Do perceived barriers and benefits vary by mammography stage?

Abstract

We investigated whether perceived barriers and benefits varied by stage of considering mammography. A total of 1,093 university employees completed questionnaires measuring constructs from the Transtheoretical and Health Belief Models. Action/Maintainers (the referent category) generally differed from Contemplators and Relapsers in perceived barriers and from Precontemplators and Contemplators in perceived benefits. Compared to Action/Maintainers, Relapsers were more likely to agree that mammograms take too much time; Contemplators and Relapsers were more likely to agree that mammograms are inconvenient, embarrassing, too costly, and hard to remember; and Precontemplators and Contemplators were less likely to agree that mammograms are painful. Lack of physician recommendation revealed the largest differences by stage (Precontemplators' odds ratios = 20.8, Contemplators' = 8.27, and Relapsers' = 4.05). For benefits, Precontemplators and Contemplators were less likely to agree that mammograms help find lumps early and find lumps before they can be felt; Precontemplators were less likely to agree that mammography can decrease mortality. Precontemplators may need more benefits-enhancing than barriers-reducing interventions. Contemplators may need persuasion that benefits are great while barriers are small. Relapsers may need barriers-reducing interventions. Physicians need to understand the importance of their role among women at all stages of considering mammography.