Journal of Education and Health Promotion

Mammography stage of adoption among Iranian women

Document Type : Original Article

Authors

. Mitra Moodi 1
. Mohsen Rezaeian 2
. Firoozeh Mostafavi 3
. Gholam R. Sharifirad 4

1 Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Department of Public Health, School of Health, Birjand University of Medical Sciences, Birjand,

2 Department of Community Medicine, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan

3 Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan

4 Department of Health Education and Health Services, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract
Background: Stage of Change and Health Belief Models are two the most common models
that have been applied in mammography screening behaviors. The purpose of this study was to
identify women in different stages of mammography adoption and to examine association between
women’s beliefs by stage of change among Iranian women. Methods: In this population-based
study, mammography screening behavior determined using the Rakoweski stage of change scale,
and women beliefs were determined by Farsi version of Champion’s Health Belief Model scale
(CHBMS). The obtained data were analyzed by SPSS (version 16.0) using statistical analysis
of variance and Chi-square tests that used to determine relation between socio-demographic
variables and HBM scales with stage of mammography. In all of the tests, a significant level
α=0.05 was considered. Results: According to stages of change distributions for mammography
screening behavior, 36.2% were in pre-contemplation, 21.1% in contemplation, 4.2% in action,
6.2% in maintenance, and 32.3% were in relapse stage. There were significant differences in
mammography stage by age, education, married status, family monthly income, husband job,
information about breast cancer, and history of breast problems. ANOVA test showed significant
differences by stages for all HBM scales, except to perceived severity. Conclusion: The findings
indicated that women in pre-contemplation, relapse, and contemplation stages are more likely need
to educational intervention, which emphasizes the benefits and barriers of mammography, health
motivation, and self-efficacy. Furthermore, examining individuals’ beliefs about breast cancer and
mammography screening by stage of mammography adoption is especially important in order
to development of effectiveness interventions, which targeted to stage of change and promote
mammography screening behavior.

Keywords

Breast cancer
Health Belief Model
mammography screening
stage of change
women
  1. Babaei M, Jaafarzadeh H, Sadjadi A, Samadi F, Yazdanbod A, Fallah
    M, et al. Cancer incidence and mortality in Ardabil: Report of an
    ongoing population-based cancer registry in Iran, 2004-2006. Iran
    J Public Health 2009;38:35-45. 2. Katapodi M, Lee K, Facione N, Dodd M. Predictors of perceived breast
    cancer risk and the relation between perceived risk and breast cancer
    screening: A meta-analytic review. Prev Med 2004;38:388-402.
    3. Farmer P, Frenk J, Knaul FM, Shulman LN, Alleyne G, Armstrong
    L, et al. Expansion of cancer care and control in countries of low
    and middle income: A call to action. Lancet 2010;376:1186-93.
    4. Naghavi M, Jafari N. Mortality views in 23 Provinces of Iran in
    2004. Tehran, Iran: Ministry of Health, Deputy for Health Directory.
    Research and Development Office; 2003. p. 75-6.
    5. Harirchi I, Kolahdoozan S, Karbakhsh M, Chegini N, Mohseni SM,
    Montazeri A, et al. Twenty years of breast cancer in Iran: Downstaging
    without a formal screening program. Ann Oncol 2011;22:93-7.
    6. Yip CH, Smith RA, Anderson BO, Miller AB, Thomas DB, Ang ES,
    et al. Guideline implementation for breast healthcare in low- and
    middle-income countries: Early detection resource allocation.
    Cancer 2008;113(8 Suppl):2244-56.
    7. Heydari Z, Mahmoudzadeh-Sagheb HR, Sakhavar N. Breast cancer
    screening knowledge and practice among women in southeast of
    Iran. Acta Med Iran 2008;46:321-8.
    8. Moodi M, Balali-Mood M, Sharifirad GR, Shahnazi H, Sharifzadeh G.
    Evaluation of breast self-examination program using Health Belief
    Model in female students. J Res Med Sci 2011;16:316-22.
    9. Emami Razavi S, Aghajani H, Haghazali M, Nadali F, Ramazani F,
    Dabiri E, et al. The most common cancers in Iranian women. Iran
    J Public Health 2009;38:109-12.
    10. Montazeri A, Ebrahimi M, Mehrdad N, Ansari M, Sajadian A. Delayed
    presentation in breast cancer: A study in Iranian women. BMC
    Womens Health 2003;3:4.
    11. Taleghani F, Yekta ZP, Nasrabadi AN. Coping with breast cancer in
    newly diagnosed Iranian women. J Adv Nurs 2006;54:265-72.
    12. Mousavi SM, Montazeri A, Mohagheghi MA, Jarrahi AM, Harirchi
    I, Najafi M, et al. Breast cancer in Iran: An epidemiological review.
    Breast J 2007;13:383-91.
    13. Yavari P, Pourhoseingholi MA. Socioeconomic factors association
    with knowledge and practice of breast self-examination among
    Iranian women. Asian Pac J Cancer Prev 2007;8:618-22.
    14. Sim HL, Seah M, Tan SM. Breast cancer knowledge and screening
    practices: A survey of 1,000 Asian women. Singapore Med J
    2009;50:132-8.
    15. American Cancer Society, (ACS). Cancer Facts and Figures 2011.
    Atlanta: American Cancer Society; 2011. p. 9-10.
    16. Gøtzsche PC, Nielsen M. Screening for breast cancer with
    mammography. Cochrane Database Syst Rev 2009;4:CD001877.
    17. Bulletins ACoP. ACOG Practice Bulletin: Clinical management
    guidelines for obstetrician gynecologists. Number 122, August
    2011: Breast Cancer screening (replaces practice bulletin, number
    152, April 2003). Obstet Gynecol 2011;122:1-11.
    18. Dundar PE, Ozmen D, Ozturk B, Haspolat G, Akyildiz F, Coban S,
    et al. The knowledge and attitudes of breast self-examination and
    mammography in a group of women in a rural area in western
    Turkey. BMC Cancer 2006;6:43.
    19. Goya M. Iranian Annual Cancer Registration Report 2005/2006.
    Ministry of Health and Medical Education, Health Deputy. Center
    for Disease Control and Prevention. 2007.
    20. Farshbaf Khalili A, Shahnazi M, Ghahveehi A, Torabi Sh.
    Performance conditions of breast cancer screening methods and
    its efficient factors among women referring to health centers of
    Tabriz. Iran J Nurs Res 2009;4:27-38.
    21. Pormehr S, Karimian NS, Sheykhan Z, Alavi Majd H. Investigation of
    breast cancer screening tests performance and affecting factors in
    women referred to Ardebil’s health and medical centers. J Ardabil
    Univ Med Sci Health Serv 2011;10:310-8.
    22. Banaeian SH, Kazemian A, Kheiri S. Knowledge, attitude and practice
    about breast cancer screening and related factors among women
    referred to health care centers in Boroujen in 2005. Shahrekord
    Univ Med Sci J 2006;7:28-34.
    23. Rahman S, Price JH, Dignan M, Lindquist PS, Jordan TR. Access to
    mammography facilities and detection of breast cancer by screening
    mammography: A GIS approach. Int J Cancer Prev 2009;2:403-13.
    24. Prochaska J, Wright J, Velicer W. Evaluating theories of
    health behavior change: A hierarchy of criteria applied to the
    transtheoretical model. Appl Psychol 2008;57:561-88.
    25. Champion V, Springston J, Zollinger T, Saywell R Jr, Monahan
    P, Zhao Q, et al. Comparison of three interventions to increase
    mammography screening in low income African American women.
    Cancer Detect Prev 2006;30:535-44.
    26. Glanz K, Rimer BK, Viswanath K. Health behavior and health
    education: Theory, research, and practice. San Francisco: JosseyBass Inc Pub; 2008. p. 98-117.
    27. Wu TY, Hsieh HF, West BT. Stages of mammography adoption in
    Asian American women. Health Educ Res 2009;24:748-59.
    28. Otero-Sabogal R, Stewart S, Shema S, Pasick R. Ethnic differences
    in decisional balance and stages of mammography adoption. Health
    Educ Behav 2007;34:278-96.
    29. Hayden J. Introduction to Health Behavior Theory. United States:
    Jones and Bartlett Learning; 2009. p. 65-78.
    30. Lin ZC, Effken JA. Effects of a tailored web-based educational
    intervention on women’s perceptions of and intentions to obtain
    mammography. J Clin Nurs 2010;19:1261-9.
    31. Rakowski W, Dube C, Goldstein M. Considerations for extending
    the transtheoretical model of behavior change to screening
    mammography. Health Educ Res 1996;11:77-96.
    32. Rakowski W, Andersen MR, Stoddard AM, Urban N, Rimer BK, Lane
    DS, et al. Confirmatory analysis of opinions regarding the pros and
    cons of mammography. Health Psychol 1997;16:433-41.
    33. Wu TY, West BT. Mammography stage of adoption and decision
    balance among Asian Indian and Filipino American women. Cancer
    Nurs 2007;30:390-8.
    34. Champion VL, Skinner CS. Differences in perceptions of risk,
    benefits, and barriers by stage of mammography adoption. J
    Womens Health (Larchmt) 2003;12:277-86.
    35. Rakowski W, Ehrich B, Dubé C, Pearlman D, Goldstein M, Peterson
    K, et al. Screening mammography and constructs from the
    transtheoretical model: Associations using two definitions of the
    stages-of-adoption. Ann Behav Med 1996;18:91-100.
    36. Taymoori P, Berry T. The validity and reliability of Champion’s Health
    Belief Model Scale for breast cancer screening behaviors among
    Iranian women. Cancer Nurs 2009;32:465-72.
    37. Kim JH, Menon U. Pre- and postintervention differences in
    acculturation, knowledge, beliefs, and stages of readiness for
    mammograms among Korean American women. Oncol Nurs Forum
    2009;36:E80-92.
    38. Tu SP, Yasui Y, Kuniyuki A, Schwartz SM, Jackson JC, Taylor VM.
    Breast cancer screening: Stages of adoption among Cambodian
    American women. Cancer Detect Prev 2002;26:33-41.
    39. Strong C, Liang W. Relationships between decisional balance and
    stage of adopting mammography and Pap testing among Chinese
    American women. Cancer Epidemiol 2009;33:374-80.
    40. Welsh AL, Sauaia A, Jacobellis J, Min SJ, Byers T. The effect of
    two church-based interventions on breast cancer screening rates
    among Medicaid-insured Latinas. Prev Chronic Dis 2005;2:A07.
    41. Kreuter MW, Lukwago SN, Bucholtz DC, Clark EM, SandersThompson V. Achieving cultural appropriateness in health
    promotion programs: Targeted and tailored approaches. Health
    Educ Behav 2003;30:133-46.
    42. Husaini BA, Sherkat DE, Levine R, Bragg R, Van CA, Emerson
    JS, et al. The effect of a church-based breast cancer screening
    education program on mammography rates among AfricanAmerican women. J Natl Med Assoc 2002;94:100-6.
    43. Husaini BA, Sherkat DE, Bragg R, Levine R, Emerson JS, Mentes
    CM, et al. Predictors of breast cancer screening in a panel study of
    African American women. Women Health 2001;34:35-51.
    44. Lubetkin EI, Santana A, Tso A, Jia H. Predictors of cancer screening
    among low-income primary care patients. J Health Care Poor
    Underserved 2008;19:135-48.
    45. Champion V, Menon U. Racial and educational differences in
    mammography-related perceptions among 1,336 nonadherent
    women. J Psychosoc Oncol 2002;20:1-18.
  2. 46. Steele-Moses SK, Russell KM, Kreuter M, Monahan P, Bourff
    S, Champion VL. Cultural constructs, stage of change, and
    adherence to mammography among low-income African
    American women. J Health Care Poor Underserved 2009;20:
    257-73.
    47. Ward E, Jemal A, Cokkinides V, Singh GK, Cardinez C, Ghafoor A,
    et al. Cancer disparities by race/ethnicity and socioeconomic status.
    CA Cancer J Clin 2004;54:78-93.
    48. Rauscher GH, Hawley ST, Earp JA. Baseline predictors of initiation
    vs. maintenance of regular mammography use among rural women.
    Prev Med 2005;40:822-30.
    49. Calvocoressi L, Kasl SV, Lee CH, Stolar M, Claus EB, Jones BA. A
    prospective study of perceived susceptibility to breast cancer and
    nonadherence to mammography screening guidelines in African
    American and White women ages 40 to 79 years. Cancer Epidemiol
    Biomarkers Prev 2004;13:2096-105.
    50. Selvin E, Brett KM. Breast and cervical cancer screening:
    Sociodemographic predictors among White, Black, and Hispanic
    women. Am J Public Health 2003;93:618-23.
    51. Greene AL, Torio CM, Klassen AC. Measuring sustained
    mammography use by urban African-American women. J
    Community Health 2005;30:235-51.
    52. Grindel CG, Brown L, Caplan L, Blumenthal D. The effect of breast
    cancer screening messages on knowledge, attitudes, perceived
    risk, and mammography screening of African American women in
    the rural South 2004. Oncol Nurs Forum 2004;31:801-8.
    53. Farmer D, Reddick B, D’Agostino R, Jackson SA. Psychosocial
    correlates of mammography screening in older African American
    women. Oncol Nurs Forum 2007;34:117-23.
    54. Taplin SH, Ichikawa L, Yood MU, Manos MM, Geiger AM, Weinmann
    S, et al. Reason for late-stage breast cancer: Absence of screening
    or detection, or breakdown in follow-up? J Natl Cancer Inst
    2004;96:1518-27.
    55. Zhu K, Hunter S, Bernard LJ, Payne-Wilks K, Roland CL, Elam LC,
    et al. An intervention study on screening for breast cancer among
    single African-American women aged 65 and older. Prev Med
    2002;34:536-45.
    56. Dailey AB, Kasl SV, Holford TR, Calvocoressi L, Jones BA.
    Neighborhood-level socioeconomic predictors of nonadherence to
    mammography screening guidelines. Cancer Epidemiol Biomarkers
    Prev 2007;16:2293-303.
    57. Fowler BA. The influence of social support relationships on
    mammography screening in African-American women. J Natl Black
    Nurses Assoc 2007;18:21-9.
    58. Dolan NC, Reifler DR, McDermott MM, McGaghie WC. Adherence to
    screening mammography recommendations in a university general
    medicine clinic. J Gen Intern Med 1995;10:299-306.
    59. Marwill SL, Freund KM, Barry PP. Patient factors associated with
    breast cancer screening among older women. J Am Geriatr Soc
    1996;44:1210-4.
    60. Champion VL. Beliefs about breast cancer and mammography by
    behavioral stage. Oncol Nurs Forum 1994;21:1009-14.
    61. Russell KM, Monahan P, Wagle A, Champion V. Differences in health
    and cultural beliefs by stage of mammography screening adoption
    in African American women. Cancer 2007;109(2 Suppl):386-95.
    62. Menon U, Champion V, Monahan PO, Daggy J, Hui S, Skinner CS.
    Health belief model variables as predictors of progression in stage
    of mammography adoption. Am J Health Promot 2007;21:255-61.
    63. Brenes GA, Skinner CS. Psychological factors related to stage of
    mammography adoption. J Womens Health Gend Based Med
    1999;8:1313-21.
    64. Lauver DR, Henriques JB, Settersten L, Bumann MC. Psychosocial
    variables, external barriers, and stage of mammography adoption.
    Health Psychol 2003;22:649-53.
    65. Champion VL, Springston J. Mammography adherence and beliefs
    in a sample of low-income African American women. Int J Behav
    Med 1999;6:228-40.
    66. Skinner CS, Arfken CL, Sykes RK. Knowledge, perceptions, and
    mammography stage of adoption among older urban women. Am
    J Prev Med 1998;14:54-63.
Journal of Education and Health Promotion
Volume 2, Issue 4
Autumn 2012
Pages 1-8

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