A Comprehensive Model for Understanding Breast Cancer Screening Hesitancy: Integrating the Health Belief Model and the Confidence, Convenience, Complacency, Constraints, and Risk and Responsibility Calculations (5C) Model

Breast cancer screening (BCS) is a critical preventive measure that can significantly reduce mortality rates. Despite its importance, screening hesitancy remains a global issue. This paper showcases the combination of the Health Belief Model (HBM) and the 5C Model and how it provides a more holistic understanding of BCS hesitancy. The first model, HBM, is a well-regarded tool that collects data based on individual beliefs such as perceived susceptibility, severity, benefits, barriers, cues to action, and self-efficacy. The second model, the 5C Model, stands for confidence, convenience, complacency, constraints, and risk and responsibility calculations. This model adds a layer of environmental considerations that HBM lacks. By combining these models, we can identify the key psychological, social, and structural barriers that contribute to BCS hesitancy. Furthermore, analysis of the literature suggests that enhancing trust in healthcare systems, increasing accessibility and affordability of screening, addressing cultural and social stigmas, and promoting a sense of collective responsibility can significantly improve screening participation rates, which are reflected in the models.