Predicting stages of adoption of mammography screening in a general population

This study assessed predictions of the Transtheoretical Model (TTM) of beha viour change applied to mammography screening in a random sample of 909 Swi ss women aged 40-80 years. We examined stages of mammography adoption, posi tive and negative attitudes toward screening (pros, cons and decisional bal ance), and additional predisposing, enabling and reinforcing characteristic s. The stage of mammography adoption was defined for 827 women, of whom 46. 9% reported on-schedule screening (action 10.2%, maintenance 29.7%, relapse risk 7.0%) and 53% did not (precontemplation 23.1%, contemplation 13.5%, r elapse 16.4%). Independent factors associated with more advanced stages (fr om precontemplation to maintenance) were high pros, low cons, belief that m ammography screening is recommended every 2 years, high objective risk of b reast cancer, being married and higher income. Independent correlates of st age regression (from action/maintenance to relapse) were high cons, belief that mammography screening is recommended every 4 years or not at all and n ot being married. Perceived utility of an organised screening programme and reluctance to pay for a mammogram were independently associated with only certain transitions between stages of adoption. Our results confirm the app licability of the TTM to mammography screening in a European context. They also suggest that constructs other than pros and cons may be useful in pred icting mammography use. (C) 2001 Elsevier Science Ltd. All rights reserved.