Application of the modified health belief model for undergoing oral mucosal examination: Comparison of different health risk groups

Objectives: Oral mucosal examination (OME) is an effective measure for detecting oral cancer, which is the fourth leading cause of cancer deaths among males in Taiwan. Despite this fact, there is a lack of literature concerning the likelihood of undergoing an OME among different health risk groups based on individuals' habits of drinking alcohol, chewing betel quid, and smoking cigarettes. Methods: We applied a modified form of the Health Belief Model (HBM) to explore the likelihood that a sample of individuals participating in a "Community Free from Betel Quid Chewing" campaign would undergo an OME. Eight-hundred and sixty-six participants completed questionnaires measuring demographic characteristics, alcohol drinking, betel quid chewing, cigarette smoking, health beliefs, cues to action, self-efficacy, and likelihood of undergoing an OME. We used structural equation modeling (SEM) to investigate the direct and indirect paths, to predict the likelihood of undergoing an OME, in three different health risk groups. Classification of participants into groups of high, moderate, and low risk of developing oral cancer was based on the whether or not the participants drank alcohol, chewed betel quid, or smoked cigarettes. Results: The modified HBM demonstrated a good fit among the high, moderate, and low-risk groups, and explained 50%, 37%, and 30% of the variance of undergoing an OME, respectively. The direct and indirect paths influencing the likelihood of undergoing an OME varied significantly among the three groups. Conclusions: Based on the findings, care must be taken when selecting responsive health education for provision to participants with different health beliefs and levels of risks. (Taiwan J Public Health. 2013;32(4):358-371).