An implementation intentions intervention to increase uptake of mammography
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Background and Purpose: This study tested an implementation intentions intervention to increase uptake in the United Kingdom’s National Health Service Breast Screening Programme. The intervention asked women to plan how they would overcome up to 3 previously identified barriers to attending.Methods: In a randomized controlled trial, 2,082 participants were allocated to an intervention condition, an assessment-only condition, or a nonassessment control condition. The intervention condition was designed to help women plan how to change their appointment, how to arrange transport, and how to negotiate time off work. The assessment-only condition controlled for the possibility that completing a questionnaire about mammography might in itself influence attendance, and the nonassessment condition was a control against any effect on attendance that mere contact with the research team might have.Results: Mean age of respondents was 56.1 years, and 99.4% were White British. In the full intention-to-treat analysis, which included all participants, attendance was found to be almost identical across the 3 conditions, around 80%. Some of the women in the intervention condition, however, failed to write their plans on the questionnaire (10.6% for changing the appointment, 2.1% for travel arrangements, and 21.1% for taking time off work) or said that planning was irrelevant to them (2.4% for changing the appointment, 1.7% for travel arrangements, and 32.4% for taking time off work). A second analysis, of planning time off work, therefore, examined the 620 respondents in the intervention condition more closely and found that those who planned were significantly more likely to attend than those who did not. A 3rd analysis, excluding the 209 respondents for whom planning time off work was irrelevant, revealed that the most likely to plan were those whose initial intentions to attend were strong but whose perceptions of control over making the necessary arrangements to attend were weak.Conclusions: Two main implications of the findings are discussed: the importance of planning in implementation intentions interventions and the validity of the theoretical distinction between motivation and volition.
Liz Steadman is now at the Department of Applied Social Sciences, Canterbury Christ Church University, United Kingdom. nt]mis
- Parkin DM, Bray FI, Devesa SS: Cancer burden in the year 2000.European Journal of Cancer. 2001,37(Suppl. 8):S4-S66. CrossRef
- Botha JL, Bray FI, Sankila R, Parkin DM.: Breast cancer incidence and mortality trends in 16 European countries.European Journal of Cancer. 2003,39:1718–1729. CrossRef
- Blanks RG, et al.: Effect of NHS breast screening programme on mortality from breast cancer in England and Wales, 1990-98: Comparison of observed with predicted mortality.British Medical Journal. 2000,321:665–669. CrossRef
- National Health Service Breast Screening Programme:NHS Breast Screening Programme Annual Review 2005. Sheffield, UK: National Health Service Breast Screening Programme, 2005.
- Rutter DR, Calnan M, Field S, Vaile MSB: Predicting reattendance in the second round of the UK National Breast Screening Programme: A prospective 3-year longitudinal analysis.The Breast. 1997,6:120–125. CrossRef
- Saidi G, Sutton S, Bickler G: A predictive study of reasons for attendance and non-attendance at a breast screening programme.Psychology and Health. 1998,13:23–33. CrossRef
- Sutton S, Saidi G, Bickler G: Women’s reasons for attending or not attending for breast screening. In Schröder H, Reschke K, Johnston M, Maes S (eds),Health Psychology—Potential in Diversity. Regensburg, Germany: S. Roderer Verlag, 1993.
- Rutter DR: Attendance and reattendance for breast cancer screening: A prospective three-year test of the theory of planned behaviour.British Journal of Health Psychology. 2000,5:1–13. CrossRef
- Sutton S, Bickler G, Sancho-Aldridge J, Saidi G: Prospective study of predictors of attendance for breast screening in inner London.Journal of Epidemiology and Community Health. 1994,48:65–73. CrossRef
- Bankhead C, Richards SH, Peters TJ, et al.: Improving attendance for breast screening among recent non-attenders: A randomised controlled trial of two interventions in primary care.Journal of Medical Screening. 2001,9:99–105. CrossRef
- Richards SH, Bankhead C, Peters TJ, et al.: Cluster randomised controlled trial comparing the effectiveness and cost-effectiveness of two primary care interventions aimed at improving attendance for breast screening.Journal of Medical Screening. 2001,8:91–98. CrossRef
- Rosenstock IM: The health belief model and preventive health behavior.Health Education Monographs. 1974,2:354–386.
- Aiken LS, West SG, Woodward CK, Reno RR, Reynolds KD: Increasing screening mammography in asymptomatic women: evaluation of a second-generation, theory-based program.Health Psychology. 1994,13:526–538. CrossRef
- Champion V, Maraj M, Hui S, et al.: Comparison of tailored interventions to increase mammography screening in nonadherent older women.Preventive Medicine. 2003,36:150–158. CrossRef
- O’Conner AM, Griffiths CJ, Underwood MR: Can postal prompts from general practitioners improve the uptake of breast screening? A randomised controlled trial in one east London general practice.Journal of Medical Screening. 1998,5:49–52.
- Gollwitzer PM: Goal achievement: The role of intentions. In Stroebe W, Hewstone M, (eds),European Review of Social Psychology. Chichester, UK: Wiley, 1993, 141–185.
- Gollwitzer PM: Implementation intentions: Strong effects of simple plans.American Psychologist. 1999,54:493–503. CrossRef
- Gollwitzer PM, Brandstätter V: Implementation intentions and effective goal pursuit.Journal of Personality and Social Psychology. 1997,73:186–199. CrossRef
- Orbell S, Hodgkins S, Sheeran P: Implementation intentions and the theory of planned behavior.Personality and Social Psychology Bulletin. 1997,23:945–954. CrossRef
- Sheeran P, Orbell S: Implementation intentions and repeated behaviour: Augmenting the predictive validity of the theory of planned behaviour.European Journal of Social Psychology. 1999,29:349–369. CrossRef
- Armitage CJ: Evidence that implementation intentions reduce dietary fat intake: A randomized trial.Health Psychology. 2004,23:319–323. CrossRef
- Verplanken B, Faes S: Good intentions, bad habits, and effects of forming implementation intentions on healthy eating.European Journal of Social Psychology. 1999,29:591–604. CrossRef
- Orbell S, Sheeran P: Motivational and volitional processes in action initiation: A field study of the role of implementation intentions.Journal of Applied Social Psychology. 2000,30:780–797. CrossRef
- Steadman L, Quine L: Encouraging young males to perform testicular self-examination: A simple, but effective, implementation intentions intervention.British Journal of Health Psychology. 2004,9:479–487. CrossRef
- Milne S, Orbell S, Sheeran P: Combining motivational and volitional interventions to promote exercise participation: Protection motivation theory and implementation intentions.British Journal of Health Psychology. 2002,7:163–184. CrossRef
- Sheeran P: Intention-behaviour relations: Aconceptual and empirical review. In Ströbe W, Hewstone M (eds),European Review of Social Psychology (Vol. 11). Chichester, UK: Psychology Press, 2001, 1–36. CrossRef
- Cohen J: A power primer.Psychological Bulletin. 1992,112:155–159. CrossRef
- Sheeran P, Orbell S: Using implementation intentions to increase attendance for cervical cancer screening.Health Psychology. 2000,19:283–289. CrossRef
- Vaile MSB, Calnan M, Rutter DR, Wall B: Breast cancer screening services in three areas: Uptake and satisfaction.Journal of Public Health Medicine. 1993,15:37–45.
- Steadman L, Rutter DR, Field S: Individually elicited versus modal normative beliefs in predicting attendance at breast screening: Examining the role of belief salience in the theory of planned behaviour.British Journal of Health Psychology. 2002,7:317–330. CrossRef
- Ajzen I: The theory of planned behavior.Organizational Behavior and Human Decision Processes. 1991,50:179–211. CrossRef
- Rutter DR, Quine L (eds):Changing Health Behaviour: Intervention and Research with Social Cognition Models. Buckingham, UK: Open University Press, 2002.
- Conner M, Sparks P: The theory of planned behaviour and health behaviours. In Conner M, Norman P (eds),Predicting Health Behaviour: Research and Practice with Social Cognition Models. Buckingham, UK: Open University Press, 1996, 121–162.
- Evans MG: The problem of analyzing multiplicative composites: Interactions revisited.American Psychologist. 1991,46:6–15. CrossRef
- French DP, Hawkins M: The expectancy-value muddle in the theory of planned behaviour-and some proposed solutions.British Journal of Health Psychology. 2003,8:37–55. CrossRef
- Orbell S, Sheeran P: Changing health behaviours: The role of implementation intentions. In Rutter DR, Quine L (eds),Changing Health Behaviour. Intervention and Research with Social Cognition Models. Buckingham, UK: Open University Press, 2002, 123–137.
- Hollis S, Campbell F: What is meant by intention to treat analysis? Survey of published randomised controlled trials.British Medical Journal. 1999,319:670–674.
- Cohen J, Cohen P, West SG, Aiken LS:Applied Multiple Regression/ Correlation Analysis for the Behavioral Sciences (3rd Ed.). Mahwah, NJ: Lawrence Erlbaum Associates, Inc., 2003.
- An implementation intentions intervention to increase uptake of mammography
Annals of Behavioral Medicine
Volume 32, Issue 2 , pp 127-134
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