Abstract
While many researchers often use a theoretical framework for mammogram repeat interventions, it seems they do not apply an identified mediation analysis method. The aim of this study was to determine the mediators of mammogram replication behavior in two tailored interventions for non-adherent Iranian women. A sample population of 184 women over 50 years old in Sanandaj, Iran, was selected for an experiment. Participants were randomly allocated into one of the three conditions: 1) an intervention based on the Health Belief Model (HBM) 2) an intervention based on an integration of the HBM and selected constructs from the Theory of Planned Behavior (TPB), and 3) a control group. Constructs were measured before the intervention, and after a 6-month follow-up. Perceived self-efficacy, behavioral control, and subjective norms were recognized as mediators in the HBM and selected constructs from the TPB intervention. Perceived susceptibility, severity, barriers, self-efficacy and behavioral control met the criteria for mediation in the HBM intervention. This study was successful in establishing mediation in a sample of women. Our findings enrich the literature on mammography repeat, indicating key intervention factors, and relegating redundant ones in the Iranian populations. The use of strategies to increase mammography repeat, such HBM and TPB constructs is suggested to be important for maintaining a screening behavior, once the behavior has been adopted.
Highlights
Some reports have documented that regular mammography screening has led to a reduction in breast cancer mortality in women between the ages 50 to 74 about approximately 25-30% (Yoo et al, 2013)
244 women were screened for the following eligibility criteria: no history of breast cancer; a history of a mammogram within the past 2-3 years; no intention to obtain a mammogram within the year; and an ability to read and write
The majority of socio-demographic and clinical variables did not vary across groups
Summary
Some reports have documented that regular mammography screening has led to a reduction in breast cancer mortality in women between the ages 50 to 74 about approximately 25-30% (Yoo et al, 2013). Until 2001, only about half of eligible women have obtained repeat mammography screening (WHO, 2008). While many researchers often use a theoretical framework for mammogram repeat interventions, it seems they do not apply an identified mediation analysis method. The aim of this study was to determine the mediators of mammogram replication behavior in two tailored interventions for non-adherent Iranian women. Results: Perceived self-efficacy, behavioral control, and subjective norms were recognized as mediators in the HBM and selected constructs from the TPB intervention. Severity, barriers, self-efficacy and behavioral control met the criteria for mediation in the HBM intervention. The use of strategies to increase mammography repeat, such HBM and TPB constructs is suggested to be important for maintaining a screening behavior, once the behavior has been adopted
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