Breast Cancer Risk Perception, Benefits of and Barriers to Mammography Adherence Among a Group of Iranian Women

School of Health & Nutrition, Department of Public Health and Management, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran.
Women & Health (Impact Factor: 1.05). 05/2011; 51(3):204-19. DOI: 10.1080/03630242.2011.564273
Source: PubMed


The study aimed to assess associations between Health Belief Model variables, stages of change, and participation in mammography for early detection of breast cancer in a sample of Iranian women. A total of 414 women, aged 40 to 73 years, were recruited by random sampling. The study took place in the winter of 2007, using a self-report questionnaire and structured interviews, designed to measure the five Health Belief Model constructs and stages of adoption for mammography. The study indicated that 45.8% of the women were in the pre-contemplation and contemplation stages of a mammogram, and 29% of participants reported having had at least one mammogram. Screening behavior was associated with older age, familial history of breast cancer, history of breast disease, health insurance coverage, and living in an urban area. Furthermore, the perceived susceptibility to breast cancer, perceived benefits and barriers for mammography, and cues to action variables defined by the Health Belief Model were four factors related to having a mammogram. The study concludes that health care professionals must provide women with more fear appeals that outline vulnerability to developing breast cancer, remove cognitive barriers to seeking mammography, and apply effective guidance on the participation of women in breast cancer screening programs.

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Available from: Hamid Allahverdipour, Nov 04, 2014
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    • "When undertaking breast cancer screening behaviors, it is important that theoretically based factors are employed to maximize the impact of the intervention. The Health Belief Model (HBM)[1516] has been used to explain factors influencing breast cancer screening behaviors and to plan and implement breast cancer screening programs in various populations.[417–19] The HBM is based on the theory that a person's willingness to change a health behavior is primarily due to the following factors: (1) perceived susceptibility (i.e., women's opinion of the chances of getting breast cancer), (2) perceived severity (i.e., a person's opinion of the seriousness of the condition), (3) perceived benefits (i.e., the opinion of the effectiveness of some advised action to reduce the risk, such as mammography), and (4) perceived barriers to having a mammography. "
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    ABSTRACT: Despite evidence that screening for breast cancer is effective, adherence with screening recommendations in Iranian women is low. The purposes of this study were to (1) identify the associations between individual characteristics, related health beliefs, and stages of mammography behavior and (2) examine the socio-demographic factors and the health beliefs that predicate stages of mammography behavior. All health care centers were considered as clusters and 30 women were randomly selected from each of them. A sample of 689 Iranian women completed a questionnaire. The questionnaire used was based on Champion's revised Health Belief Model Scale (CHBMS). One-way analysis of covariance (ANCOVA) was used to assess differences in the outcome variables (perceived severity, susceptibility, benefits, and barriers) across the stages. Multinomial logistic regression was conducted to test multivariate relationships. THE PERCENTAGE OF PARTICIPANTS IN EACH STAGE WAS: 40.1% in pre-contemplation, 34.7 in contemplation, 7.5% in relapse, 12% in action, and 5.7% in maintenance stage of mammography adoption. Older women were most likely to be in the pre-contemplation stage and action stage, and the youngest women were most likely to be in the relapse stage. Differences across stages of change were found for related beliefs for all participants except those in the relapse stage. Iranian women are less likely to be in maintenance and action stages than ot er Asian women and this study identifies constructs that may be targeted in interventions.
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    ABSTRACT: BACKGROUND:: Despite evidence that screening for breast cancer is effective, adherence with screening recommendations in Iranian women is low. OBJECTIVES:: The aims of this study were to (a) examine the relationships between related beliefs and (b) to determine to what extent women in stages of mammography adoption differ in their agreement of individual perceived health beliefs. METHODS:: A sample of 686 Iranian women completed a questionnaire including selected constructs of the Health Belief Model and stages of mammography adoption. RESULTS:: Proportions of participants who were in the preadoption and adoption stages were 75% and 17.8%, respectively. Precontemplators showed significantly lower positive attitude and greater agreement for most of the barrier items than did those in other adoption stages. In terms of specific items, women in the relapse and maintenance stages endorsed greatest agreement for the barrier items "not knowing how to get a mammogram" and "forget to schedule," respectively. Common barriers for women in preadoption stages were being painful, taking much time, and embarrassing. CONCLUSION:: Iranian women are less likely than other Asian women to be in the maintenance and action stages. Identifying the associations between perceived related beliefs items and stages of mammography adoption may provide detailed information to allow for future research and guide the development of interventions not only for Iranian women but also for similar cultural and immigrant groups that have been neglected to date in the breast cancer literature. IMPLICATIONS FOR PRACTICE:: Examining the interactions between perceived related beliefs items and other beliefs such as perceived control and self-efficacy to having a mammography is warranted.
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    ABSTRACT: Physicians' attitudes toward disease prevention are crucial. The purposes of this study are to examine the prevalence of cardiovascular risk factors and adherence to international preventive screening programs by a group of physicians. On-line and paper format questionnaires were completed by a sample of 650 physicians from November 2010 to March 2011. The collected data included the main components of screening programs, which are recommended in international guidelines. The data shows that 30.5% of male physicians currently smoke, 19.4 % are obese, 15.2% have hypertension, 38% are physical inactive and 10.9% have diabetes. Nearly all (95%) of the female participants and most (83%) of the male participants older than 45 years had never had a colonoscopy. Of the male physicians older than 55 years, 36.4% had never had prostate specific antigen (PSA) testing, and only 10.9% had undergone a digital rectal examination. Among the female physicians, 27.4% were obese, and 42% had never had a mammogram. The prevalence of behavioral risk factors for cardiovascular disease is high among physicians. A substantial percentage of the practicing physicians did not adhere to the age-specified preventive screening measures recommended in international guidelines.
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