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Table 1 Factors of the SEM and TTI modified and applied in this study

From: The impact of the social environment on Zambian cervical cancer prevention practices

SEM a TTI b Environment level
(Stakeholders, Special interest groups, Policy makers)
Factors that influence behaviour as applied in the interview guides of the current study
(Stakeholders) - Social institutions with organizational characteristics, and formal/informal rules and regulations for operation.
Aspects of women’s immediate surroundings, neighbourhoods, social institutions, and culture that, although beyond the personal control of women, put them at risk
• availability of servicesc
• employment ratesc
• inadequate schoolsc
• media depictionsc
• (worksite) policies that vaccination and screeningd
(Special interest groups) - Relationships among organisations, institutions and informal networks within defined boundaries.
Values and behaviours of women that contribute to their attitudes toward screening and vaccination
• information opportunities (media and advertisements)
• interaction with social institutions (conducting campaigns)
• knowledgec
• stigma, values and evaluations (religious beliefs, cultural norms, barriers/uptake, priority, prevalence)
Public policy
(Policy makers) - Local, state, and national laws and policies
Beliefs and evaluations about the benefits of cervical cancer prevention
• age recommendations of screening and vaccination
• possibility of self-screening and cost
• possibility of vaccinating girls and boys
  1. aSEM definitions of levels from [3]; [9]
  2. bTTI definitions of levels from [19]
  3. cOnly the TTI mentions this factor
  4. dThe factor “policy”, is mentioned in the SEM at both organizational and public policy level