Beliefs about breast cancer and mammography by behavioral stage.

PURPOSE/OBJECTIVES: To explore the relationships of Health Belief Model (HBM) variables and the Trans-theoretical Model with regard to behavioral stage of mammography adoption. DESIGN: Descriptive, correlational. SETTING: Large midwestern city. SAMPLE: 405 women over age 40 obtained through random digit dialing. Subjects had agreed to participate in a larger intervention study. METHODS: Data were collected during in-home interviews. Subjects completed six scales developed from the HBM and answered questions related to mammography compliance. MAIN RESEARCH VARIABLES: Perceptions of breast cancer susceptibility and seriousness, perceived benefits of and barriers to mammography, motivation to stay healthy, and perceived control over health; degree of mammography compliance. FINDINGS: Women complaint with mammography guidelines had significantly higher scores on seriousness, benefits, health motivation, and control as well as significantly lower scores on barriers. In addition, scores on susceptibility, seriousness, benefits, barriers, and health motivation were significantly different across stages of mammography (precontemplation, contemplation, and action/maintenance). CONCLUSIONS: Interventions should target attitudes about susceptibility and seriousness of breast cancer in women who do not comply with established guidelines for mammography. Women who are not in compliance and have no plans to seek mammography would benefit from additional emphasis on mammography benefits and from removal of barriers. Health motivation also must be addressed in noncompliant women. IMPLICATIONS FOR NURSING PRACTICE: These results promise to expand the understanding of a person's motivation to change health-seeking behaviors, specifically obtaining routine screening mammograms. Further research using this new framework is needed to substantiate these results with a cross section of women.