Cervical Cancer Screening Behavior and Its Determinants Among Primary Health Care Providers in Georgia: A Cross-Sectional Study

Background: Cervical cancer remains a leading cause of preventable mortality among women in low- and middle-income countries. Primary health care providers are essential for promoting screening uptake, yet little is known about their own participation in screening programs in Georgia. This study assessed cervical cancer screening uptake and its behavioral determinants among female primary health care providers. Methods: A cross-sectional survey was conducted in December 2023 among 1,613 female primary health care providers enrolled in a national training program in Georgia (response rate: 95.3%). A self-administered questionnaire captured screening behaviors and behavioral drivers on the basis of the Capability, Opportunity, Motivation–Behavior (COM-B) framework. Multivariate logistic regression was used to identify factors independently associated with screening uptake. Results: Only 57% of participants reported ever undergoing cervical cancer screening, and 42% had been screened within the past three years. Screened providers were more likely to recommend or refer six or more patients per week for screening (OR = 1.49; 95% CI: 1.20–1.85). Six behavioral factors were independently associated with uptake: perceived sufficient knowledge (AOR = 1.60; 95% CI: 1.30–1.95), self-efficacy (AOR = 1.61; 95% CI: 1.32–1.96), receipt of training (AOR = 1.94; 95% CI: 1.58–2.38), family support (AOR = 1.94; 95% CI: 1.55–2.42), spousal support (AOR = 2.09; 95% CI: 1.68–2.60), and intention to be screened in the future (AOR = 2.25; 95% CI: 1.80–2.82). These factors correspond to the psychological capability, social opportunity, and reflective motivation domains of the COM-B model. Conclusions: Cervical cancer screening uptake among primary health care providers in Georgia is low, despite their critical role in patient education and referrals. Interventions to improve provider screening behavior should focus on enhancing knowledge, building confidence, and fostering supportive environments. Applying behavioral science frameworks may improve not only provider participation but also broader population-level engagement with screening programs.