Breast health information, motivation, behavioral skills, and breast self-examination behavior among female medical college students: a cross-sectional study

ObjectiveBased on the Information-Motivation-Behavioral Skills Model (IMB), this study examined differences in breast cancer (BC) prevention knowledge, perceived barriers, self-efficacy, and breast self-examination (BSE) practices between female nursing and pharmacy students. We hypothesized that nursing students would demonstrate more favorable IMB profiles and that the association between academic major and BSE behavior would be statistically explained by these constructs.MethodsA cross-sectional survey was conducted among 997 female nursing and pharmacy students from a medical college (May-June 2026). Data were collected using the Champion Health Belief Model Scale (CHBMS) and a self-developed BC knowledge questionnaire. Multivariate logistic regression identified factors associated with BSE behavior, adjusting for grade, residence, and family history. Analyses were performed using SPSS 20.0 (α = 0.05).ResultsCompared with pharmacy students, nursing students exhibited significantly higher knowledge scores (7.21 ± 2.51 vs. 6.05 ± 2.89, t = 6.21, p < 0.001, Cohen's d = 0.43), self-efficacy scores (3.35 ± 0.72 vs. 3.18 ± 0.79, t = 3.54, p < 0.001, Cohen's d = 0.22), and BSE rates (60.6% vs. 32.0%, χ2 = 81.07, p < 0.001), with small to moderate effect sizes. Nursing students also reported lower perceived barrier scores (2.65 ± 0.78 vs. 2.95 ± 0.85, t = −6.04, p < 0.001, Cohen's d = −0.37). Multivariate logistic regression identified prior breast health education (OR = 4.642, 95% CI: 3.231–6.670, p < 0.001) and higher self-efficacy (OR = 1.817, 95% CI: 1.453–2.272, p < 0.001) as independent predictors of BSE, while higher perceived barriers were associated with lower odds of BSE (OR = 0.286, 95% CI: 0.226–0.360, p < 0.001). After adjusting for these IMB constructs, the OR for nursing major decreased from 1.912 to 1.648, suggesting that these factors partially explain the inter-major difference in BSE behavior.ConclusionIn this cross-sectional study, nursing students demonstrated higher BC prevention literacy than pharmacy students. Higher self-efficacy and lower perceived barriers, but not knowledge, were independently associated with BSE. These findings suggest that breast health education in medical colleges should prioritize skills training and barrier reduction over knowledge transfer alone.