Abstract
In late 1987, a total of 852 Rhode Island women ages 40 and older were interviewed by telephone (78 percent response rate) to measure their use of breast cancer screening and to investigate potential predictors of use. Predictors included the women's socioeconomic status, use of medical care, a provider's reported recommendations for screening, and the women's health beliefs about breast cancer and mammography. The Health Belief Model guided the construction of the interview questions and data analysis. Logistic regression was used to identify leading independent predictors of breast cancer screening according to contemporary recommendations: reporting that a medical provider had ever recommended a screening mammogram (odds ratio [OR] = 18.77), having received gynecological care in the previous year (OR = 4.92), having a regular source of gynecological care (OR = 2.63), having ever had a diagnostic mammogram (OR = 2.32), and perceiving mammography as safe enough to have annually (OR = 1.93). The findings suggest that programs intended to increase the use of breast cancer screening should include "inreach" and "outreach" elements; inreach to patients with established patient-provider relationships, by assuring that physicians recommend screening to all eligible patients, and outreach to all eligible women, by helping them overcome barriers to effective primary care, and by promoting mammography, emphasizing its effectiveness and safety. The findings also suggest that socioeconomically disadvantaged women, who are less likely to be screened than other women, should become special targets of inreach and outreach interventions.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Aho W. R. Participation of senior citizens in the swine flu inoculation program: an analysis of Health Belief Model variables in preventive health behavior. J Gerontol. 1979 Mar;34(2):201–208. doi: 10.1093/geronj/34.2.201. [DOI] [PubMed] [Google Scholar]
- Aho W. R. Smoking, dieting, and exercise: age differences in attitudes and behavior relevant to selected health belief model variables. The perceived seriousness is an important factor in influencing behavior. R I Med J. 1979 Mar;62(3):85–92. [PubMed] [Google Scholar]
- Baker L. H. Breast Cancer Detection Demonstration Project: five-year summary report. CA Cancer J Clin. 1982 Jul-Aug;32(4):194–225. doi: 10.3322/canjclin.32.4.194. [DOI] [PubMed] [Google Scholar]
- Baker L. H., Chin T. D., Wagner K. V. Progress in screening for early breast cancer. J Surg Oncol. 1985 Oct;30(2):96–102. doi: 10.1002/jso.2930300207. [DOI] [PubMed] [Google Scholar]
- Becker M. H., Maiman L. A., Kirscht J. P., Haefner D. P., Drachman R. H. The Health Belief Model and prediction of dietary compliance: a field experiment. J Health Soc Behav. 1977 Dec;18(4):348–366. [PubMed] [Google Scholar]
- Becker M. H., Radius S. M., Rosenstock I. M., Drachman R. H., Schuberth K. C., Teets K. C. Compliance with a medical regimen for asthma: a test of the health belief model. Public Health Rep. 1978 May-Jun;93(3):268–277. [PMC free article] [PubMed] [Google Scholar]
- Bodenheimer H. C., Jr, Fulton J. P., Kramer P. D. Acceptance of hepatitis B vaccine among hospital workers. Am J Public Health. 1986 Mar;76(3):252–255. doi: 10.2105/ajph.76.3.252. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Burack R. C., Liang J. The acceptance and completion of mammography by older black women. Am J Public Health. 1989 Jun;79(6):721–726. doi: 10.2105/ajph.79.6.721. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Burack R. C., Liang J. The early detection of cancer in the primary-care setting: factors associated with the acceptance and completion of recommended procedures. Prev Med. 1987 Nov;16(6):739–751. doi: 10.1016/0091-7435(87)90014-4. [DOI] [PubMed] [Google Scholar]
- Calnan M. W., Moss S. The health belief model and compliance with education given at a class in breast self-examination. J Health Soc Behav. 1984 Jun;25(2):198–210. [PubMed] [Google Scholar]
- Calnan M., Rutter D. R. Do health beliefs predict health behaviour? An analysis of breast self-examination. Soc Sci Med. 1986;22(6):673–678. doi: 10.1016/0277-9536(86)90039-0. [DOI] [PubMed] [Google Scholar]
- Calnan M. The health belief model and participation in programmes for the early detection of breast cancer: a comparative analysis. Soc Sci Med. 1984;19(8):823–830. doi: 10.1016/0277-9536(84)90399-x. [DOI] [PubMed] [Google Scholar]
- Cerkoney K. A., Hart L. K. The relationship between the health belief model and compliance of persons with diabetes mellitus. Diabetes Care. 1980 Sep-Oct;3(5):594–598. doi: 10.2337/diacare.3.5.594. [DOI] [PubMed] [Google Scholar]
- Collette H. J., Day N. E., Rombach J. J., de Waard F. Evaluation of screening for breast cancer in a non-randomised study (the DOM project) by means of a case-control study. Lancet. 1984 Jun 2;1(8388):1224–1226. doi: 10.1016/s0140-6736(84)91704-5. [DOI] [PubMed] [Google Scholar]
- Croog S. H., Richards N. P. Health beliefs and smoking patterns in heart patients and their wives: a longitudinal study. Am J Public Health. 1977 Oct;67(10):921–930. doi: 10.2105/ajph.67.10.921. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cummings K. M., Jette A. M., Brock B. M., Haefner D. P. Psychosocial determinants of immunization behavior in a swine influenza campaign. Med Care. 1979 Jun;17(6):639–639. doi: 10.1097/00005650-197906000-00008. [DOI] [PubMed] [Google Scholar]
- Fox S., Baum J. K., Klos D. S., Tsou C. V. Breast cancer screening: the underuse of mammography. Radiology. 1985 Sep;156(3):607–611. doi: 10.1148/radiology.156.3.4023217. [DOI] [PubMed] [Google Scholar]
- French K., Porter A. M., Robinson S. E., McCallum F. M., Howie J. G., Roberts M. M. Attendance at a breast screening clinic: a problem of administration or attitudes. 1982 Aug 28-Sep 4Br Med J (Clin Res Ed) 285(6342):617–620. doi: 10.1136/bmj.285.6342.617. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hallal J. C. The relationship of health beliefs, health locus of control, and self concept to the practice of breast self-examination in adult women. Nurs Res. 1982 May-Jun;31(3):137–142. [PubMed] [Google Scholar]
- Hayward R. A., Shapiro M. F., Freeman H. E., Corey C. R. Who gets screened for cervical and breast cancer? Results from a new national survey. Arch Intern Med. 1988 May;148(5):1177–1181. [PubMed] [Google Scholar]
- Herold E. S. The health belief model: can it help us to understand contraceptive use among adolescents? J Sch Health. 1983 Jan;53(1):19–21. doi: 10.1111/j.1746-1561.1983.tb04047.x. [DOI] [PubMed] [Google Scholar]
- Hirschfield-Bartek J. Health beliefs and their influence on breast self-examination practices in women with breast cancer. Oncol Nurs Forum. 1982 Summer;9(3):77–81. [PubMed] [Google Scholar]
- King J. B. The impact of patients perceptions of high blood pressure on attendance at screening, An extension of the Health Belief Model. Soc Sci Med. 1982;16(10):1079–1091. doi: 10.1016/0277-9536(82)90184-8. [DOI] [PubMed] [Google Scholar]
- Kruse J., Phillips D. M. Factors influencing women's decision to undergo mammography. Obstet Gynecol. 1987 Nov;70(5):744–748. [PubMed] [Google Scholar]
- Larson E. B., Bergman J., Heidrich F., Alvin B. L., Schneeweiss R. Do postcard reminders improve influenza compliance? A prospective trial of different postcard "cues". Med Care. 1982 Jun;20(6):639–648. doi: 10.1097/00005650-198206000-00010. [DOI] [PubMed] [Google Scholar]
- Larson E. B., Olsen E., Cole W., Shortell S. The relationship of health beliefs and a postcard reminder to influenza vaccination. J Fam Pract. 1979 Jun;8(6):1207–1211. [PubMed] [Google Scholar]
- Leathar D. S., Roberts M. M. Older women's attitudes towards breast disease, self examination, and screening facilities: implications for communication. Br Med J (Clin Res Ed) 1985 Mar 2;290(6469):668–670. doi: 10.1136/bmj.290.6469.668. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ludvigsson J., Richt B., Svensson P. G. Compliance and the health relief model--its relevance to the treatment of juvenile diabetes mellitus. Scand J Soc Med Suppl. 1980;18:57–72. [PubMed] [Google Scholar]
- Maclean U., Sinfield D., Klein S., Harnden B. Women who decline breast screening. J Epidemiol Community Health. 1984 Dec;38(4):278–283. doi: 10.1136/jech.38.4.278. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mamon J. A., Zapka J. G. Breast self-examination by young women: I. Characteristics associated with frequency. Am J Prev Med. 1986 Mar-Apr;2(2):61–69. [PubMed] [Google Scholar]
- McDonald C. J., Hui S. L., Smith D. M., Tierney W. M., Cohen S. J., Weinberger M., McCabe G. P. Reminders to physicians from an introspective computer medical record. A two-year randomized trial. Ann Intern Med. 1984 Jan;100(1):130–138. doi: 10.7326/0003-4819-100-1-130. [DOI] [PubMed] [Google Scholar]
- Reeder S., Berkanovic E., Marcus A. C. Breast cancer detection behavior among urban women. Public Health Rep. 1980 May-Jun;95(3):276–281. [PMC free article] [PubMed] [Google Scholar]
- Rundall T. G., Wheeler J. R. Factors associated with utilization of the swine flu vaccination program among senior citizens in Tompkins County. Med Care. 1979 Feb;17(2):191–200. doi: 10.1097/00005650-197902000-00009. [DOI] [PubMed] [Google Scholar]
- Rutledge D. N., Hartmann W. H., Kinman P. O., Winfield A. C. Exploration of factors affecting mammography behaviors. Prev Med. 1988 Jul;17(4):412–422. doi: 10.1016/0091-7435(88)90040-0. [DOI] [PubMed] [Google Scholar]
- Shapiro S., Venet W., Strax P., Venet L., Roeser R. Ten- to fourteen-year effect of screening on breast cancer mortality. J Natl Cancer Inst. 1982 Aug;69(2):349–355. [PubMed] [Google Scholar]
- Tabár L., Fagerberg C. J., Gad A., Baldetorp L., Holmberg L. H., Gröntoft O., Ljungquist U., Lundström B., Månson J. C., Eklund G. Reduction in mortality from breast cancer after mass screening with mammography. Randomised trial from the Breast Cancer Screening Working Group of the Swedish National Board of Health and Welfare. Lancet. 1985 Apr 13;1(8433):829–832. doi: 10.1016/s0140-6736(85)92204-4. [DOI] [PubMed] [Google Scholar]
- Verbeek A. L., Hendriks J. H., Holland R., Mravunac M., Sturmans F., Day N. E. Reduction of breast cancer mortality through mass screening with modern mammography. First results of the Nijmegen project, 1975-1981. Lancet. 1984 Jun 2;1(8388):1222–1224. doi: 10.1016/s0140-6736(84)91703-3. [DOI] [PubMed] [Google Scholar]
- Walker L. R., Glanz K. Psychosocial determinants of breast self-examination. Am J Prev Med. 1986 May-Jun;2(3):169–178. [PubMed] [Google Scholar]
- Waters W. E., Nichols S. Breast cancer: women's knowledge and attitudes and the difficulties of influencing them. Community Med. 1982 Aug;4(3):173–180. doi: 10.1007/BF02548807. [DOI] [PubMed] [Google Scholar]
- Weisman C. S., Celentano D. D., Klassen A. C., Rosenshein N. B. Utilization of obstetrician-gynecologists and prevention of cervical cancer. Obstet Gynecol. 1987 Sep;70(3 Pt 1):373–377. [PubMed] [Google Scholar]
- Zapka J. G., Stoddard A. M., Costanza M. E., Greene H. L. Breast cancer screening by mammography: utilization and associated factors. Am J Public Health. 1989 Nov;79(11):1499–1502. doi: 10.2105/ajph.79.11.1499. [DOI] [PMC free article] [PubMed] [Google Scholar]