WHY DO WOMENS ATTITUDES TOWARD MAMMOGRAPHY CHANGE OVER TIME - IMPLICATIONS FOR PHYSICIAN-PATIENT COMMUNICATION

The present study examines women's decision making about mammography o ver a 1-year period, using ''decisional balance,'' a summary of women' s positive and negative perceptions about mammography derived from the Transtheoretical Model (TTM). Data were from a survey of women ages 5 0-74 years who completed both the baseline and 1-year follow-up teleph one surveys (n = 1144) for an intervention study to increase the use o f mammography screening, A shift toward less favorable perceptions abo ut mammography was related to being a smoker and not having a recent c linical breast examination and Pap test, Change in women's attitudes t oward mammography was also related to four dimensions of a woman's inf ormation environment, Women who rated the opinions of a physician as s omewhat or not important, those who reported that at least one family member or friend discouraged them from having a mammogram, and women w ho felt they lacked enough people in their social network with whom th ey could discuss health concerns were less likely to express favorable attitudes about mammography over 1 year, In contrast, women who consi stently communicated the value of mammography to others expressed more favorable views of screening over the study period, Interventions des igned to promote breast cancer screening must recognize that a woman n ot only reacts to mammography information provided by significant othe rs in her social network but may preactively reach out to others as an advocate of breast cancer screening, thus reinforcing or changing oth ers' opinions or behavior as well as her own.