Applying the information–motivation–behavioral model to explore the factors affecting oral cancer screening behavior among tobacco users in western India

Abstract

Tobacco use is the leading cause of oral cancer worldwide, with India accounting for nearly one-third of the global oral cancer burden. Regular oral cancer screening (OCS) is crucial for early detection among tobacco users. This study examines how information, motivation, and behavioral (IMB) factors affect OCS behavior among tobacco users in Western India. In a cross-sectional study, 332 current tobacco users were recruited during 2023–2024 from a dental hospital and 15 dental camps in Daman, India. Using multivariable logistic regression and Structural Equation Modeling (SEM) analyses, we examined the association between IMB factors and OCS behavior. Only 8.73% of participants reported undergoing OCS. Higher OCS uptake was significantly associated with greater information about oral cancer risk factors, signs, symptoms, and screening [adjusted Odds Ratio (aOR) = 1.17, 95% confidence interval (CI): 1.08 to 1.26, p = 0.001]; personal motivation (aOR = 1.23, 95% CI: 1.12 to 1.35, p < 0.001); intention (aOR = 1.44, 95% CI: 1.11 to 1.88, p = 0.005) and objective skills (aOR = 2.14, 95% CI: 1.63 to 2.82, p < 0.001). The SEM analysis revealed that objective skills had a direct positive effect on OCS behavior, while information, personal motivation, social motivation and/or intention positively influenced OCS indirectly through objective skills and self-efficacy. These findings underscore the importance of IMB factors and need for public health interventions that enhance information, personal motivation, intention and objective skills. Strengthening these factors can improve OCS uptake, facilitating early oral cancer detection and prevention among tobacco users.

Publication Title

International Journal of Health Promotion and Education

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