The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #60387

Jo Anne G. Jensen, PhD, Public and Community Health, University of Maryland, 2387 HHP Building, Valley Drive, College Park, MD 301-594-5196 and Robert H Feldman, PhD, Department of Public and Community Health, University of Maryland, Valley Drive, College Park, MD 20742, 301.405.2519, rfeldman@wam.umd.edu.

Screening mammography is the primary means of decreasing breast cancer deaths. Though the number of women adhering to screening guidelines is increasing, there remains large number of women in the U. S. who are not screened periodically. It is important to identify models that reliably predict screening behaviors. The Health Belief Model (HBM) and the Transtheoretical Model (TTM) are two behavioral change models used frequently by health professionals. This study compared and contrasted these two models. Three hundred and thirteen women, 42 years and older were surveyed in two Southern states. Predictors assessed included perceived benefits/pros, perceived barriers/cons, self-efficacy, perceived susceptibility, perceived seriousness, cues to action, and processes of change: thinking beyond self, information acquisition, and commitment to screening. Multivariate logistic regression (MLR) analyses identified significant predictors from both models. The study results demonstrated that women who had a high school education or less and unmarried women were less likely to screen (OR = 0.37, p = 0.04, 95% CI = 0.15, 0.94; OR = 0.35, p = 0.03, 95% CI = 0.14, 0.89, respectfully). However, women who were retired were more likely to screen (OR = 4.00, p = 0.01, CI = 1.48, 10.86). Using multivariate logistic regression analysis and Chi-square statistics to compare the two models, the TTM demonstrated a significant improvement (p = 0.001) in prediction over the HBM with screening mammography.

Learning Objectives:

By the end of the presentation, participants will: (
• recognize similarities and differences in the HBM and the TTM concepts and (
• describe strengths and weakness of each model and (
• identify reliable predictors of screening mammography behavior.

Keywords: Theory, Mammography Screening

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.