Social cognition and social structure in the prediction of cervical screening uptake

<jats:p>A random sample of women (<jats:italic>N</jats:italic> = 614) was interviewed following a campaign to encourage uptake of cervical screening. Previously non‐screened women were sent leaflets explaining the purpose of cervical screening together with up to three invitation letters to encourage attendance. Following the campaign, socio‐demographic characteristics of women remaining unscreened were compared with those of the screened population to assess the role of service provision in ameliorating differences in uptake. A small social class differential existed after the call programme. The study tested the utility of cognitions specified by the Health Belief Model to distinguish participants versus non‐participants and to mediate the effects of marital status, social class and sexual experience in screening uptake. Overall, health beliefs, socio‐demographic variables and number of sexual partners accounted for 57 per cent of variance in screening uptake. Screened women reported greater sexual experience and the effects of sexual experience on screening uptake were mediated by perceived susceptibility, perceived costs, perceived benefits and normative belief. The effects of social class on screening uptake were mediated by perceived susceptibility, perceived aversiveness of the test procedure and perceived aversiveness of a positive result, suggesting persistent cultural barriers to uptake. No evidence was found to suggest that practical difficulties in attendance contributed to socio‐demographic differentials. These findings suggest that where repeated opportunities for screening are provided by the health service, health beliefs are sufficient to identify those who take up screening.</jats:p>