Abstract
In line with the health belief model, perceived barriers have proven to be a key determinant of intentions to screen for breast cancer. The standard measure of perceived barriers to breast cancer screening is an 11 item scale developed by Victoria Champion. However, perceived barriers emerge and change over time, and Champion’s perceived barriers scale was last revised in 1999. Moreover, the original scale did not address barriers which may be more pronounced in particular populations, such as congruity of action with faith. As part of the Utah Screening Project, a sample of women 40–74 (N = 341, Mage = 51.19, SD = 8.11) were recruited from four Utah counties in 2014 to complete a survey. The results revealed that the four new perceived barrier items explained 6.4 % of intentions to screen, above and beyond other predictors. In addition to barriers identified in past research, the current study identified several novel barriers including (a) concerns about negative effects to breast implants, (b) perceived conflict with faith, and the (c) perception that mammography is no longer recommended. The new perceived barriers items are useful to researchers interested in exploring barriers not addressed by the original instrument. The barriers also suggest potential belief-based targets and channels (e.g., plastic surgery clinics, faith-based interventions) for delivering mammography interventions.
References
American Cancer Society (2013) Breast cancer facts and figures 2013–2014. American Cancer Society, Inc, Atlanta
Siegel RL, Miller KD, Jemal A (2015) Cancer statistics, 2015. CA Cancer J Clin 65(1):5–29
Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds.) (2013). SEER Cancer Statistics Review, 1975–2011, National Cancer Institute. Bethesda, MD. Retrieved from http://seer.cancer.gov/csr/1975_2011/
Nelson HD, Tyne K, Naik A, Bougatsos C, Chan BK (2009) Screening for breast cancer: an update for the U.S. Preventive Services Task Force. Ann Intern Med 151:727–737
National Cancer Institute (2012) Cancer trends progress report: 2011/2012 update. Breast cancer screening [Internet] Bethesda, MD: National Cancer Institute; 2012. [cited 2015 Feb 19]. Retrieved from: http://progressreport.cancer.gov/doc_detail.asp?pid=1&did=2011&chid=102&coid=1016&mid=
Fulton JP, Buechner JS, Scott HD, DeBuono BA, Feldman JP, Smith RA, Kovenock D (1991) A study guided by the health belief model of the predictors of breast cancer screening of women ages 40 and older. Public Health Rep 106(4):410
Glanz K, Bishop DB (2012) The role of behavioral science theory in the development and implementation of public health interventions. Annu Rev Public Health 21:299–418. doi:10.1146/annurev.publhealth.012809.103604
Hyman RB, Baker S, Ephraim R, Moadel A, Philip J (1994) Health Belief Model variables as predictors of screening mammography utilization. J Behav Med 17(4):391–406
Champion V, Skinner CS (2003) Differences in perceptions of risk, benefits, and barriers by stage of mammography adoption. J Women’s Health 12:277–286
Jensen JD, King AJ, Carcioppolo N, Davis L (2012) Why are tailored messages more effective? A multiple mediation analysis of a breast cancer screening intervention. J Commun 62(5):851–868
Champion VL (1984) Instrument development for health belief model constructs. Adv Nurs Sci 6(3):73–85
Champion V (1995) Development of a benefits and barriers scale for mammography utilization. Cancer Nurs 18(1):53–59
Menon U, Champion V, Monahan PO, Daggy J, Hui S, Sugg Skinner C (2003) Health belief model variables as predictors of progression in stage of mammography adoption. Am J Health Promot 21(4):255–261
Champion V (1999) Revised susceptibility, benefits, and barriers scale for mammography screening. Res Nurs Health 22:341–348
National Cancer Institute (2012) Directly Estimated 2012 BRFSS Data. State Cancer Profiles [Online]. Retrieved from: http://statecancerprofiles.cancer.gov/quick-profiles/index.php?statename=utah#t=1. Accessed 20 Feb 2015
Brown W, Pakenham KI (2004) Mammography screening distress and pain: changes over time and relations with breast symptoms, implants and cancer detection concerns. Psychol Health Med 9(4):403–410
Benjamins MR, Trinitapoli J, Ellison CG (2006) Religious attendance, health maintenance beliefs, and mammography utilization: findings from a nationwide survey of Presbyterian women. J Sci Study Relig 45(4):597–607
Fox SA, Pitkin K, Paul C, Carson S, Duan N (1998) Breast cancer screening adherence: does church attendance matter? Health Educ Behav 25(6):742–758
Katz ML, Kauffman RM, Tatum CM, Paskett ED (2008) Influence of church attendance and spirituality in a randomized controlled trial to increase mammography use among a low-income, tri-racial, rural community. J Relig Health 47:227–236
Krakow MM, Jensen JD, Carcioppolo N, Weaver J, Liu M, Guntzviller LM (2015) Psychosocial predictors of human papillomavirus vaccination intentions for young women 18–26: religiosity, morality, promiscuity, and cancer worry. Women’s Health Issues 25(2):105–111
Mitchell J, Lannin DR, Mathews HF, Swanson MS (2002) Religious beliefs and breast cancer screening. J Women’s Health 11(10):907–915
Howard DH, Adams EK (2012) Mammography rates after the 2009 US Preventive Services Task Force screening recommendation. Prev Med 55(5):485–487
Pace LE, He Y, Keating NL (2013) Trends in mammography screening rates after publication of the 2009 US Preventive Services Task Force recommendations. Cancer 119(14):2518–2523
Finney Rutten LJ, Ebbert JO, Jacobson DJ, Squiers LB, Fan C, Breitkopf CR, Roger VL, St. Sauver JL (2014) Changes in U.S. preventive services task force recommendations: effect on mammography screening in Olmsted County, MN 2004–2013. Prev Med 69:235–238
Finney Rutten LJ, Ebbert JO, Jacobsen DJ, Squiers LB, Fan C, Breitkopf CR, Roger VL, Sauver JL (2014) Changes in U.S. Preventive Services Task Force recommendations: effects on mammography screening in Olmsted County, MN 2004–2013. Prev Med 69:235–238
Tolma EL, Reininger BM, Evans A, Ureda J (2006) Examining the theory of planned behavior and the construct of self-efficacy to predict mammography intention. Health Education Behav 33(2):233–251
Menon U, Champion V, Monahan PO, Daggy J, Hui S, Skinner CS (2007) Health belief model variables as predictors of progression in stage of mammography adoption. Am J Health Promot 21(4):255–261
Gail MH, Costantino JP, Pee D, Bondy M, Newman L, Selvam M, Bernstein L (2007) Projecting individualized absolute invasive breast cancer risk in African American women. J Natl Cancer Inst 99:1782–1792
Champion V, Skinner CS, Menon U (2005) Development of a self-efficacy scale for mammography. Res Nurs Health 28:329–336
Carpenter CJ (2010) A meta-analysis of the effectiveness of health belief model variables in predicting behavior. Health communication 25(8):661–669
Sampson S (2011) Cosmetic surgery: is Utah still the vainest? Retrieved on 2 March 2015, from http://www.ksl.com/?sid=17790344
Holt CL, Lukwago SN, Kreuter MW (2003) Spirituality, breast cancer beliefs and mammography utilization among urban African American women. J Health Psychol 8(3):383–396
Acknowledgments
Jakob D. Jensen is an Associate Professor in the Department of Communication and the Huntsman Cancer Institute at the University of Utah. Chelsea Ratcliff, Jeremy Weaver, William Payton, and Sherrie Loewen are graduate students in the Department of Communication at the University of Utah. Melinda Krakow is a post-doctoral fellow at the National Cancer Institute. This research was funded by a grant from the Utah Department of Health.
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Jensen, J.D., Ratcliff, C., Weaver, J. et al. Explicating perceived barriers to mammography for the USCREEN project: concerns about breast implants, faith violations, and perceived recommendations. Breast Cancer Res Treat 154, 201–207 (2015). https://doi.org/10.1007/s10549-015-3581-2
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DOI: https://doi.org/10.1007/s10549-015-3581-2