent, PhD, RN, both at the University of Illinois at Chicago College of Nursing. The article is available for download at no cost while it is featured. Here is a message that Jinghua An provided about this work.

As a nurse, are you involved in promoting cancer screening participation in your community? Early cancer detection is key to improving patients’ chance of survival. The Theory of Planned Behavior (TPB), one of the most frequently applied behavioral theories, has been used to understand, predict, and change cancer screening–related behaviors. In this paper, we applied Fawcett and DeSanto-Madeya’s 2013 framework for analysis and evaluation of nursing theory to critique the TPB from a nursing perspective.

We systematically analyzed and evaluated the TPB to identify its contributions to and usefulness in cancer screening research and practice. The TPB is philosophically congruent with the nursing metaparadigm. The logical congruence between the TPB and the nursing discipline provides the basis for nurses to consider the TPB as a shared theory. The propositions of the TPB could provide information about the individual, interpersonal, social, and environmental determinants of health behavior. Thus, the TPB is applicable in diverse nursing practice situations and settings. It could have profound theoretical significance on nursing if researchers better integrated research findings within the nursing discipline.
The predictive validity of attitude, subjective norm, and perceived behavioral control for intention and behavior has generally been supported in empirical studies. Nevertheless, inconsistencies and gaps exist between empirical data and the theory, particularly with respect to the multiplicative combination rule, intention as a mediator of the effects of attitude and subjective norm on behavior, and the moderation effects of perceived behavioral control. Methodologically sound empirical studies are called for to test these theory propositions.

In addition, the TPB’s utility for developing interventions to promote behavioral change in the cancer screening domain requires further empirical testing. Specifically, future research should provide details of the mechanism of change, the intervention characteristics, and the corresponding theory elements (either from the current TPB or an expanded TPB that integrates other theories). Finally, we believe that translational studies are needed to evaluate the theory’s pragmatic adequacy for promoting cancer screening in nursing practice.