Health belief model variables as predictors of progression in stage of mammography adoption

Purpose. Identify predictors of change in mammography stage for nonadherent women so that appropriate stage-based interventions can be developed. Design. Participants were randomly assigned to one of four groups in a randomized clinical trial to increase mammography screening. This report focuses on predictors of stages of change of mammography behavior; intervention results are reported elsewhere. Setting. Indigent clinic and health maintenance organization. Subjects. Women, 50 or older, with no breast cancer diagnosis and nonadherent with mammography screening. Intervention. The intervention and results are described elsewhere. Measures. Previously validated belief scales. Results. Results showed that precontemplators and contemplators differed significantly at baseline and follow-up on all breast cancer beliefs except fear. Changes in barriers, benefits, and self-efficacy scores significantly predicted forward stage movement for women entering the study in precontemplation or contemplation (p = .0009, p = .037, and p = .048, respectively). Conclusions. Changes in beliefs predict stage movement, and beliefs differ significantly among stages, leading the way for interventions tailored to both beliefs and stages of behavior adoption. In practical terms, we may be able to cut down on the "bulkiness" of our interventions and the number of tailoring variables, focusing more intensively on tailoring interventions to the beliefs whose changes have now been shown to predict stage advancement. These predictions are in addition to intervention effect which is reported elsewhere.