Knowledge, attitudes, and practice in breast cancer early detection: evidence from a nationally stratified study of healthcare providers in Jordan.
Breast cancer remains the most prevalent cancer among women in Jordan. Although national early detection efforts have expanded over recent years, opportunities remain to further improve timely diagnosis and screening uptake. Healthcare providers (HCPs) play a central role in influencing screening uptake, and strengthening their knowledge, attitudes, and practices (KAP) can support program effectiveness.
To assess KAP of HCPs related to breast cancer early detection in Jordan and identify factors influencing their translation into practice.
A nationally stratified cross-sectional study was conducted among 544 HCPs between January and June 2025 using a structured, interviewer-administered questionnaire. Composite scores for KAP were calculated and further dichotomized for multivariable logistic regression to identify predictors of KAP domains.
The mean knowledge score was 57.0%, with high knowledge of signs and symptoms (78.1%) but substantially lower knowledge of screening recommendations, including clinical breast examination (27.4%) and mammography guidelines (28.6%). Attitudes were generally favorable (53.5%), with strong professional orientation (82.2%) and high perceived patient-level barriers (77.3%). Mean practice score was reflecting moderate implementation (49.0%). While most providers reported encouraging screening (98.9%) and appropriate case management (91.9%), correct screening practices were limited, including initiation age (30.3%) and screening intervals (20.8%). Female providers demonstrated higher odds of adequate knowledge (OR 1.78) and optimal practice (OR 1.93), while nurses had significantly lower knowledge (OR 0.46) and practice (OR 0.17). Regional disparities were observed, with lower knowledge but higher practice in southern regions.
The findings indicate opportunities to better align provider knowledge, attitudes, and routine practice, particularly in screening-related competencies. Strengthening role-specific training, integrating guidelines into routine care, and addressing implementation and service-delivery factors are essential to improve early detection outcomes in Jordan and similar settings.
To assess KAP of HCPs related to breast cancer early detection in Jordan and identify factors influencing their translation into practice.
A nationally stratified cross-sectional study was conducted among 544 HCPs between January and June 2025 using a structured, interviewer-administered questionnaire. Composite scores for KAP were calculated and further dichotomized for multivariable logistic regression to identify predictors of KAP domains.
The mean knowledge score was 57.0%, with high knowledge of signs and symptoms (78.1%) but substantially lower knowledge of screening recommendations, including clinical breast examination (27.4%) and mammography guidelines (28.6%). Attitudes were generally favorable (53.5%), with strong professional orientation (82.2%) and high perceived patient-level barriers (77.3%). Mean practice score was reflecting moderate implementation (49.0%). While most providers reported encouraging screening (98.9%) and appropriate case management (91.9%), correct screening practices were limited, including initiation age (30.3%) and screening intervals (20.8%). Female providers demonstrated higher odds of adequate knowledge (OR 1.78) and optimal practice (OR 1.93), while nurses had significantly lower knowledge (OR 0.46) and practice (OR 0.17). Regional disparities were observed, with lower knowledge but higher practice in southern regions.
The findings indicate opportunities to better align provider knowledge, attitudes, and routine practice, particularly in screening-related competencies. Strengthening role-specific training, integrating guidelines into routine care, and addressing implementation and service-delivery factors are essential to improve early detection outcomes in Jordan and similar settings.
Authors
ALSalamat ALSalamat, Qtaishat Qtaishat, Jardaneh Jardaneh, Al-Hadid Al-Hadid, Al-Ajlouni Al-Ajlouni
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