O'Neill Suzanne C, Bowling J Michael, Brewer Noel T, Lipkus Isaac M, Skinner Celette Sugg, Strigo Tara S, Rimer Barbara K
UNC Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA.
J Womens Health (Larchmt). 2008 Sep;17(7):1133-41. doi: 10.1089/jwh.2007.0600.
Recent attention has focused on moving women from having initial mammograms to maintaining adherence to regular mammography schedules. We examined behavioral intentions to maintain mammography adherence, which include the likelihood of performing a behavior, and implementation intentions, specific action plans to obtain mammograms. Potential predictors were Theory of Planned Behavior constructs, previous barriers, previous mammography maintenance, and age.
Respondents were 2062 currently adherent women due for their next mammograms in 3-4 months according to American Cancer Society recommendations for annual screening. Statistical models were used to examine predictors of behavioral and two implementation intentions, including having thought about where women would get their next mammograms and having thought about making appointments.
With the exception of pros, cons, and subjective norms, all variables predicted behavioral intentions (p <or= 0.05). Stronger perceived control, previous mammography maintenance, and one barrier (vs. none) predicted being more likely to have thought about where to get their next mammograms. Previous maintenance and no barriers (vs. two) predicted being more likely to have thought about making appointments.
Our findings suggest that among women currently adherent to mammography, volitional factors, such as barriers, may be better predictors of implementation intentions than motivational factors, such as attitudes. Implementation variables may be useful in understanding how women move from intentions to action. Future research should examine how such factors relate to mammography maintenance behaviors and can be integrated into behavior change interventions.
近期的关注焦点已从让女性进行初次乳房X光检查转向促使她们坚持定期的乳房X光检查计划。我们研究了维持乳房X光检查依从性的行为意图，包括执行某种行为的可能性以及实施意图，即获取乳房X光检查的具体行动计划。潜在预测因素包括计划行为理论结构、既往障碍、既往乳房X光检查维持情况以及年龄。
根据美国癌症协会的年度筛查建议，2062名目前依从的女性受访者将在3至4个月后进行下一次乳房X光检查。使用统计模型来研究行为意图以及两种实施意图的预测因素，这两种实施意图包括是否考虑过女性将在哪里进行下一次乳房X光检查以及是否考虑过预约检查。
除了益处、弊端和主观规范外，所有变量均能预测行为意图（p≤0.05）。更强的感知控制、既往乳房X光检查维持情况以及一个障碍（与无障碍相比）预示着更有可能考虑过在哪里进行下一次乳房X光检查。既往维持情况以及无障碍（与有两个障碍相比）预示着更有可能考虑过预约检查。
我们的研究结果表明，在目前坚持进行乳房X光检查的女性中，诸如障碍等意志因素可能比态度等动机因素更能预测实施意图。实施变量可能有助于理解女性如何从意图转变为行动。未来的研究应探讨这些因素与乳房X光检查维持行为之间的关系，以及如何将其纳入行为改变干预措施中。
