The Mediating Role of Religious Health Fatalism and Modesty on the Association Between Religiosity and Mammography Screening Behavior Among Saudi Women

Introduction: Breast cancer is the most prevalent malignancy among Saudi women, yet mammography screening rates remain low despite government-funded initiatives. Socioreligious factors may influence mammography screening behaviors, but their roles remain underexplored. This study examines the direct effect of religiosity on mammography screening and the mediating roles of religious health fatalism (RHF) and modesty. Method: A cross-sectional study was conducted among 86 Saudi women. Data were collected through self-administered questionnaires measuring religiosity, RHF, modesty, and mammography screening behavior. Hierarchical logistic regression and mediation analyses were performed using SPSS and Hayes’s PROCESS macro. Results: Religiosity positively influenced screening behavior ( p = .006). However, RHF ( p = .015) and modesty ( p = .027) mediated this relationship, reducing screening likelihood. Physician recommendations were the strongest predictor ( p < .001). Discussion: While religiosity may encourage screening, RHF and modesty create barriers. Culturally sensitive interventions and physician engagement are crucial to improving screening uptake.