Association between health beliefs and patient delay in oral cancer diagnosis in Pakistan: An exploratory factor analysis.

Background/purpose: The Health Belief Model (HBM) has been applied to study help-seeking behaviors for various chronic diseases, but the association between HBM and patient delay in oral cancer (OC) diagnosis remains under-explored. The objectives of this study were to describe sociocultural perceptions of OC using the HBM framework and the association between sociocultural perceptions and patient delay in Pakistan. Materials and methods: We conducted a multicenter cross-sectional study among 152 patients diagnosed with oral squamous cell carcinoma (OSCC). We collected data by structured, questionnaire-based interviews. We performed exploratory factor analysis (EFA) with varimax rotation on HBM questions to identify latent constructs, then we used multivariate logistic regression to assess their association with patient delay. Results: We identified six factors using EFA: perceived economic barriers, religious beliefs, perceived severity, perceived susceptibility, psychological barriers, and cues to action. Religious beliefs emerged as a distinct factor, while perceived severity incorporated items from multiple HBM domains. Perceived economic barriers were positively associated with patient delay (AOR = 10.18; 95 % CI: 2.00-62.50), whereas perceived severity (AOR = 0.13; 95 % CI: 0.03-0.49) and perceived susceptibility (AOR = 0.25; 95 % CI: 0.07-0.81) were negatively associated with patient delay. Conclusion: We were able to identify latent constructs in HBM using EFA that were both risk factors and preventive factors for patient delay. The findings of our study suggest that relevant stakeholders should consider developing culturally sensitive interventions that focus on reducing economic barriers and emphasize OC's severity and susceptibility.