Determinants of breast self-examination practice among women in Surabaya, Indonesia: an application of the health belief model

Triana Kesuma Dewi*, Karlijn Massar, Robert A.C. Ruiter, Tino Leonardi

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


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.

Original languageEnglish
Article number1581
Number of pages8
JournalBMC Public Health
Issue number1
Publication statusPublished - 27 Nov 2019


  • Adult
  • Breast Self-Examination/psychology
  • Cross-Sectional Studies
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Indonesia
  • Middle Aged
  • Models, Psychological
  • Young Adult
  • Perceived barriers
  • Champion's health belief model
  • Cues to action
  • Perceived benefits
  • Self-efficacy
  • Breast self-examination
  • Indonesian women
  • Breast cancer


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